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A Health Communication Strategy to Promote Dementia Risk Reduction: The
<scp>CULTIVAMENTE</scp>
Pragmatic Cluster‐Randomized Trial
(Wiley, 2025-12-23)
Jose M. Aravena
;
Hugo Castro
;
Ronald Poblete
;
Maria Ines Aravena
;
Waldo Torres
<jats:title>ABSTRACT</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Although dementia prevention is a global priority, few interventions have been successfully translated into public health and community settings. This study evaluated the effectiveness of a nudge‐based communication strategy to promote Alzheimer's disease (AD) prevention on behavioral, cognitive, and provider‐level outcomes in a real‐world setting.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p> We conducted a pragmatic cluster‐randomized trial across seven senior centers. Eligible participants were adults aged ≥ 60 with cognitive impairment but no dementia. Centers were randomized to intervention ( <jats:italic>n</jats:italic> = 3) or control ( <jats:italic>n</jats:italic> = 4) arms. All centers offered standard activities and provider training in dementia management. The intervention arm additionally received CULTIVAMENTE, a low‐intensity, nudge‐based communication strategy involving posters, brochures, and web‐based content promoting AD prevention. Main outcomes included changes in a composite cognitive healthy behavior score, cognitive performance (memory and executive function), prevalence of mild‐to‐moderate cognitive impairment, and provider practices (AD prevention discussions and referrals). Analyses used intention‐to‐treat linear mixed models. </jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p> Among 211 participants (mean age 74.8 ± 7.0 years; 80.5% women), after 6 months, those in the intervention group ( <jats:italic>n</jats:italic> = 101) demonstrated greater improvement in cognitive healthy behaviors compared to control (SD difference = 0.15; 95% CI = 0.02–0.28; <jats:italic>p</jats:italic> = 0.021; 95.4% greater increase than control). Cognitive scores improved significantly in the intervention group (memory = 0.24; 95% CI = 0.07–0.41; memory–executive functioning = 0.21; 95% CI = 0.08–0.33), and mild‐to‐moderate cognitive impairment cases declined in the intervention group (from 70 to 67) compared to the control group (from 71 to 75; <jats:italic>p</jats:italic> < 0.001). Additionally, intervention participants were more likely to report increases in knowing how to prevent AD, having discussions about ways to prevent AD with providers, and receiving referrals to manage risk factors. </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Embedding nudge‐based messaging into senior centers improved dementia prevention behaviors, cognitive outcomes, and provider practices. These results support testing low‐cost, scalable strategies in real‐world settings to reduce dementia risk.</jats:p> </jats:sec>
Scopus© Citations 2 1
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Neck Circumference Cut-Off Points for Identifying Adiposity: Association with Chronic Metabolic Diseases in Older People
(2024)
Dominique A. Díaz
;
Lydia Lera
;
Carlos Márquez
;
Andrea Valenzuela
;
Rodrigo Saguez
<jats:p>Background: The leading cause of death in older people is cardiovascular diseases. Several studies have found that neck circumference (NC) is a simple anthropometric marker associated with adiposity. The aim of this study is to estimate and validate NC cut-off points as adiposity markers and analyze their association with cardiovascular and chronic metabolic diseases in older people. Methods: A cross-sectional study in 358 non-disabled, community-dwelling older people (71.7 ± 3.9 years) living in Santiago de Chile and participating in the HTSMayor study was conducted. Measurements of body composition and cardiovascular risks were evaluated. Receiver operating characteristic (ROC) curves and multiple logistic regression models were used to evaluate the association of NC with cardiovascular and chronic metabolic diseases. NC cut-off points were obtained to predict obesity, abdominal obesity, and adiposity. Results: The best performance values of neck circumference relative to obesity and adiposity were obtained with respect to abdominal obesity (40.6 cm in men and 34.2 cm in women). Higher NC values were associated with a higher area under the curve (AUC) for men and women (men: AUC = 0.84; women: AUC = 0.86). NC was significantly associated with a higher risk for diabetes mellitus (OR = 1.95), hypertension (OR = 2.42), acute myocardial infarction (OR = 4.36), and comorbidities (OR = 2.01), and a lower risk for sarcopenia (OR = 0.35). Conclusions: This study shows that NC is a useful tool for detecting abdominal obesity, obesity, and adiposity in older people and that a higher NC increases the risk of chronic diseases.</jats:p>
1Scopus© Citations 5
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The first genome‐wide association study in the Argentinian and Chilean populations identifies shared genetics with Europeans in Alzheimer's disease
(2023)
Maria Carolina Dalmasso
;
Itziar de Rojas
;
Natividad Olivar
;
Carolina Muchnik
;
Bárbara Angel
<jats:title>Abstract</jats:title><jats:sec><jats:title>INTRODUCTION</jats:title><jats:p>Genome‐wide association studies (GWAS) are fundamental for identifying loci associated with diseases. However, they require replication in other ethnicities.</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>We performed GWAS on sporadic Alzheimer's disease (AD) including 539 patients and 854 controls from Argentina and Chile. We combined our results with those from the European Alzheimer and Dementia Biobank (EADB) in a meta‐analysis and tested their genetic risk score (GRS) performance in this admixed population.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>We detected apolipoprotein E ε4 as the single genome‐wide significant signal (odds ratio = 2.93 [2.37–3.63], <jats:italic>P</jats:italic> = 2.6 × 10<jats:sup>−23</jats:sup>). The meta‐analysis with EADB summary statistics revealed four new loci reaching GWAS significance. Functional annotations of these loci implicated endosome/lysosomal function. Finally, the AD‐GRS presented a similar performance in these populations, despite the score diminished when the Native American ancestry rose.</jats:p></jats:sec><jats:sec><jats:title>DISCUSSION</jats:title><jats:p>We report the first GWAS on AD in a population from South America. It shows shared genetics modulating AD risk between the European and these admixed populations.</jats:p></jats:sec><jats:sec><jats:title>Highlights</jats:title><jats:p><jats:list list-type="bullet"> <jats:list-item><jats:p>This is the first genome‐wide association study on Alzheimer's disease (AD) in a population sample from Argentina and Chile.</jats:p></jats:list-item> <jats:list-item><jats:p>Trans‐ethnic meta‐analysis reveals four new loci involving lysosomal function in AD.</jats:p></jats:list-item> <jats:list-item><jats:p>This is the first independent replication for <jats:italic>TREM2L</jats:italic>, <jats:italic>IGH‐gene‐cluster</jats:italic>, and <jats:italic>ADAM17</jats:italic> loci.</jats:p></jats:list-item> <jats:list-item><jats:p>A genetic risk score (GRS) developed in Europeans performed well in this population.</jats:p></jats:list-item> <jats:list-item><jats:p>The higher the Native American ancestry the lower the GRS values.</jats:p></jats:list-item> </jats:list></jats:p></jats:sec>
Scopus© Citations 3 1
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The impacts of social determinants of health and cardiometabolic factors on cognitive and functional aging in Colombian underserved populations
(2023)
Hernando Santamaria-Garcia
;
Sebastian Moguilner
;
Odir Antonio Rodriguez-Villagra
;
Felipe Botero-Rodriguez
;
Stefanie Danielle Pina-Escudero
<jats:title>Abstract</jats:title><jats:p>Global initiatives call for further understanding of the impact of inequity on aging across underserved populations. Previous research in low- and middle-income countries (LMICs) presents limitations in assessing combined sources of inequity and outcomes (i.e., cognition and functionality). In this study, we assessed how social determinants of health (SDH), cardiometabolic factors (CMFs), and other medical/social factors predict cognition and functionality in an aging Colombian population. We ran a cross-sectional study that combined theory- (structural equation models) and data-driven (machine learning) approaches in a population-based study (<jats:italic>N</jats:italic> = 23,694;<jats:italic>M</jats:italic> = 69.8 years) to assess the best predictors of cognition and functionality. We found that a combination of SDH and CMF accurately predicted cognition and functionality, although SDH was the stronger predictor. Cognition was predicted with the highest accuracy by SDH, followed by demographics, CMF, and other factors. A combination of SDH, age, CMF, and additional physical/psychological factors were the best predictors of functional status. Results highlight the role of inequity in predicting brain health and advancing solutions to reduce the cognitive and functional decline in LMICs.</jats:p>
Scopus© Citations 10 1

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