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Neural embedding of frailty in cognitively unimpaired aging and dementia across Latin America
(Wiley, 2026-04)
Joaquin Migeot
;
Olivia Wen
;
Raul Gonzalez‐Gomez
;
Hernan Hernandez
;
David Aguillon
<jats:title>Abstract</jats:title> <jats:sec> <jats:title>INTRODUCTION</jats:title> <jats:p>Frailty influences dementia risk and severity. However, its role in differentiating dementia subtypes and associations with brain structural and functional alterations remain understudied, especially in Latin America.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>Multi‐Partner Consortium to Expand Dementia Research in Latin America data included 3461 participants (cognitively unimpaired [CU], Alzheimer's disease [AD], and frontotemporal lobar degeneration [FTLD]) from Latin America using a frailty index constructed from 32 health‐related variables. XGBoost‐logistic regression models tested group discrimination, and voxel‐based morphometry plus functional connectivity analyses explored neural correlates.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Frailty distinguished CU from AD (area under the curve [AUC] = 0.85) and CU from FTLD (AUC = 0.88) but not AD from FTLD (AUC = 0.59). Higher frailty was linked to widespread gray matter loss, with temporal involvement in CU and stronger frontotemporal effects in dementia, particularly FTLD. Connectivity analyses showed fronto‐temporo‐posterior reductions and increased connectivity across the frailty network.</jats:p> </jats:sec> <jats:sec> <jats:title>DISCUSSION</jats:title> <jats:p>Findings position frailty as a promising marker for identifying AD and FTLD relative to CU individuals, linked with brain health alterations in Latin American populations.</jats:p> </jats:sec>
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Diagnostic utility and psychometric properties of the Technology Activities of Daily Living Questionnaire (T-ADLQ) in people with non-formally educated with Alzheimer’s disease in Lima, Peru
(Frontiers Media SA, 2025-11-12)
Rosa Montesinos
;
Loreto Olavarria
;
Fernando Henriquez
;
Diego Chambergo-Michilot
;
Belén Custodio
<jats:sec> <jats:title>Objective</jats:title> <jats:p>To evaluate the discriminative capacity and psychometric properties of the Technology–Activities of Daily Living Questionnaire (T-ADLQ) in distinguishing cognitively unimpaired individuals from those with amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease dementia (ADD) in a population with no formal education.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p> This cross-sectional study included individuals with no formal education over 50 years of age residing in Callao, Peru. Participants were classified into three cognitive groups: cognitively unimpaired (CU; <jats:italic>n</jats:italic> = 64), aMCI ( <jats:italic>n</jats:italic> = 60), and early ADD ( <jats:italic>n</jats:italic> = 63). Functional decline was assessed with the T-ADLQ. Group comparisons were conducted using the chi-square or ANOVA tests, as appropriate. Pearson correlations were used to assess concurrent validity. The reliability of the T-ADLQ was assessed using Cronbach’s alpha. Receiver operating characteristic (ROC) curve analyses and area under the curve (AUC) metrics were used to assess the discriminative validity of the measures across the three cognitive groups. </jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>In a sample of 187 illiterate older adults, the T-ADLQ demonstrated excellent internal consistency (Cronbach’s α = 0.966) and strong inverse correlations with global and executive cognitive measures (MMSE, RUDAS, IFS). It also showed a moderate positive correlation with PFAQ. ROC analyses revealed excellent discriminative performance of the T-ADLQ. The total score and the instrumental (IADL) and advanced (AADL) domains achieved perfect accuracy in differentiating cognitively unimpaired individuals from those with aMCI or ADD. The basic activities of daily living (BADL) domain also showed high accuracy, particularly in distinguishing aMCI from ADD.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>The T-ADLQ and its subdomains exhibit strong psychometric properties and high discriminative capacity in detecting functional decline in individuals with aMCI and ADD. These findings support the T-ADLQ as a valid and reliable tool for assessing functional impairment in populations with no formal education.</jats:p> </jats:sec>
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Dementia prevention requires moving beyond individual choice: the costs of effort and time intersect with social determinants of health
(Elsevier BV, 2025-11)
Joaquín Migeot
;
Daniel Araya-Ríos
;
Matias Montecinos
;
Sandra Baez
;
BEHRENS PELLEGRINO, MARIA ISABEL
Scopus© Citations 5 2
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Can Frontal Assessment Battery Discriminate between Patients with Alzheimer’s and Frontotemporal Dementia?
(Oxford University Press (OUP), 2025-08-29)
Fabrissio Grandi
;
Loreto Olavarría
;
Mario A Parra
;
David Martínez-Pernía
;
Cesar Serey
Objectives: The Frontal Assessment Battery (FAB) is a widely used tool for assessing executive function. However, its ability to distinguish between Alzheimer's disease dementia (ADD) and behavioural variant frontotemporal dementia (bvFTD) remains under debate. This study assessed the diagnostic utility of the Chilean version of the FAB (FAB-Ch) in differentiating ADD from bvFTD and used data-driven cluster analysis to explore dysexecutive profiles. Method: A total of 288 participants were recruited: 45 with ADD, 33 with bvFTD, and 208 cognitively unimpaired controls (CU). Mean FAB-Ch total scores were compared across groups. Receiver operating characteristic (ROC) curves evaluated the instrument's ability to distinguish (i) dementia from no dementia, (ii) ADD from bvFTD, and (iii) executive dysfunction. Hierarchical cluster analysis was conducted to identify executive profiles among dementia patients. Results: FAB-Ch scores were significantly lower in individuals with dementia compared to controls (p < .001). However, there were no significant differences between ADD and bvFTD groups (p = .59). The FAB-Ch showed strong discriminatory power between dementia and controls (AUC = 0.882; sensitivity = 0.731; specificity = 0.885), but poor discrimination between ADD and bvFTD (AUC = 0.465; p = .59). Cluster analysis among patients with dementia revealed three distinct executive profiles corresponding to different levels of cognitive impairment (p < .001). Conclusion: The FAB-Ch effectively differentiates individuals with dementia from cognitively unimpaired controls but does not distinguish between ADD and bvFTD. Nevertheless, it is sensitive to executive dysfunction and can aid in the clinical characterization of dementia severity and heterogeneity.
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Frequency and Determinants of Poststroke Cognitive Impairment at Three and Twelve Months in Chile
(2010)
Carolina Delgado
;
Archibaldo Donoso
;
Patricia Orellana
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Carolina Vásquez
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DIAZ TAPIA, VIOLETA DEL CARMEN
A higher risk of poststroke cognitive impairment (CI) has been reported in Hispanics in a US cohort but has not been systematically studied in Latin America. Objectives: Our purpose was to investigate the frequencies and determinants of poststroke CI in the hispano-mestizo population of Santiago, Chile. Methods: A prospective study of hospitalized patients aged >60 years admitted with an ischemic or hemorrhagic stroke was conducted. The cognitive status was determined at 3 and 12 months after the stroke by informant questionnaires, neuropsychological testing and clinical diagnosis. Cardiovascular risk factors, brain imaging and stroke features were analyzed using regression models to establish determinants for poststroke CI. Results: A total of 164 patients (mean age = 72 ± 7.5 years) were recruited. Out of 122 patients (74%) evaluated at 3 months, 81 (66%) had CI. Out of 101 patients (62%) evaluated at 12 months, 39 (39%) had CI no dementia, and 22 (22%) were demented. The new-onset dementia frequency at 1 year was 16%. Independent determinants for dementia were higher functional impairment at hospital egress (OR = 4.0), left-hemisphere large-vessel infarction (OR = 6.9) and a larger amount of white matter changes (OR = 1.3). Conclusions: In this first study on poststroke CI in Latin America, the frequencies and determinants of poststroke CI were similar to those in other cohorts of different ethnic origin.
3Scopus© Citations 26
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Association of Vitamin D Receptor Polymorphisms with Amyloid-β Transporters Expression and Risk of Mild Cognitive Impairment in a Chilean Cohort
(2021)
Nohela B. Arévalo
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Daniela P. Castillo-Godoy
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Italo Espinoza-Fuenzalida
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Nicole K. Rogers
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Gonzalo Farias
<jats:p>Background: Amyloid-β peptide (Aβ) deposition in Alzheimer’s disease (AD) is due to an imbalance in its production/clearance rate. Aβ is transported across the blood-brain barrier by LRP1 and P-gp as efflux transporters and RAGE as influx transporter. Vitamin D deficit and polymorphisms of the vitamin D receptor (VDR) gene are associated with high prevalence of mild cognitive impairment (MCI) and AD. Further, vitamin D promotes the expression of LRP1 and P-gp in AD-animal model brains. Objective: To associate VDR polymorphisms Apa I (rs7975232), Taq I (rs731236), and Fok I (rs2228570) with the risk of developing MCI in a Chilean population, and to evaluate the relationship of these polymorphisms to the expression of VDR and Aβ-transporters in peripheral blood mononuclear cells (PBMCs). Methods: VDR polymorphisms Apa I, Taq I, and Fok I were determined in 128 healthy controls (HC) and 66 MCI patients. mRNA levels of VDR and Aβ-transporters were evaluated in subgroups by qPCR. Results: Alleles A of Apa I and C of Taq I were associated with a lower risk of MCI. HC with the Apa I AA genotype had higher mRNA levels of P-gp and LRP1, while the expression of VDR and RAGE were higher in MCI patients and HC. For Fok I, the TC genotype was associated with lower expression levels of Aβ-transporters in both groups. Conclusion: We propose that the response to vitamin D treatment will depend on VDR polymorphisms, being more efficient in carriers of protective alleles of Apa I polymorphism.</jats:p>
1Scopus© Citations 7 20
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Standardization and diagnostic utility of the Frontal Assessment Battery for healthy people and patients with dementia in the Chilean population
(2022)
Fabrissio Grandi
;
David Martínez-Pernía
;
Mario Parra
;
Loreto Olavarria
;
David Huepe
<jats:p>ABSTRACT. The Frontal Assessment Battery (FAB) is a screening test that measures executive functions. Although this instrument has been validated in several countries, its diagnostic utility in a Chilean population has not been studied yet. Objectives: This study aimed to (1) adapt FAB in a Chilean population; (2) study the psychometric properties of the FAB in a Chilean population; (3) assess the sociodemographic influence in the performance of the FAB in a sample of healthy controls (HC); and (4) develop normative data for this healthy group. Methods: A HC (n=344) and a group of patients with dementia (n=156) were assessed with the Chilean version of FAB. Results: FAB showed good internal consistency (Cronbach's alpha=0.79) and acceptable validity based on the relationship with other variables. Factor analysis showed the unidimensionality of the instrument. Significant differences were found in the total FAB value between the HC and dementia groups. With the matched sample, the established cutoff point was 13.5, showing a sensitivity of 80.8% and a specificity of 90.4%. Regression analysis showed that education and age significantly predicted FAB performance in the healthy group. Finally, normative data are provided. Conclusions: This study shows that FAB is a useful tool to discriminate between healthy people and people with dementia. However, further studies are needed to explore the capacity of the instrument to characterize the dysexecutive syndrome in people with dementia in the Chilean population.</jats:p>
Scopus© Citations 2 11
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Population attributable fraction of modifiable risk factors for dementia in Chile
(2022)
Rodrigo C. Vergara
;
Pedro Zitko
;
Andrea Slachevsky
;
Consuelo San Martin
;
Carolina Delgado
20Scopus© Citations 25
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Validation of Picture Free and Cued Selective Reminding Test for Illiteracy in Lima, Peru
(2022)
Rosa Montesinos
;
Jose F. Parodi
;
Monica M. Diaz
;
Eder Herrera-Perez
;
Elizabeth Valeriano-Lorenzo
<jats:p> Dementia in Latin America is a crucial public health problem. Identifying brief cognitive screening (BCS) tools for the primary care setting is crucial, particularly for illiterate individuals. We evaluated tool performance characteristics and validated the free and total recall sections of the Free and Cued Selective Reminding Test-Picture version (FCSRT-Picture) to discriminate between 63 patients with early Alzheimer’s disease dementia (ADD), 60 amnestic mild cognitive impairment (aMCI) and 64 cognitively healthy Peruvian individuals with illiteracy from an urban area. Clinical, functional, and cognitive assessments were performed. FCSRT-Picture performance was assessed using receiver operating characteristic curve analyses. The mean ± standard deviation scores were 7.7 ± 1.0 in ADD, 11.8 ± 1.6 in aMCI, and 29.5 ± 1.8 in controls. The FCSRT-Picture had better performance characteristics for distinguishing controls from aMCI compared with several other BCS tools, but similar characteristics between controls and early ADD. The FCSRT-Picture is a reliable BCS tool for illiteracy in Peru. </jats:p>
Scopus© Citations 4 1
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Percepción de conocimiento sobre las demencias en profesionales de la salud de Chile
(2016)
Loreto Olavarría
;
Cristóbal Mardones
;
Carolina Delgado
;
Andrea Slachevsky Ch
4Scopus© Citations 13

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