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Dementia screening protocol for primary care in South America: a Delphi consensus study
(Frontiers Media SA, 2026-04-08)
Belen Custodio
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Rosa Montesinos
;
Paulo Caramelli
;
Ismael Calandri
;
Sonia Maria Dozzi Brucki
<jats:sec> <jats:title>Introduction</jats:title> <jats:p>Rapid population aging in South America (SA) highlights the need for effective dementia detection strategies. Primary care is essential for early identification, yet no shared, regionally contextualized approach exists. This study aimed to develop expert-based recommendations for dementia screening in SA primary care.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>A two-round modified Delphi process involved 20 SA experts from different specialties. Round 1 explored open-ended and ranking questions on cognitive and functional screening tools, cut-offs, referral criteria, administration time, and professional roles. Round 2 sought consensus (≥75%) on items informed by Round 1.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Consensus was reached on using an initial screening question to identify potential cognitive decline, the duration of a brief screening battery, and the primary care team’s roles. Experts emphasized the need for educational, cultural, and sensory adaptations and proposed strategies for patients without reliable informants. An agreement on functional assessment tools and some cut-off points was not achieved.</jats:p> </jats:sec> <jats:sec> <jats:title>Discussion</jats:title> <jats:p>These recommendations provide a structured, flexible, and culturally sensitive framework for primary care dementia screening, supporting timely detection, timely referral and integration into person-centered approaches to healthy aging, while highlighting areas requiring further research and standardization.</jats:p> </jats:sec>
Scopus© Citations 1 2
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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
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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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The landscape of dementia research, diagnosis, treatment, and care in Latin America
(Wiley, 2026-03)
Claudia K. Suemoto
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Nilton Custodio
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Diego Aguilar
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José A. Avila‐Funes
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Sandra Baez
<jats:title>Abstract</jats:title> <jats:sec> <jats:label/> <jats:p>Latin America is undergoing rapid population aging alongside a rising burden of dementia. While the region holds substantial potential for dementia risk reduction, challenges remain, such as delayed diagnoses, limited access to specialized care and biomarker testing, persistent stigma, and deep‐rooted structural inequities. To address these gaps and foster regionally informed solutions, the Alzheimer's Association convened the 2025 Alzheimer's Association International Conference (AAIC) Satellite Symposium in Lima, Peru, on May 14–15, in collaboration with the Global Brain Health Institute (GBHI) and the Atlantic Fellows for Equity in Brain Health. The meeting aimed to bring core elements of the global AAIC meeting to regional Latin American settings, recognizing that national and cultural contexts demand tailored approaches to dementia prevention, risk reduction, treatment and care all aimed at promoting brain health in the region. This manuscript synthesizes the symposium's key discussions, scientific advances, and opportunities for collaboration across the region.</jats:p> </jats:sec>
1Scopus© Citations 1
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The exposome of brain aging across 34 countries
(Springer Science and Business Media LLC, 2026-04-03)
Agustina Legaz
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Sebastian Moguilner
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Pablo Barttfeld
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Jhosmary Cuadros Castro
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Dante Sebastián Galván Rial
Scopus© Citations 7 1
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Blood-based AT(N) biomarkers for Alzheimer’s disease and frontotemporal lobar degeneration in Latin America
(Springer Science and Business Media LLC, 2026-02-13)
Ariel Caviedes
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Felipe Cabral-Miranda
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Paulina Orellana
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Hernán Hernández
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Raul Gonzalez-Gomez
2
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Brief Cognitive Screening Tools for Dementia in Low-Educated Population from South America: A Systematic Review
(S. Karger AG, 2025-09-29)
Diego Chambergo-Michilot
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Nilton Custodio
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Rosa Montesinos
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Belen Custodio
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Nelson Luis Cahuapaza-Gutierrez
<jats:p>Introduction: Despite less education being common in Latin America, there is no systematic review on the use of brief cognitive screening (BCS) tools in illiterate and low-educated adults in the region. We systematically reviewed brief cognitive tests used to identify dementia in illiterate or low-educated adults from South America (SA). Methods: A systematic review was conducted according to the PRISMA and Cochrane guidelines. We searched four major databases: PubMed, Scopus, Web of Science, and Embase, for studies up to September 2023, and included observational studies that reported at least sensitivity, specificity, area under the receiver operating characteristic (ROC) curve, positive predictive value, or negative predictive value of dementia screening tools in illiterate or low-educated (less than 6 years of education) adults from SA. Results: Most studies in samples with illiteracy or low education across SA used BCS tools adapted to the local population’s language. Seventeen tests were identified; among them, the Mini-Mental State Examination (MMSE) and Rowland Universal Dementia Assessment Scale (RUDAS) were the more common tools with good diagnostic accuracy in people with dementia. The sensitivity and specificity of reported BCS tools were at least 90%, and the area under the ROC curve was higher than 0.95. Conclusions: The cutoff points for detecting dementia in illiterates and the low-educated adult population of SA should be adjusted for most brief cognitive tests. Developing specific and sensitive cognitive batteries for our region for cognitive evaluation in low-educated/illiterate participants is mandatory, including specific functionality evaluation.</jats:p>
Scopus© Citations 3 1
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Cardiovascular risk factors and the allostatic interoceptive network in dementia
(Oxford University Press (OUP), 2025-10)
Jessica L Hazelton
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Joaquín Migeot
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Raul Gonzalez-Gomez
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Florencia Altschuler
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Claudia Duran-Aniotz
2
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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
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Loreto Olavarria
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Fernando Henriquez
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Diego Chambergo-Michilot
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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>
1
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Social exposome and brain health outcomes of dementia across Latin America
(Springer Science and Business Media LLC, 2025-09-11)
Joaquin Migeot
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Stefanie D. Pina-Escudero
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Hernan Hernandez
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Raul Gonzalez-Gomez
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Agustina Legaz
A multidimensional social exposome (MSE)—the combined lifespan measures of education, food insecurity, financial status, access to healthcare, childhood experiences, and more—may shape dementia risk and brain health over the lifespan, particularly in underserved regions like Latin America. However, the MSE effects on brain health and dementia are unknown. We evaluated 2211 individuals (controls, Alzheimer’s disease, and frontotemporal lobar degeneration) from a non-representative sample across six Latin American countries. Adverse exposomes associate with poorer cognition in healthy aging. In dementia, more complex exposomes correlate with lower cognitive and functional performance, higher neuropsychiatric symptoms, and brain structural and connectivity alterations in frontal-temporal-limbic and cerebellar regions. Food insecurity, financial resources, subjective socioeconomic status, and access to healthcare emerge as critical predictors. Cumulative exposome measures surpass isolated factors in predicting clinical-cognitive profiles. Multiple sensitivity analyses confirm our results. Findings highlight the need for personalized approaches integrating MSE across the lifespan, emphasizing prevention and interventions targeting social disparities.
1
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Peruvian validation and standardization of the TabCAT-brain health assessment
(Frontiers Media SA, 2025-08-29)
Andrés Muñoz-Najar
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Manuel Montemurro
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María del Carmen Tejada
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Claudia Rivera-Fernández
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Miguel Sánchez-Fernández
Introduction. Detecting cognitive impairment in low-educated and marginalized populations may result in under- or over-estimation of diagnoses due to reliance on non-validated approaches and normative data. This study validates and standardizes TabCAT-BHA for older adults living in the Andean region of Peru using regression-based normalization.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Two hundred fifty-eight participants were assessed with the MMSE, RUDAS, and TabCAT-BHA. Classified as either cognitively healthy or impaired based on Clinical Dementia Rating criteria.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>By incorporating sex, place of residence, age, and years of education as covariates, the TabCAT-BHA demonstrated greater accuracy in detecting cognitive impairment (AUC = 75.3%) compared to the MMSE (AUC = 66.4%) and RUDAS (AUC = 71.4%). After incorporating only significant sociodemographic predictors, TabCAT-BHA obtained better AUC (77.4%) compared to MMSE (66.6%) and RUDAS (71.9%).</jats:p></jats:sec><jats:sec><jats:title>Discussion</jats:title><jats:p>The TabCAT-BHA proves to be a valid tool for detecting cognitive impairment, and incorporating sociodemographic factors improves its accuracy in marginalized settings of Peru.
Scopus© Citations 1 1

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