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Functional Capacity in Activities of Daily Living in the Alzheimer’s Disease Continuum
(Wiley, 2024-12)
Fernando Henriquez
;
Carmen Dominguez
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Fabrissio Grandi
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Cecilia Gonzalez Campo
;
Patricio Riquelme Contreras
The most common and prevalent dementia worldwide is Alzheimer’s disease (AD). AD is a continuum composed of Subjective Cognitive Impairment (SCD), Mild Cognitive Impairment (MCI), and Alzheimer’s Disease dementia (ADD) stage. One of the main clinical variables in patients with dementia is performance in functional capacity since its alterations are associated with poor prognosis and disease progression. Functional capacity is measured through activities of daily living (ADL), which are divided into three domains: i) Basic (BADL), ii) Instrumental (IADL), and iii) Advanced (AADL). The study aimed to characterize the performance of the different stages of the AD continuum in the ADL domains and their association with cognitive abilities.</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>A cross‐sectional study of subjects at different stages of the AD continuum was conducted: Healthy Controls (CTR) (n = 17), SCD (n = 77), MCI (n = 30), and ADD (n = 23), who were matched for age, sex, and education. ADLs were estimated using The Technology‐Activities of Daily Living Questionnaire (T‐ADLQ), which assesses the three domains and a total score. T‐ADLQ performance was compared across groups and correlated with cognitive ability instruments (ACE‐III and IFS).</jats:p></jats:sec><jats:sec><jats:title>Result</jats:title><jats:p>The results showed that patients with ADD performed worse on the BADL, IADL, and total ADLs compared to the other three groups. There were no significant differences between the CTR, SCD, and MCI on the BADL, IADL, and total ADLs. However, the AADL, in addition to differentiating the ADD patients from the other three groups, also showed differences between CTR and MCI subjects and between SCD and MCI subjects (Table 1 and Figure 1). The correlation study showed that AADL correlated significantly with global cognitive and executive function assessment (Figure 2).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>AADL shows progressive functional impairment at different stages of the AD continuum, which is further associated with global cognitive and executive function performances. As one progresses to a more advanced stage of the disease continuum, the performance of ADLs, especially AADLs, worsens, which could indicate a marker of disease progression, allowing for better patient follow‐up.
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The “when” matters: Evidence from memory markers in the clinical continuum of Alzheimer’s disease.
(2023)
Gonzalo Forno
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Mario A. Parra
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Daniela Thumala
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Roque Villagra
;
Mauricio Cerda
6Scopus© Citations 5
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Assessing subjective cognitive decline in older adults attending primary health care centers: what question should be asked?
(2023)
Matías Molina-Donoso
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Teresa Parrao
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Céline Meillon
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Daniela Thumala
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Patricia Lillo
Scopus© Citations 1 1
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Moral Emotions and Their Brain Structural Correlates Across Neurodegenerative Disorders
(2023)
Sandra Baez
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Catalina Trujillo-Llano
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Leonardo Cruz de Souza
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Patricia Lillo
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Gonzalo Forno
<jats:p>Background: Although social cognition is compromised in patients with neurodegenerative disorders such as behavioral variant frontotemporal dementia (bvFTD) and Alzheimer’s disease (AD), research on moral emotions and their neural correlates in these populations is scarce. No previous study has explored the utility of moral emotions, compared to and in combination with classical general cognitive state tools, to discriminate bvFTD from AD patients. Objective: To examine self-conscious (guilt and embarrassment) and other-oriented (pity and indignation) moral emotions, their subjective experience, and their structural brain underpinnings in bvFTD (n = 31) and AD (n = 30) patients, compared to healthy controls (n = 37). We also explored the potential utility of moral emotions measures to discriminate bvFTD from AD. Methods: We used a modified version of the Moral Sentiment Task measuring the participants’ accuracy scores and their emotional subjective experiences. Results: bvFTD patients exhibited greater impairments in self-conscious and other-oriented moral emotions as compared with AD patients and healthy controls. Moral emotions combined with general cognitive state tools emerged as useful measures to discriminate bvFTD from AD patients. In bvFTD patients, lower moral emotions scores were associated with lower gray matter volumes in caudate nucleus and inferior and middle temporal gyri. In AD, these scores were associated with lower gray matter volumes in superior and middle frontal gyri, middle temporal gyrus, inferior parietal lobule and supramarginal gyrus. Conclusion: These findings contribute to a better understanding of moral emotion deficits across neurodegenerative disorders, highlighting the potential benefits of integrating this domain into the clinical assessment.</jats:p>
24Scopus© Citations 3
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Multidimensional inhibitory signatures of sentential negation in behavioral variant frontotemporal dementia
(2022)
Mariano N Díaz-Rivera
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Agustina Birba
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Sol Fittipaldi
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Débora Mola
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Yurena Morera
<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Processing of linguistic negation has been associated to inhibitory brain mechanisms. However, no study has tapped this link via multimodal measures in patients with core inhibitory alterations, a critical approach to reveal direct neural correlates and potential disease markers.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Here we examined oscillatory, neuroanatomical, and functional connectivity signatures of a recently reported Go/No-go negation task in healthy controls and behavioral variant frontotemporal dementia (bvFTD) patients, typified by primary and generalized inhibitory disruptions. To test for specificity, we also recruited persons with Alzheimer's disease (AD), a disease involving frequent but nonprimary inhibitory deficits.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>In controls, negative sentences in the No-go condition distinctly involved frontocentral delta (2–3 Hz) suppression, a canonical inhibitory marker. In bvFTD patients, this modulation was selectively abolished and significantly correlated with the volume and functional connectivity of regions supporting inhibition (e.g. precentral gyrus, caudate nucleus, and cerebellum). Such canonical delta suppression was preserved in the AD group and associated with widespread anatomo-functional patterns across non-inhibitory regions.</jats:p> </jats:sec> <jats:sec> <jats:title>Discussion</jats:title> <jats:p>These findings suggest that negation hinges on the integrity and interaction of spatiotemporal inhibitory mechanisms. Moreover, our results reveal potential neurocognitive markers of bvFTD, opening a new agenda at the crossing of cognitive neuroscience and behavioral neurology.</jats:p> </jats:sec>
Scopus© Citations 18 4
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Dementia in Latin America: Paving the way toward a regional action plan
(2020)
Mario Alfredo Parra
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Sandra Baez
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Lucas Sedeño
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Cecilia Gonzalez Campo
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Hernando Santamaría‐García
2Scopus© Citations 115
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Cohort Profile: The Community‐based Cohort of Functional Decline in Subjective Cognitive Complaint elderly study of the Geroscience Center for Brain Health and Metabolisms (GERO)
(2022)
Andrea Slachevsky
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Anne Peters
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Pedro Zitko
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Patricia Lillo
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Daniela Thumala
4
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Does culture shape our understanding of others’ thoughts and emotions? An investigation across 12 countries.
(2022)
François Quesque
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Antoine Coutrot
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Sharon Cox
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Leonardo Cruz de Souza
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Sandra Baez
24Scopus© Citations 35
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Apathy, Executive Function, and Emotion Recognition Are the Main Drivers of Functional Impairment in Behavioral Variant of Frontotemporal Dementia
(2022)
Gada Musa Salech
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Patricia Lillo
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Karin van der Hiele
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Carolina Méndez-Orellana
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Agustín Ibáñez
<jats:p><jats:bold>Background:</jats:bold> The cognitive and neuropsychiatric deficits present in patients with behavioral variant frontotemporal dementia (bvFTD) are associated with loss of functionality in the activities of daily living (ADLs). The main purpose of this study was to examine and explore the association between the cognitive and neuropsychiatric features that might prompt functional impairment of basic, instrumental, and advanced ADL domains in patients with bvFTD.</jats:p><jats:p><jats:bold>Methods:</jats:bold> A retrospective cross-sectional study was conducted with 27 patients with bvFTD in its early stage (&lt;2 years of evolution) and 32 healthy control subjects. A neuropsychological assessment was carried out wherein measures of cognitive function and neuropsychiatric symptoms were obtained. The informant-report Technology–Activities of Daily Living Questionnaire was used to assess the percentage of functional impairment in the different ADL domains. To identify the best determinants, three separate multiple regression analyses were performed, considering each functional impairment as the dependent variable and executive function, emotion recognition, disinhibition, and apathy as independent variables.</jats:p><jats:p><jats:bold>Results:</jats:bold> For the basic ADLs, a model that explains 28.2% of the variability was found, in which the presence of apathy (β = 0.33, <jats:italic>p</jats:italic> = 0.02) and disinhibition (β = 0.29, <jats:italic>p</jats:italic> = 0.04) were significant factors. Concerning instrumental ADLs, the model produced accounted for 63.7% of the functional variability, with the presence of apathy (β = 0.71, <jats:italic>p</jats:italic> &lt; 0.001), deficits in executive function (β = −0.36, <jats:italic>p</jats:italic> = 0.002), and lack of emotion recognition (β = 0.28, <jats:italic>p</jats:italic> = 0.017) as the main contributors. Finally, in terms of advanced ADLs, the model found explained 52.6% of the variance, wherein only the presence of apathy acted as a significant factor (β = 0.59, <jats:italic>p</jats:italic> &lt; 0.001).</jats:p><jats:p><jats:bold>Conclusions:</jats:bold> The results of this study show the prominent and transverse effect of apathy in the loss of functionality throughout all the ADL domains. Apart from that, this is the first study that shows that the factors associated with loss of functionality differ according to the functional domain in patients with bvFTD in its early stage. Finally, no other study has analyzed the impact of the lack of emotion recognition in the functionality of ADLs. These results could guide the planning of tailored interventions that might enhance everyday activities and the improvement of quality of life.</jats:p>
1Scopus© Citations 28
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Multidimensional Clinical Assessment in Frontotemporal Dementia and Its Spectrum in Latin America and the Caribbean: A Narrative Review and a Glance at Future Challenges
(2022)
Fernando Henríquez
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Victoria Cabello
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Sandra Baez
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Leonardo Cruz de Souza
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Patricia Lillo
<jats:p>Frontotemporal dementia (FTD) is the third most common form of dementia across all age groups and is a leading cause of early-onset dementia. The Frontotemporal dementia (FTD) includes a spectrum of diseases that are classified according to their clinical presentation and patterns of neurodegeneration. There are two main types of FTD: behavioral FTD variant (bvFTD), characterized by a deterioration in social function, behavior, and personality; and primary progressive aphasias (PPA), characterized by a deficit in language skills. There are other types of FTD-related disorders that present motor impairment and/or parkinsonism, including FTD with motor neuron disease (FTD-MND), progressive supranuclear palsy (PSP), and corticobasal syndrome (CBS). The FTD and its associated disorders present great clinical heterogeneity. The diagnosis of FTD is based on the identification through clinical assessments of a specific clinical phenotype of impairments in different domains, complemented by an evaluation through instruments, i.e., tests and questionnaires, validated for the population under study, thus, achieving timely detection and treatment. While the prevalence of dementia in Latin America and the Caribbean (LAC) is increasing rapidly, there is still a lack of standardized instruments and consensus for FTD diagnosis. In this context, it is important to review the published tests and questionnaires adapted and/or validated in LAC for the assessment of cognition, behavior, functionality, and gait in FTD and its spectrum. Therefore, our paper has three main goals. First, to present a narrative review of the main tests and questionnaires published in LAC for the assessment of FTD and its spectrum in six dimensions: (i) Cognitive screening; (ii) Neuropsychological assessment divided by cognitive domain; (iii) Gait assessment; (iv) Behavioral and neuropsychiatric symptoms; (v) Functional assessment; and (vi) Global Rating Scale. Second, to propose a multidimensional clinical assessment of FTD in LAC identifying the main gaps. Lastly, it is proposed to create a LAC consortium that will discuss strategies to address the current challenges in the field.</jats:p>
1Scopus© Citations 12 4

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