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Background: The Addenbrooke's Cognitive Examination III (ACE-III), an adaptation of the ACE cognitive screening test, has been demonstrated to have high sensitivity and specificity in detecting cognitive impairment in patients with dementia and other neurological and psychiatric disorders. Although the Spanish-language version of the ACE-III has already been validated in Spain, it is yet to be validated in Latin America. The aim of this study was to validate the ACE-III test in an Argentinean and Chilean population. Methods: ACE-III was administered to 70 patients with Alzheimer disease, 31 patients with behavioural variant frontotemporal dementia, and a control group of 139 healthy volunteers. Participants were recruited at centres in both countries. Results: The Spanish-language version of ACE-III was found to have good internal consistency (Cronbach's alpha = 0.87). We found significant differences in total ACE-III scores between patients with Alzheimer disease and controls (P

Background: The prevalence of cognitive impairment (CI) will double in the next 20 years, making early detection a key priority. Objectives: Validation of a 5-minute CI screening test. Methods: Adults aged 60 years and older were recruited from memory clinics and the community at large in the Santiago, Chile metropolitan area. Based on clinical examination they were categorised as No CI (NCI), Mild CI (MCI) and dementia sufferers (DS). We measured the validity of a new test, MEFO, evaluating memory (5 points), phonetic verbal fluency (2 points) and orientation (6 points) by comparing its results with those from the MMSE. Results: We evaluated 214 subjects, comprising 49 with dementia, 47 with MCI, and 118 with no CI. The MEFO differentiated between all 3 groups whereas the MMSE did not discriminate between the MCI and NCI groups. The area under the ROC curve (AUC) for the MEFO distinguishing NCI subjects from dementia sufferers was 0.97; for NCI vs CI (dementia + MCI), 0.89; and for NCI vs MCI, 0.80. On the MMSE these values were 0.95, 0.84, and 0.73, respectively. A cut-off score of 6/7 on the MEFO identified dementia sufferers with a sensitivity of 86% and a specificity of 96%. A cut-off score of 8/9 distinguished CI from NCI subjects with a sensitivity of 83% and a specificity of 75%. Conclusions: The MEFO is a valid and reliable test for discriminating between dementia and CI sufferers and subjects with no CI. Its validity is similar to that of the MMSE under these conditions, but it is more effective for identifying subjects with MCI and its administration time is shorter. Resumen: Antecedentes: En los próximos 20 años se duplicará la cantidad de personas con deterioro cognitivo (DC) apremiando su pronta detección. Objetivos: Validar una prueba de cribado de DC aplicable en < de 5 minutos. Métodos: Adultos ≥60 años reclutados desde la comunidad y clínicas de memoria de la zona urbana de Santiago de Chile fueron clasificados clínicamente en: Dementes, DC leve (DCL) y Sin DC (SDC). Se evaluó la validez de un nuevo test: MEFO, consistente en la evaluación de: Memoria (5 puntos), Fluidez Fonética (2 puntos) y Orientación (6 puntos) contrastado con los resultados del MMSE. Resultados: Se evaluaron 214 personas: 49 con demencia, 47 con DCL y 118 SDC. El MEFO diferenció a los 3 grupos clínicos entre sí, mientras que el MMSE no permitió discriminar DCL de SDC. El área bajo la curva ROC en el MEFO para diferenciar los grupos SDC versus: i: Demencia fue = 0,97; ii: DC (dementes + DCL)fue = 0,89; y iii: DCL fue = 0,80; siendo estos valores para el MMSE de 0,95, 0,84, y 0,73, respectivamente. Un punto de corte (PC) del MEFO = 6/7 distinguió a las personas con demencia con una sensibilidad (S) = 86% y especificidad (E) = 96%; y un PC = 8/9 distinguió a aquellos con DC con una: S = 83% y E = 75%. Conclusiones: El MEFO resultó una prueba confiable y válida para diferenciar a personas con demencia y DC, similar al MMSE en éstos casos, pero con mayor utilidad para distinguir a los pacientes con DCL y de menor duración de aplicación. Keywords: Cognitive impairment screening, Chile, Dementia, Spanish, Palabras clave: Cribado de deterioro cognitivo, Chile, Demencias, Español

BackgroundCOVID-19-related restrictions led to an increase in overall loneliness and social isolation. Before the pandemic, care partners reported higher levels of loneliness and higher loneliness prevalence compared to non-care partners. Because of the spread and severity of the infections, and the access to support spread, we expect a different impact of the COVID-19 pandemic on LATAM care partners.ObjectivesTo describe the loneliness levels of LATAM caregivers and to identify socioeconomic and health factors associated.DesignAn international online cross-sectional survey for care partners, embedded within the ‘Coping with Loneliness and Isolation during COVID-19’ (CLIC) Study conducted between June 2020– and November 2020.SettingWe analysed data from 246 family care partners living in Latin American countries (46% Mexico, 26% Chile,18% Brazil, and 10% from Argentina, Peru, Venezuela, Panama, Guatemala y Costa Rica).MeasurementsWe assessed loneliness using the 6-items of De Jong Gierveld loneliness Scale. We described the levels of overall, emotional, and social loneliness pre and during Covid, and reported the distribution of care partners who improved, worsened or maintained their levels of loneliness. Moreover, we used longitudinal multiple linear regression models with bootstraps errors of 1,000 iterations to identify factors associated with the levels of overall, emotional, and social loneliness during the pandemic.ResultsParticipants were mostly women, 50 years and older, in a partnership, highly educated and with finances meeting their needs, with good to excellent physical and mental health. Among the total of care partners, 55% perceived higher overall loneliness, 56% higher emotional loneliness, and 21% higher social loneliness during the pandemic in comparison with pre-COVID-19 levels. Perceived mental health was associated with the overall, emotional, and social loneliness.ConclusionsRegardless of their living and health situation, during the pandemic, loneliness increased in all groups of care partners. These should be taken in consideration when planning public health approaches for crises such as pandemics or other large-scale disruptive events.

Abstract The Latin American Brain Health Institute (BrainLat) has released a unique multimodal neuroimaging dataset of 780 participants from Latin American. The dataset includes 530 patients with neurodegenerative diseases such as Alzheimer’s disease (AD), behavioral variant frontotemporal dementia (bvFTD), multiple sclerosis (MS), Parkinson’s disease (PD), and 250 healthy controls (HCs). This dataset (62.7 ± 9.5 years, age range 21–89 years) was collected through a multicentric effort across five Latin American countries to address the need for affordable, scalable, and available biomarkers in regions with larger inequities. The BrainLat is the first regional collection of clinical and cognitive assessments, anatomical magnetic resonance imaging (MRI), resting-state functional MRI (fMRI), diffusion-weighted MRI (DWI), and high density resting-state electroencephalography (EEG) in dementia patients. In addition, it includes demographic information about harmonized recruitment and assessment protocols. The dataset is publicly available to encourage further research and development of tools and health applications for neurodegeneration based on multimodal neuroimaging, promoting the assessment of regional variability and inclusion of underrepresented participants in research.

ABSTRACT Rowland Universal Dementia Assessment Scale (RUDAS) is a cognitive screening that evaluates older people with low educational levels. In Chile, there are no normative data to assess this population. Objective: To obtain normative data on RUDAS in older Chilean people with up to 12 years of schooling, and to determine whether age and schooling years influence a person’s performance on RUDAS and on the items that constitute it. Methods: A group of cognitively healthy people 60 years old or over, with up to 12 schooling years was evaluated (n=135). Multiple regression models were applied to obtain normative data on RUDAS, according to age and schooling years, and to measure the effects of schooling on different items. Results: Regression analysis showed that none of the items had schooling as a significant predictor, except for the visuoconstruction item. The variables age and schooling explained 12.6% (R^2=0.126) of the RUDAS total score variance. The item visuoconstruction was the most associated with the educational level (OR=1,147). Conclusion: This study showed that RUDAS is a recommended instrument for evaluating older people with low educational levels. However, more studies are needed to prove the validity of the RUDAS on Chilean older people.

Background: Most research initiatives have emerged from high‐income countries (HIC), leaving a gap in understanding the disease's genetic basis in diverse populations like those in Latin American countries (LAC). ReDLat tackles this gap, focusing on LAC's unique genetics and socioeconomic factors to identify specific Alzheimer's Disease (AD) and Frontotemporal Dementia (FTD) risk factors in Mexico, Colombia, Peru, Chile, Argentina, and Brazil. Method: We employed a comprehensive genetic analysis approach, integrating Whole Genome Sequencing (WGS), Exome Sequencing, and SNP arrays to understand the cohort's unique genetic architecture. We conducted ancestry analysis and searched for disease‐causing variants with mendelian inheritance, genome‐wide association studies (GWAS), rare variant enrichment, and evaluation of Polygenic Risk Scores (PRS). Results: We recruited and genotyped an initial cohort of 1046 participants with AD, 423 with FTD, and 855 healthy controls (HC) between 2020 and 2023. Analysis is ongoing, and we expect to sequence ∼600 additional samples in the coming months. Ancestry analysis revealed tri‐continental admixture, except for Brazil, which showed an additional Asian component (Figure 1). Top candidate gene rare variant enrichment associations (SKAT p < 0.05) were TREM2 for FTD and ABCA7 and ABCA1 for AD. GWAS identified a robust association with the APOE locus on chromosome 19 in AD vs. HC.. We tested an AD PRS developed in European populations by Bellenguez et al (2020). on our cohort using 83 single‐nucleotide polymorphisms.. The PRS modestly distinguishes between all patients and HC (p = 2.4 × 10^‐12), AD vs. HC (p = 2.2 × 10^‐12), and even FTD vs. HC (p = 4.3 × 10^‐5), albeit with modest separation between groups, as expected for its application in a genetically admixed population. Conclusion: Our findings represent a pivotal step in understanding the genetic landscape of AD and FTD in admixed populations. They underscore the importance of including diverse populations in genetic research, paving the way for future studies. These findings have the potential to inform more personalized approaches to the diagnosis and treatment of neurodegenerative diseases in diverse global populations, as well as identify novel targets for therapeutic development. [ABSTRACT FROM AUTHOR]

Background: 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. Method: 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). Result: 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). Conclusion: 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. [ABSTRACT FROM AUTHOR]

Background: COVID-19-related restrictions led to an increase in overall loneliness and social isolation. Before the pandemic, care partners reported higher levels of loneliness and higher loneliness prevalence compared to non-care partners. Because of the spread and severity of the infections, and the access to support spread, we expect a different impact of the COVID-19 pandemic on LATAM care partners. Objectives: To describe the loneliness levels of LATAM caregivers and to identify socioeconomic and health factors associated. Design: An international online cross-sectional survey for care partners, embedded within the 'Coping with Loneliness and Isolation during COVID-19' (CLIC) Study conducted between June 2020– and November 2020. Setting: We analysed data from 246 family care partners living in Latin American countries (46% Mexico, 26% Chile,18% Brazil, and 10% from Argentina, Peru, Venezuela, Panama, Guatemala y Costa Rica). Measurements: We assessed loneliness using the 6-items of De Jong Gierveld loneliness Scale. We described the levels of overall, emotional, and social loneliness pre and during Covid, and reported the distribution of care partners who improved, worsened or maintained their levels of loneliness. Moreover, we used longitudinal multiple linear regression models with bootstraps errors of 1,000 iterations to identify factors associated with the levels of overall, emotional, and social loneliness during the pandemic. Results: Participants were mostly women, 50 years and older, in a partnership, highly educated and with finances meeting their needs, with good to excellent physical and mental health. Among the total of care partners, 55% perceived higher overall loneliness, 56% higher emotional loneliness, and 21% higher social loneliness during the pandemic in comparison with pre-COVID-19 levels. Perceived mental health was associated with the overall, emotional, and social loneliness. Conclusions: Regardless of their living and health situation, during the pandemic, loneliness increased in all groups of care partners. These should be taken in consideration when planning public health approaches for crises such as pandemics or other large-scale disruptive events. [ABSTRACT FROM AUTHOR]

Background: Cognitive complaints (CC) refer to a reported experience of cognitive decline and are recognized as a potential precursor to future functional decline and progression to dementia. Identifying individuals with CC may be a valuable opportunity for preventive measures, early detection, and intervention strategies to address dementia risk. However, the characteristics of CC and its associated risk of progression to dementia are highly heterogeneous, influenced significantly by CC identification methods, recruitment approaches, and attrition in longitudinal cohort studies. This study aims to inform the inclusion and attrition processes of the GERO cohort. Method: The GERO cohort is a prospective cohort study of community‐dwelling elderly individuals with CC without dementia, aged 70 or older, living in Santiago, Chile. In this study, two samples were analyzed (dropout and non‐dropout groups) using logistic regression to assess the variables associated with attrition. Binary logistic regression analyses were conducted with dropout as the outcome variable. Prior to the multivariable models, univariate analyses were performed. Result: Out of 17,759 households approached, we successfully recruited 291 participants. Of the individuals initially recruited, 102 participants withdrew before the first follow‐up assessment. The results showed that the non‐dropout group (64.9%) was characterized by being younger (OR: 1.09; 95% CI: 1.04‐1.14), had better cognitive status according to the MoCA test (OR: 0.92; 95% CI: 0.87‐0.98), had better functionality according to the T‐ADLQ (OR: 1.08; 95% CI: 1.04‐1.12), better performance in instrumental ‐IADL‐ (OR: 1.06; 95% CI: 1.03‐1.09) and advanced ‐aADL‐ (OR: 1.03; 95% CI: 1.01‐1.04) dimensions, and better performance on the ECOG test (OR: 2.56; 95% CI: 1.13‐4.53) compared to the dropout group (35.1%). In the multivariate logistic regression model, dropout was associated with the performance of instrumental activities of daily living IADL (OR: 1.05; 95% CI: 1.01‐1.09), whereas the other variables did not exhibit statistical significance (Table 1). Conclusion: The rate of participants included, considering the number of households approached, inform on the difficulties to recruit participants with CC in the community. Functionality in daily life emerged as the key factor associated with the risk of dropout. Furthers research is needed to understand the role of functionality in CC. [ABSTRACT FROM AUTHOR]

Dementia is a syndrome characterized by cognitive and neuropsychiatric symptoms associated with progressive functional decline (FD). FD is a core diagnostic criterion for dementia, setting the threshold between its prodromal stages and the full-blown disease. The operationalization of FD continues to generate a great deal of controversy. For instance, the threshold of FD for the diagnosis of dementia varies across diagnostic criteria, supporting the need for standardization of this construct. Moreover, there is a need to reconsider how we are measuring FD to set boundaries between normal aging, mild cognitive impairment, and dementia. In this paper, we propose a multidimensional framework that addresses outstanding issues in the assessment of FD: i) What activities of daily living (ADLs) are necessary to sustain an independent living in aging? ii) How to assess FD in individuals with suspected neurocognitive disorders? iii) To whom is the assessment directed? and iv) How much does FD differentiate healthy aging from mild and major neurocognitive disorders? Importantly, the To Whom Question introduces a person-centered approach that regards patients and caregivers as active agents in the assessment process of FD. Thus, once impaired ADLs have been identified, patients can indicate how significant such impairments are for them in daily life. We envisage that this new framework will guide future strategies to enhance functional assessment and treatment of patients with dementia and their caregivers. [ABSTRACT FROM AUTHOR]

Dementia can disrupt how people experience and describe events as well as their own role in them. Alzheimer's disease (AD) compromises the processing of entities expressed by nouns, while behavioral variant frontotemporal dementia (bvFTD) entails a depersonalized perspective with increased third-person references. Yet, no study has examined whether these patterns can be captured in connected speech via natural language processing tools. To tackle such gaps, we asked 96 participants (32 AD patients, 32 bvFTD patients, 32 healthy controls) to narrate a typical day of their lives and calculated the proportion of nouns, verbs, and first- or third-person markers (via part-of-speech and morphological tagging). We also extracted objective properties (frequency, phonological neighborhood, length, semantic variability) from each content word. In our main study (with 21 AD patients, 21 bvFTD patients, and 21 healthy controls), we used inferential statistics and machine learning for group-level and subject-level discrimination. The above linguistic features were correlated with patients' scores in tests of general cognitive status and executive functions. We found that, compared with HCs, (i) AD (but not bvFTD) patients produced significantly fewer nouns, (ii) bvFTD (but not AD) patients used significantly more third-person markers, and (iii) both patient groups produced more frequent words. Machine learning analyses showed that these features identified individuals with AD and bvFTD (AUC = 0.71). A generalizability test, with a model trained on the entire main study sample and tested on hold-out samples (11 AD patients, 11 bvFTD patients, 11 healthy controls), showed even better performance, with AUCs of 0.76 and 0.83 for AD and bvFTD, respectively. No linguistic feature was significantly correlated with cognitive test scores in either patient group. These results suggest that specific cognitive traits of each disorder can be captured automatically in connected speech, favoring interpretability for enhanced syndrome characterization, diagnosis, and monitoring. [ABSTRACT FROM AUTHOR]

Background: Previous studies reported the negative impact of social isolation on mental health in people with dementia (PwD) and their caregivers, butlongitudinal studies seem scarcer. Objective: To describe a one-year follow-up impact of the COVID-19 pandemic on PwD and their caregivers in both Brazil and Chile. Methods: This study analyzed the impact of the pandemic on the psychological and physical health of PwD and their family caregivers after one year of follow-up in three outpatient clinics in Brazil (n = 68) and Chile (n = 61). Results: In both countries, PwD reduced their functional capacity after one year of follow-up (p = 0.017 and p = 0.009; respectively) and caregivers reported worse physical and mental health (p = 0.028 and p = 0.039). Only in Chile, caregivers reported more sadness associated with care (p = 0.001), and reduced time sleeping (p = 0.07). Conclusions: In conclusion, the COVID-19 pandemic appears to have had a long-lasting impact on PwD and their caregivers. However, it is essential to acknowledge that the inherent progression of dementia itself may also influence changes observed over a year. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Verbal fluency tasks are common in Alzheimer's disease (AD) assessments. Yet, standard valid response counts fail to reveal disease‐specific semantic memory patterns. Here, we leveraged automated word‐property analysis to capture neurocognitive markers of AD vis‐à‐vis behavioral variant frontotemporal dementia (bvFTD). METHODS: Patients and healthy controls completed two fluency tasks. We counted valid responses and computed each word's frequency, granularity, neighborhood, length, familiarity, and imageability. These features were used for group‐level discrimination, patient‐level identification, and correlations with executive and neural (magnetic resonanance imaging [MRI], functional MRI [fMRI], electroencephalography [EEG]) patterns. RESULTS: Valid responses revealed deficits in both disorders. Conversely, frequency, granularity, and neighborhood yielded robust group‐ and subject‐level discrimination only in AD, also predicting executive outcomes. Disease‐specific cortical thickness patterns were predicted by frequency in both disorders. Default‐mode and salience network hypoconnectivity, and EEG beta hypoconnectivity, were predicted by frequency and granularity only in AD. DISCUSSION: Word‐property analysis of fluency can boost AD characterization and diagnosis. Highlights: We report novel word‐property analyses of verbal fluency in AD and bvFTD.Standard valid response counts captured deficits and brain patterns in both groups.Specific word properties (e.g., frequency, granularity) were altered only in AD.Such properties predicted cognitive and neural (MRI, fMRI, EEG) patterns in AD.Word‐property analysis of fluency can boost AD characterization and diagnosis. [ABSTRACT FROM AUTHOR]

The Latin American Brain Health Institute (BrainLat) has released a unique multimodal neuroimaging dataset of 780 participants from Latin American. The dataset includes 530 patients with neurodegenerative diseases such as Alzheimer's disease (AD), behavioral variant frontotemporal dementia (bvFTD), multiple sclerosis (MS), Parkinson's disease (PD), and 250 healthy controls (HCs). This dataset (62.7 ± 9.5 years, age range 21–89 years) was collected through a multicentric effort across five Latin American countries to address the need for affordable, scalable, and available biomarkers in regions with larger inequities. The BrainLat is the first regional collection of clinical and cognitive assessments, anatomical magnetic resonance imaging (MRI), resting-state functional MRI (fMRI), diffusion-weighted MRI (DWI), and high density resting-state electroencephalography (EEG) in dementia patients. In addition, it includes demographic information about harmonized recruitment and assessment protocols. The dataset is publicly available to encourage further research and development of tools and health applications for neurodegeneration based on multimodal neuroimaging, promoting the assessment of regional variability and inclusion of underrepresented participants in research. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) represents a substantial burden to patients, their caregivers, health systems, and society in Latin America and the Caribbean (LAC). This impact is exacerbated by limited access to diagnosis, specialized care, and therapies for AD within and among nations. The region has varied geographic, ethnic, cultural, and economic conditions, which create unique challenges to AD diagnosis and management. To address these issues, the Americas Health Foundation convened a panel of eight neurologists, geriatricians, and psychiatrists from Argentina, Brazil, Colombia, Ecuador, Guatemala, Mexico, and Peru who are experts in AD for a three-day virtual meeting to discuss best practices for AD diagnosis and treatment in LAC and create a manuscript offering recommendations to address identified barriers. In LAC, several barriers hamper diagnosing and treating people with dementia. These barriers include access to healthcare, fragmented healthcare systems, limited research funding, unstandardized diagnosis and treatment, genetic heterogeneity, and varying social determinants of health. Additional training for physicians and other healthcare workers at the primary care level, region-specific or adequately adapted cognitive tests, increased public healthcare insurance coverage of testing and treatment, and dedicated search strategies to detect populations with gene variants associated with AD are among the recommendations to improve the landscape of AD. [ABSTRACT FROM AUTHOR]

Background: Subjective cognitive complaints (SCCs), defined as cognitive concerns of people who may or may not have deficits in objective, is considered a predictor for cognitive and functional decline and incident to dementia risk of progression to dementia. SCC is a heterogeneous condition associated. Most of the studies have been carried out in populations other than those of Latin America. The objective of this study was to analyze the socio‐demographic and functional profile in SCC elderly with and without cognitive impairment. Method: The GERO cohort is a prospective cohort study of community‐dwelling elderly with SCC, without dementia, aged 70 or older living in Santiago, Chile. Participants were identified by a household census and information on demographics, biomedical, psychosocial, neuropsychological, neuropsychiatric, and motor function were collected by means of questionnaires and evaluations. Montreal Cognitive Assessment (MOCA) was used to compare individuals with and without cognitive impairment (MOCA score ≤ 21 and > 21 respectively). Functionality was measured with the Pfeffer Functional Activities Questionnaire (FAQ) and Technology Activities of Daily Living Questionnaire (T‐ADLQ) that yield a global score and score by domain of activities of daily living (ADL), i.e basic (BADL), instrumental (IADL), and advanced ADL (a‐ADL). Result: From May 2017 to December 2020, a total of 17,759 households were successfully approached, identifying 2,533 eligible subjects, of which 299 individuals were included. After evaluation, 7 individuals were excluded for different reasons and 291 individuals were analyzed, female 80% (n = 243). The age of the individuals was 76.8 ± 5 years old, 60% of the participants were older than 75 years old. Participants with cognitive impairment compared to those without it were older (p = 0.003), with lower education years (p = <0.001), lower income (p = 0.036), lower MMSE score (p = <0.001), decline in a‐ADL (p = 0.006) and with more hypertension prevalence (p = 0.009) Conclusion: Few other studies addressed cognitive complaint and functionality decline in recruited elderly at home. Older adults with cognitive impairments are characterized by less years of education, income, poor functionality and more comorbidities. Future multidimensional and prospective analysis of this cohort could bring more information about this association. [ABSTRACT FROM AUTHOR]

Background: Currently, dementia training is only offered in a few large medical centers in a handful of Latin America ́s biggest cities. Reduced access and the heterogeneous quality of dementia education for clinicians hinder the diagnosis and treatment of neurodegeneration in Latin America. Aim: This project aims to fill the education gaps and increase specialist´s diagnostic and therapeutic skills in neurodegenerative diseases through an interactive online Spanish‐language pilot program tailored for Latin America. Methods: We put together a 108 hour curriculum formed by four modules: basic aspects of behavioral neurology, neurobehavioral and neuropsychiatric syndromes,treatment, and other aspects of neurodegenerative diseases. It was delivered by 35 brain health experts and reviewers that coolaborate with the Global Brain Health Institute in at the University of California, San Francisco to a pilot group formed by 35 geriatricians, neurologists and psychiatrists from six Latin American Countries (Peru, Mexico, Chile, Colombia, Ecuador, and Venezuela). An initial and final evaluations were performed with the Spanish‐dementia knowledge assessment scale (Carnes et al, 2021), the Frontotemporal Dementia Knowledge Scale (Magrath et al 2021) and clinical cases. In addition, short evaluations submitted by professor were answered before and after each class. Separately, we requested feedback from the students about the course. Results: Comparing the overall scores between the initial and final evaluation, there was a 7% increase in the Geriatrician´s score, 4% in Neurologists´ score and 9% in the Psychiatrist's score. The greatest increase was in Frontotemporal Dementia Knowledge. (Figures 1 and 2). The topics with the worse baseline scores were clinical evaluation attention, executive functions, and atypical Alzheimer´s Disease. We observed an increase in knowledge after every class. Most of the feedback brought to light that there were many topics that specialists had not had the opportunity to learn before such as sleep in neurodegeneration, traumatic encephalopathy, and atypical dementia syndromes. Conclusion: It is imperative to find ways of bringing education to regions where dementia prevalence is increasing, and specialist do not have enough knowledge. Online programs are feasible and effective strategies to close educational gaps. [ABSTRACT FROM AUTHOR]

Background: Functional decline (FD) is defined as the deterioration of the ability to perform activities of daily living (ADLs). This FD is a critical dimension that allows determining the threshold between dementia disorders and previous stages of cognitive impairment. ADLs include activities that are divided into three main dimensions: basic (BADL), instrumental (IADL), and advanced (AADL). The Technology‐Activities of Daily Living Questionnaire (T‐ADLQ) (1) assesses these different ADL dimensions. To date, the dimensions of ADLs have not been assessed in the continuum ranging from healthy controls (HC), amnestic mild cognitive impairment (a‐MCI), to Alzheimer's disease dementia (ADD) in the illiterate population. The study aimed is to validate the T‐ADLQ and evaluate FD across the three dimensions of ADL in healthy and cognitively impaired illiterate adults >50 years. Method: A cross‐sectional study of illiterate subjects in Peru. Inclusion criteria: men and women over 50 years of age; with less than one whole year of formal education and unable to read and write and grouped into 1 of 3 cognitive categories: healthy controls (HC) (n = 64), a‐MCI (n = 60), and early ADD (n = 63). Neuropsychological measures included the RUDAS, MMSE, and IFS. FD was assessed with the FAQ and the T‐ADLQ. The latter questionnaire, assessed by informants, evaluated the different dimensions of ADLs. Result: The results on the global FD (T‐ADLQ total score) and the three ADL dimensions differed significantly among the three groups (Table 1). The T‐ADLQ total score correlated significantly with the FAQ (Table 2) and had high internal consistency (Cronbach's alpha = 0.966). In addition, the T‐ADLQ total correlated significantly with instruments of global cognition and executive functions (Table 2). Finally, receiver operating characteristic (ROC) analyses, through the calculation of the area under the curve (AUC), showed that the total T‐ADLQ and the different dimensions discriminated better between HC vs. ADD and HC vs. a‐MCI but not between a‐MCI and ADD (Table 3). Conclusion: The total T‐ADLQ scale and its three dimensions have good psychometric properties (validity and reliability) and excellent diagnostic utility. This result demonstrates that the T‐ADLQ is a good instrument to evaluate FD in illiterate populations. [ABSTRACT FROM AUTHOR]

Background: Social cognition dysfunction in neurodegenerative diseases such as the behavioral variant frontotemporal dementia (bvFTD) and Alzheimer's Disease (AD) is typically ascribed to the underlying pathophysiological processes spanning specific atrophy and connectivity alterations. However, social cognition performance might be modulated by a set of more heterogenous, non‐specific factors, including demographics (sex, age, education, socioeconomic status), general cognitive and executive abilities, and behavior inside the scanner (i.e., movements), but their relative contribution is poorly understood. Here, we develop a machine learning approach to characterize multimodal factors that explain the inter‐individual heterogeneity of social cognition in a diverse multicentric sample. Method: A total of 998 individuals > 50 years from international research networks in high‐ and middle‐income countries participated in this study: 102 with bvFTD, 339 with AD, 96 with mild cognitive impairment (MCI), and 461 with preserved cognition (with and without cognitive complaints). Social cognition was assessed with the Mini Social Cognition and Emotional Assessment (MiniSEA) battery, which includes tests of facial emotion recognition and theory of mind. After data harmonization, we implemented support vector regressions combined with bootstrapping to predict social cognition outcomes from multimodal features, including diagnosis, demographics, cognitive and executive functions, grey matter volume, fMRI resting‐state network connectivity, and movement artifacts, and assessed their relative contribution to performance (Figure 1). Models were assessed with the coefficient of determination R², Fisher's F test, Cohen's F², 95% confidence intervals, and p‐values. Result: General cognitive and executive functions and years of education consistently emerged among the top predictive features of social cognition performance and explained more variance than diagnosis. Other features making significant contributions were: sex, the gray matter volume of relevant regions, and in‐scanner movements. Age and resting‐state network connectivity did not make any significant contribution to performance heterogeneity (Figure 2). Conclusion: Social cognition performance was more strongly predicted by a set of heterogenous individual differences than by neurodegenerative diagnoses and associated brain signatures. Diagnoses might relate to complex profiles. Results highlight a critical modulator role of heterogeneity on social cognition, with implications for the neuropsychological assessment in brain health and disease across diverse, multi‐setting populations. [ABSTRACT FROM AUTHOR]

Objectives: Latin American longitudinal studies in family carers of people living with dementia (PLWD) are scarce. This study aimed to determine the trajectories of depressive and anxious symptomatology in Chilean family carers of PLWD over two years. Methods: A telephone survey was conducted with 300 family caregivers of PLWD at baseline (T1) who responded to a survey about themselves, characteristics of the PLWD, and social factors. In the second wave, 208 carers participated (T2), and 155 in the third wave (T3). Latent Growth Curve and Latent Class Growth Mixture analyses were performed. Results: Both depressive and anxious symptomatology increased significantly over time (p < 0.001). Ninety-five percent of carers, regardless of the level of depressive symptomatology at baseline, showed statistically significant trajectories of increase in depressive symptomatology (p < 0.001). In addition, 67% of carers (with low and high baseline levels) showed a significant progressive increase in anxious symptomatology (p < 0.005) and 33% remained at a moderate level of depressive symptomatology (p = 0.07). Finally, it was found that anxious symptomatology increased by 0.82 points more in women compared to men (p = 0.01). Conclusions: The results emphasize the importance of ongoing screening for depressive and anxious symptomatology in carers over time, particularly in women. Health professionals in primary care should be capacitated to assess and offer timely and appropriate support to family carers of PLWD in order to improve their mental health. Finally, interventions for carers should be an essential part of national dementiaplans. [ABSTRACT FROM AUTHOR]

Summary: Specialist Memory Clinics play a crucial role in evaluating individuals suspected of dementia. While these clinics have long been established in developed economies, their introduction has only recently begun in developing countries. In Chile, Memory Clinics were implemented as part of the Chilean Memory Plan and the inclusion of dementia in the General Regime of Explicit Guarantees in Health. This legal framework ensures access to diagnosis and treatment for patients with dementia. The Chilean system prioritizes primary care, with specialist care reserved for cases where diagnosis or treatment cannot be adequately addressed at the primary care level. As a result, Memory Units serve only a subset of diagnosed dementia patients. So far, there is a lack of studies on the clinical profiles of patients evaluated in memory clinics and resourceutilization. Objectives: This study aims to comprehensively describe patient demographics and clinical characteristics while examining the frequency of evaluations needed about their specific diagnoses and comorbidities. Methods: We analyzed the total number of consultations, considering the primary diagnosis and any comorbidities present. Clinical records were managed using a customized web platform software, which enabled the healthcare team to document all patient interactions, including appointments, medication prescriptions, and care coordination. Results: CMYN received 1,220 patients (57% women) and 36 caregivers in the first five years. Among the patients, 222 (20%) had mild cognitive impairment, while 622 (57%) had dementia, with 48% diagnosed with Alzheimer's disease dementia and 58% with other types of dementia. More than 75% of patients had less than ten consultations. Patients with dementia had more consultations than those without, as presented in Table 1. Conclusions: The recent establishment of Memory Clinics in developing countries addresses a crucial gap in specialist care for dementia patients. In our experience, the diagnosis and the number of comorbidities may predict the level of interventions patients require. A more comprehensive understanding of the patient profile and their needs will assist in tailoring resources for implementing memory clinics and estimating the cost of care. Further studies need to address the characteristics of patients that require specialist-levelattention. [ABSTRACT FROM AUTHOR]