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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: Subjective cognitive complaint (SCC) is a risk factor of functional impairment in activities of daily living (ADL). ADL are divided from basic (BADL), instrumental (IADL), and advanced activities of daily living (a‐ADL), according to their cognitive complexity. These three dimensions of ADL have been scarcely explored in SCC The objective of this study was to analyze these three dimensions of ADL and their association with global cognition and sociodemographic factors in SCC. Method: 291 participants from the GERO prospective cohort study of community‐dwelling elderly with SCC, aged 70 or older, living in Santiago ‐ Chile were analyzed. ADL were evaluated with the Technology Activities of Daily Living Questionnaire (T‐ADLQ), an informant‐rated questionnaire measuring BADL, IADL and aADL (T‐ADLQ total score and dimension score range 0‐100, higher values meaning worse performance), global cognition with the Mini‐mental state (MMSE) and sociodemographic factors measured with age, gender, marital status, education, household‐income, working status. A multivariate logistic regression model was performed considering MMSE and sociodemographic factors as explanatory variables and the different dimensions of ADL as dependent variables. Results were evaluated with coefficient of regression and 95% confidence intervals. Result: Performances in T‐ADLQ total score ranged from 0 to 56; in BADL from 0 to 40; in IADL from 0 to 67 and a‐ADL from 0 to 100. T‐ADLQ total score was independently associated with MMSE (Coef: ‐0.24), age (Coef: 0.40) and marital status (Coef: 3.44), BADL with age (Coef: 0.14), IADL with age (Coef: 0.45) and marital status (Coef: 3.59), a‐ADL with marital status (Coef: 7.25). Results are presented in Table 1. Conclusion: Impairment in ADL and their associated factors in SCC differ according to their complexity, being the aADL the most affected. Studying dimensions of ADL could contribute to better understanding functionality in SCC. Slachevsky, A., ..., Thumala, D. (2020). GERO Cohort Protocol, Chile, 2017‐2022: Community‐based Cohort of Functional Decline in Subjective Cognitive Complaint elderly. BMC geriatrics, 20(1), 505. Slachevsky, A., ... Hornberger, M. (2019). Mapping the neuroanatomy of functional decline in Alzheimer's disease from basic to advanced activities of daily living. Journal of neurology, 266(6), 1310‐1322 Funding: ANID/FONDAP/15150012; ANID /FONDECYT/ 1231839 and ANID/PIA/ANILLOS ACT210096. [ABSTRACT FROM AUTHOR]

Background: Timely diagnosis of Alzheimer's disease (AD) is a critical first step in clinical care treatment. However, the availability of diagnostic tools for these conditions is either unavailable or unaffordable, especially in Latin American and the Caribbean (LAC) countries. In this scenario, microRNAs (miRNA) have recently emerged as promising cost‐effective and noninvasive biomarkers since they can be readily detected in different biofluids such as plasma bound to protein or inside exosomes. Our aim is to identify new blood biomarkers to calculate the risk to develop AD in the early stages using machine learning based on exosomal miRNAs detection and different cognitive domains. Method: miRNAs were extracted from plasma circulating exosomes samples of Subjective Cognitive Complaint subjects belonging to the GERO cohort in two different times (T1 = baseline and T2 = 18 months, n = 50). miRNAs were sequencing to identify the expression levels. Dysregulated miRNAs were analyzed and correlated with neuropsychological evaluations to create machine learning algorithms. miRNAs obtained from algorithms were validated in a new population of subjects at both stages (T1 and T2, n = 50), using qRT‐PCR and correlation analysis with neuropsychological tests. Result: For algorithm development, we classified subjects into stationary and progressive impairment. Algorithms were trained using the sequenced miRNAs, neuropsychological tests and neuroimaging. As possible predictors of progression of cognitive impairment, the best performing algorithm was Random forest using only miRNAs data. In a new group of subjects, three miRNAs selected by the algorithm and four miRNAs obtained from the literature were validated and the ROC curves were constructed. The combination of these miRNAs (algorithm and literature miRNAs), were the best predictor of the progression of cognitive impairment. Conclusion: This study could be used in the initial phases of the diagnostic process of AD because it is minimally invasive, low cost and accessible to a large number of patients in Latin American and the Caribbean (LAC) countries. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has impacted the wellbeing of older adults. Pandemic‐related stress has implications on cognitive status, including decline due to Alzheimer's disease and related dementias. Yet, evidence suggests that COVID‐19 has impacted culturally and linguistically diverse communities differently. We sought to examine the role of COVID‐19 on coping and wellbeing in an international, multi‐ethnic sample of older adults. Method: Data from 955 older adults (age = 66.7±7.9 years; education = 15.2±5.9 years; 71% female; 41% Hispanic/Latino) were pulled from a larger, international sample examining the response of older adults to COVID‐19. All participants completed demographic questionnaires, measures of psychological distress, the Brief‐COPE – a 28‐item self‐report questionnaire used to measure respondent's efforts to minimize distress from a stressful life event – and the Epidemic‐Pandemic Impacts Inventory (EPII) – a 92‐item inventory of pandemic related experiences across several life domains. Using linear regression, we examined relationships between Brief‐COPE scores, ethnicity, and select EPII items controlling for several covariates (age, sex, education, marital status, number of children, employment status, household income, and history of COVID‐19 symptoms) in all analyses. Result: Hispanic/Latino (H/L) ethnicity was associated with slightly higher scores on the approach‐focused coping subscale compared to the non‐Hispanic White (NHW) group (Approach: 27.3±6.6 vs 26.1±6.1; B = 1.205, p = 0.015, CI: 0.238, 2.172). There was no effect of ethnicity on Brief‐COPE Total or Avoidance subscale scores (both ps>0.050). Notably, review of covariates suggested increased age was associated with lower scores on Approach (B = ‐0.065, p = 0.041, CI: ‐0.128, ‐0.003), Avoidance (B = ‐0.054, p = 0.034, CI: ‐0.104, ‐0.004), and Total scores (B = ‐0.136, p = 0.028, CI: ‐0.257, ‐0.015). Higher Approach scores were associated with greater endorsement of Positive Life Changes in both ethnic groups (NHW: partial r = 0.298, p<0.001; H/L: partial r = 0.249, p<0.036), but with endorsement of Mental Health Problems in NHWs only (NHW: partial r = 0.144; p = 0.001; H/L: partial r = ‐0.019, p>0.050). Conclusion: Findings suggest cross‐cultural differences in the stress coping response of older adults during the pandemic, even after controlling for symptomatic history and other relevant covariates. Moreover, coping may be differentially related to positive and negative outcomes across cultural groups. These results support the need to consider cultural background when considering coping and wellbeing in older adults. [ABSTRACT FROM AUTHOR]

Background: Dementia worldwide is one of the most important causes of disability in the elderly and the most rapidly growing cause of death in the last 20 years in Chile. Cognitive complaint is considered a predictor for cognitive and functional decline (FD), incident mild cognitive impairment, and incident dementia. The GERO cohort aims to determine multidimensional risks factors associated with the prognosis of elderly with cognitive complaint on DF. Method: The GERO cohort is a prospective cohort study of community‐dwelling elderly with cognitive complaint, without dementia, aged 70 or older living in 4 municipalities 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. Neuroimaging, blood, and stool samples were also obtained. FD was measured by the Pfeffer (score range 0‐33), Technology Activities of Daily Living Questionnaire (T‐ADLQ, score range 0‐100), and Everyday Cognition (ECOG, score range 0‐36) questionnaires. Result: A total of 17,759 households were successfully approached, identifying 2,533 eligible subjects, accepting to participate 299 (59 men; 240 women). The mean age was 76.8±5.1, 25% older than 79. The average years of schooling was 8.9± 4.8. None of participants showed underweight. The average score for the Mini‐mental State Exam (MMSE) was 27.1± 2.4, with 5.3% of the sample scoring less than 23. The mean values for Pfeffer, T‐ADLQ, and ECOG were 0.8±1.3, were 11.9± 10.3, and 0.4±0.4 respectively. In the multivariate analysis MMSE was inversely correlated with the ECOG score (regression coefficient: ‐0.03 [95%CI ‐0.07; ‐0.002]. Pfeffer also was associated, but its statistical significance was lost after the multivariate adjustment. Conclusion: Few other studies addressed cognitive complaint and functionality in elderly recruited at home. Elderly in the GERO‐cohort with cognitive complaint, without dementia, show a good level of functioning at the first assessment. Cognitive function measured by the MMSE seems to be associated to a subtle decline in general functioning as everyday cognition. Future multidimensional and prospective analysis of this cohort could bring more information about this association. [ABSTRACT FROM AUTHOR]

Background: Dementia is one of the mean causes of disability in elderly. Peripheral inflammatory biomarkers and ApoE‐ε4 allele have been described as important biological risk factors of dementia in Caucasian population. Currently, there is scarce information about the specific age‐related and predisposition factors to develop dementia in Latino populations. The aim of this study is to investigate these biological risks factors in Chilean elderly with healthy and pathological brain ageing. Method: We evaluated and quantified plasma samples obtained from the GERO cohort (114 elderly subjects, >70 years, classified in 51 subjects with subjective cognitive complaint (SCC) and 63 with mild cognitive impairment (MCI)), in addition to 36 healthy brain controls (HBC) and 31 subjects with Alzheimer's disease dementia (ADD). Genotyping of ApoE gene was analyzed by qPCR. We analyzed inflammatory biomarkers using Luminex technique including IL‐2, IL‐6, IL‐10, TNF‐α, CRP and SAP proteins. All subjects receive a clinical and neuropsychological assessment. Result: CRP protein was found significant decrease expression in SCC and ADD groups compared to MCI and HBC (p=0.048). In SAP protein was found a significant decrease in expression in the SSC (p=0.04) and MCI (p=0.0178) groups compared to HBC. It was observed a positive correlation in the SCC, MCI and ADD groups with the IL‐6 and TNFα, and, SAP and CRP. A negative correlation between IL‐2, IL‐6 and IL‐10 cytokines was found with Direct Span Digit test, which assess attentional capacity. Also was identified a negative correlation between SAP protein and the Free and Cued Selective Reminding Test (FCSRT), which assess verbal episodic memory, and IL‐10 cytokine and Montreal Cognitive Assessment (MoCA), which assess global cognition. Finally, a positive correlation was found in CRP protein with Pfeffer Functional Activity Questionnaire. Frequency of the ApoE‐ε4 allele, was significantly higher in ADD (52%) and SCC (27%) patients than controls and MCI (p=1x10‐4). Conclusion: The results shown correlations between the different inflammatory proteins and performance in neuropsychological test suggesting that inflammatory biomarkers are associated with pathological brain ageing. The correlations in SCC and MCI are not being reported previously. Additionally, the frequency of ApoE‐ε4 allele in ADD group is higher than worldwide populations. [ABSTRACT FROM AUTHOR]

Background: Cognitive assessments able to detect impairments as early as neuropathological changes that occur in neurodegenerative diseases initiate are urgently needed. The Visual Short‐Term Memory Binding Test (VSTMBT) and the Free and Cued Selective Reminding Test (FCRST) have been recently recommended by the Neurodegenerative Diseases Working Group (Costa et al., 2017) as promising preclinical markers of AD. They have never been used before to assess elderlies with cognitive complain recruited from the community. Method: A total of 271 subjects (37 healthy controls (HC), 112 subjective cognitive complain (SCC), 96 mild cognitive impairment (MCI) and 26 Alzheimer's disease dementia (ADD)), recruited from Geroscience Center for Brain Health and Metabolism (GERO) Cohort and the Memory and Neuropsychiatric Clinic (CMYN), underwent assessment with the VSTMBT and the Visual Version of the FCRST (FCRST‐Visual). Two memory loads were used for the VSTMBT (low and high). The ability of these tests to discriminate between groups. Result: Significant differences were found between HC, MCI and ADD using the VSTMBT and the FCRST‐Visual version. Notably, the STMB was the only test that "marginally" differentiated between HC from SCC (p = 0.055). Moreover, whereas the FCRST‐Visual showed a gradient (HC = SCC) > MCI > AD, the VSTMBT's gradient was HC > (SCC = MCI = ADD) suggesting that the function assessed by the latter test may be sensitive to the very early stages of the disease dropping to levels that cannot decline further. Conclusion: Our results suggest that the VSTMBT and FCSRT are sensitive to the early stages of dementia. Whereas the former detects changes in the early subjective stages, the latter is more sensitive to later objective stages of cognitive decline. The latter but not the former could help monitor disease progression. These results raise important questions about the usefulness of cognitive screening tools to detect and monitor disease progression and to separate normal and abnormal ageing trajectories. We propose the need of cognitive assessments that detect subtle differences as early as neuropathological changes occur in the brain, which will lead to the development of new "cognitive biomarkers" for dementia. [ABSTRACT FROM AUTHOR]