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Dementia is a significant decline in cognition that interfere with independent, daily functioning. Dementia is a syndrome caused by a myriad and include primary neurologic, neuropsychiatric, and medical conditions. It has been projected that the prevalence of dementia will triple in the elderly population by the year 2050. Despite the benefits of early diagnosis, there is an effective under-detection of around 62% of people with mild cognitive impairment (MCI) or dementia. One of the factors associated with this problem is that diagnostic techniques are affected by the educational level of those evaluated. This is an important aspect to consider in the use of brief cognitive tests for the detection of dementia. This review presents and critically analyzes the available evidence regarding the effect of educational level on the diagnostic utility of three of the most widely used tools in the clinical setting: the Mini-mental Test Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Addenbrooke's Cognitive Examination (ACE). Previous evidence shows that the tasks that require reading, writing, calculation, phonological fluency, and visuoconstruction are affected by educational level. These results lead to discourage the use of these tests in older people with less than 6 years of schooling. The development of brief cognitive tests appropriate for people with a low educational level is recommended. We posit that adequate cognitive tests should not consider tasks or items that resemble characteristics of academic contexts and should be more analogous to daily activities situations.

Background: The COVID-19 pandemic has had a great impact on cognitive health in Latin American older adults, increasing the risk of cognitive impairment and dementia. Our objective was to analyze the prevalence of dementia and the associated factors in Latin American older adults during SARS-CoV-2 pandemic. Methods: A multicentric first phase cross-sectional observational study was conducted during the SARS-CoV-2 pandemic. Five thousand two hundred and forty-five Latin American adults over 60 years of age were studied in 10 countries: Argentina, Bolivia, Chile, Colombia, Ecuador, Guatemala, Mexico, Peru, the Dominican Republic, and Venezuela. We used the telephone version of Montreal Cognitive Assessment, the “Alzheimer Disease 8” scale for functional and cognitive changes, and the abbreviated version of the Yesavage depression scale. We also asked for sociodemographic and lockdown data. All the evaluation was made by telephone. Cross-tabulations and χ2 tests were used to determine the variability of the prevalence of impairment by sociodemographic characteristics and binary logistic regression to assess the association between dementia and sociodemographic factors. Results: We observed that the prevalence of dementia in Latin America is 15.6%, varying depending on the country (Argentine = 7.83 and Bolivia = 28.5%). The variables most associated with dementia were race and age. It does not seem to be associated with the pandemic but with social and socio-health factors. Conclusion: The prevalence of dementia shows a significant increase in Latin America, attributable to a constellation of ethnic, demographic, and socioeconomic factors.

No existen instrumentos de evaluación cognitiva libres de sesgo educacional, para pesquisar funciones ejecutivas en personas mayores con bajo nivel educativo. Frente a esto, nos propusimos diseñar un nuevo test ejecutivo libre de escolaridad (TELE) para estas personas. Se llevó a cabo un estudio no experimental, transversal e instrumental, en una muestra compuesta por un total de 90 participantes, de nacionalidad chilena, de los cuales, 74 fueron personas mayores cognitivamente sanas (grupo control) y 16 con diagnóstico de trastorno neurocognitivo mayor leve (TNCM). Utilizamos el Addenbrook’s Cognitive Assessment III (ACE III) y el Trail Making Tests (TMT) parte A y B, como pruebas cognitivas de comparación y la escala Activities of Daily Living Questionnaire (T-ADLQ) para evaluar el deterioro funcional. Posteriormente, un evaluador ciego a los resultados de estas pruebas y al diagnóstico de los participantes, aplicó el TELE. Se establecieron tres grupos de comparación, control cognitivamente sano de baja escolaridad (2 a 8 años), escolaridad media (9 a 12 años) y un grupo clínico con diagnóstico de TNCM. Utilizando la prueba ANOVA con post hoc de Tukey, se encontró que a diferencia de TMT y ACE III, TELE total y TELE tiempo, no presentó diferencias significativas entre los grupos controles de distinto nivel de escolaridad, pero si con el grupo TNCM. TELE tiempo y total, mostraron correlación positiva de nivel moderado a alto con TMT y ACE III y correlación negativa con T-ADLQ. De todos los test cognitivos aplicados, solo TELE no fue afectado por los años de escolaridad, según lo reportado por el análisis de covarianza ANCOVA (TELE total: p=.570, TELE tiempo: p=.273). Conclusión: TELE es un test para FE capaz de diferenciar personas mayores cognitivamente sanas de personas mayores con trastorno neurocognitivo mayor leve, cuenta con validez convergente y no se encuentra afectado por los años de escolaridad.

Functional impairment (FI) relates to the condition of executive functions (EFs). While EFs become affected by age and educational level (EL). Seniors suffering from depression (SSDs) on the other hand show EF-related deficiencies; however, there is hardly any literature available regarding their relationship with FI in Latin SSDs, who usually have low ELs.To verify the relationship between EFs and FI in SSDs of Latin origins, by controlling the effects associated with age and educational level.Cross-sectional study, of cases and controls, conducted on a nonprobability sample, made up of 102 self-sufficient SSDs and 142 control subjects over age 50, monolinguals of Latin origin (Chileans), all assessed by means of a battery of assessments such as: Geriatric Depression Scale, Addenbrook's Cognitive Assessment III, Trail making Tests A and B, STROOP word-color test, and semantic and phonological verbal fluency tests. A domain of composite EFs was established with standardized Chilean population scores, where age and educational levels were controlled. A simple linear regression analysis was conducted to determine the relationship between EFs and FI in SSDs.Upon controlling age and educational levels, EFs explained an FI variance of 3.9% in SSDs; depression explained an EF variance of 3.2%, and 3.7% of FI.The results of the present study highlight the importance of a timely intervention when it comes to geriatric depression, considering the negative effect it has over the executive functions and the functionality of seniors.

Fibromyalgia (FMS) is a chronic condition that encompasses widespread pain associated with cognitive impairment and significant emotional distress related to functional disability that affects mainly women. However, the mechanisms underlying the origin of the cognitive impairments and how the current COVID-19 pandemic impacts remain elusive. This study aimed to determine whether there is an association between cognitive performance in executive functions, physical pain, and psychological distress caused by the pandemic in a group of Chilean women with FMS using a novel online protocol of neuropsychological evaluation. We found that women with FMS present cognitive impairment predominantly explained by pain and anxiety symptoms, which are associated with the difficulties experienced from the COVID-19 pandemic. These results point out the importance of considering a broader perspective for treatment, including anxiety symptoms and the psychological distress caused by the pandemic as a therapeutic target for cognitive impairments.

The COVID-19 pandemic has shown the need for neuropsychological care for older adults with memory complaints in different contexts, including rural areas or areas with difficult access.This study aimed to analyze the clinical utility of the Phototest, through telemedicine, to identify mild cognitive impairment in rural older adults with memory complaints, during the COVID-19 pandemic.We performed a cross-sectional, case-control, and clinical utility comparison of brief cognitive tests (BCTs). The sample included 111 rural elderly people with mild cognitive impairment (MCI) and 130 healthy controls from the Los Lagos region, Chile. The instruments adopted were modified Mini-Mental State Examination (MMSEm) and adapted version of the Phototest (PT) for Chile.To identify mild cognitive impairment, using a cutoff score of 27-28 points, the Phototest showed a sensitivity of 96.6% and a specificity of 81.8%; indicators superior to those of the MMSEm.The Phototest is more accurate than the MMSEm in identifying cognitive alterations in rural older adults with cognitive memory complaints through telemedicine. Therefore, its use in primary care is recommended in order to perform early detection of preclinical cognitive alterations in mild cognitive impairment or neurodegenerative diseases.A pandemia de COVID-19 mostrou a necessidade de cuidados neuropsicológicos para adultos idosos com queixas de memória em diferentes contextos, incluindo áreas rurais ou áreas de difícil acesso.Analisar a utilidade clínica do Phototest, por meio da telemedicina, para identificar uma leve deficiência cognitiva em adultos idosos rurais com queixas de memória, durante a pandemia de COVID-19.Realizamos uma comparação transversal, caso-controle e utilidade clínica dos testes cognitivos breves. Amostra: Cento e onze idosos rurais com deficiência cognitiva leve (DCL) e 130 controles saudáveis da região de Los Lagos, Chile. Instrumentos: Minimental modificado (MMSEm) e versão do teste fotográfico (PT) adaptada para o Chile.Para identificar a DCL, usando pontuação de corte de 27-28 pontos, o Phototest mostrou sensibilidade de 96,6% e especificidade de 81,8%; indicadores superiores aos do MMSEm.O Phototest é mais preciso que o MMSEm para identificar, por meio da telemedicina, alterações cognitivas em adultos idosos rurais com queixas de memória cognitiva. Sendo assim, seu uso na atenção primária é recomendado para realizar a detecção precoce de alterações cognitivas pré-clínicas em DCL ou doenças neurodegenerativas.

Introducción La detección de síntomas de ansiedad entre el personal sanitario que atiende a pacientes contagiados de COVID-19 es una prioridad actual. Se requieren instrumentos rápidos y válidos para esta población. El objetivo es establecer la validez de constructo y la confiabilidad de la Escala de Ansiedad Generalizada (GAD-7) en médicos colombianos durante la cuarentena por la COVID-19. Métodos Estudio eSalud, en el que se recopilaron datos transversales en línea (n = 1.030) de 610 médicos de COVID y 420 no de COVID durante la cuarentena colombiana, entre el 20 de abril y el 10 de agosto de 2020. Se contactó con cada sujeto, que confirmó participación, identidad y función profesional. Resultados Se encontró una estructura factorial de 1 solo factor, conformado por los 7 ítems del instrumento, que logró explicar el 70% de la varianza. Los índices de bondad de ajuste (RMSEA = 0,080; CFI = 0,995; SRMR = 0,053; p 0,07. Por último, la consistencia interna del instrumento fue buena, con alfa de Cronbach = 0,920 (IC95%, 8,80-9,71). Conclusiones El GAD-7 es un instrumento que presenta indicadores adecuados de validez y confiabilidad. Es un excelente instrumento, confiable, fácil y rápido de usar para la detección de los síntomas de ansiedad generalizada en personal médico, atienda o no a pacientes contagiados de COVID-19.

Introduction Epilepsy is a chronic neurological disorder that may occur alongside cognitive changes, with effects on multiple cognitive domains. Objective To compare the cognitive performance of patients with epilepsy and healthy controls through Montreal Cognitive Assessment (MoCA) during outpatient consultation at a reference diagnostic center in Colombia and analyze and the influencing factors. Materials and methodology One-hundred and four patients during neurology outpatient consultation in the city of Cartagena, Colombia, were assessed with the (MoCA) test, i.e., 54 people who consulted for headache and have not been diagnosed with epilepsy (NEP) and 50 with a diagnosis of epilepsy (EPs) according to the diagnostic criteria of the International League Against Epilepsy (ILAE). Results Significant differences were found in the total mean scores of the (MoCA) between (EPs) and (NPE) groups (t = 4.72; p

In Latin America, the volume of care of infected patients, higher presence of comorbidities among older adults, and restricted access to clinical controls have become this age group into one with the highest risk (Dubey etal , 2020) [ ]a Consortium of universities, research centers, and clinical centers have joined forces to carry out research which seeks to know the emotional state of Latin American older adults during confinement by Coronavirus disease (COVID-19) The protocol we used includes a sociodemographic and clinical questionnaire, information on confinement, lifestyles, and the abbreviated version of the Yesavage Geriatric Depression Scale (Martinez de la Iglesia etal , 2020)