Biomarkers.

Background: Dementia, encompassing Alzheimer's disease (AD) and frontotemporal dementia (FTD), poses a substantial public health challenge in Latin America. Barriers such as a shortage of healthcare professionals, limited medical accessibility, and underdiagnosis contribute to the complexity. While biomarkers aligned with the ATN framework (Amyloid, Tau, Neurodegeneration) have revolutionized diagnosis, their cost limits adoption in Latin America.

Biomarkers.

Background: Normative models (NM) of brain metrics based on large, diverse populations offer novel strategies to detect individual brain abnormalities. To create an age-dependent statistical model of brain microstructure over the human lifespan, we built the largest multi-site NM of white matter (WM) diffusion tensor imaging (DTI) metrics based on 54,591 subjects. We used state-of-the-art tools to adjust for site-dependent effects.

Public Health.

Background: Poor sleep is associated with cognitive decline, and ∼45% of Alzheimer's disease (AD) patients experience sleep disturbances. Emerging evidence suggests that reduced non-rapid eye movement (NREM) slow wave sleep (SWS) is linked to amyloid accumulation and APOE ε4-related genetic vulnerability to AD. Here, we investigate the effects of amyloid and APOE status on SWS, and their interaction, in a cohort of cognitively unimpaired (CU) individuals at higher risk of AD.

Public Health.

Background: Latino adults face a 1.5-to-2-fold increased risk of ADRDs compared to non-Hispanic whites. Sleep disturbances among Latinos have been linked with worse neurocognitive function and a higher risk for ADRD.

Public Health.

Background: It is known that cardiometabolic diseases are related to Alzheimer´s Disease.

Method: We included 23 residents of Jalisco with at least one first-degree relative with ADAD (ADADG). We rated the participants using the Clinical Dementia Rating (CDR) as CDR = 0 (n = 20, 87%), CDR = 0.

Public Health.

Background: Lifestyle interventions targeting multiple Alzheimer's disease (AD) risk factors are effective strategies to prevent cognitive decline. Emerging evidence suggests synergistic effects between various intervention components, including lifestyle modifications, supplements, and pharmacological approaches. The PENSA study, part of the World-Wide FINGERs network, is a randomized, double-blind clinical trial following the Finger 2.

Continuous endoscopic manual suturing for colorectal anastomotic fistula closure.

A 54-year-old male underwent a low anterior resection in 2015 for rectal adenocarcinoma. He presented to the emergency department with a two-week history of fever, perianal pain, an erythematous, warm, and actively draining mass. Physical examination revealed a perianal abscess in the left posterior gluteal region, with a palpable internal fistulous orifice 3 cm from the anal margin.

Ischemic cholangiopathy secondary to endoscopic treatment of bleeding duodenal ulcer.

Case report of a patient with a duodenal ulcer, initially treated with sclerosing agents, as is common practice for most bleeding ulcers. However, the evolution following this treatment is unusual. The patient developed secondary ischemic cholangitis, leading to extensive aerobilia and secondary portal pneumatosis, accompanied by inflammatory changes in the head of the pancreas.

Leiomyosarcoma of the colon. An uncommon condition.

The gastrointestinal leiomyosarcoma is a rare tumor of the colon that arises from the smooth muscle cells of the intestinal wall. It is a very aggressive tumor with a poor prognosis.

Utility of cellular indices in abdominal pain of probable surgical etiology in pediatrics.

Abdominal pain is one of the leading causes of consultation in pediatrics, accounting for up to 10% of emergency department visits. The patient's age, medical history, and physical examination are critical in diagnosing and differentiating between surgical, non-surgical, and extra-abdominal etiologies. However, this distinction can be challenging, leading to diagnostic delays with therapeutic and prognostic implications.

Public Health.

Background: Household crowding is a longstanding focus of public health research; there is growing interest in its impact on dementia risk. In the US, household crowding is prevalent among low-income immigrant communities that have historically been excluded from dementia research. We evaluated the relationship between household crowding and neurocognitive performance among a novel cohort of middle-aged and primarily immigrant Latinas living in an underserved agricultural community and whether mental health or sleep duration might serve as potential mechanisms.

Public Health.

Background: Assessing knowledge of dementia prevention from both the individual (patients) and the structural level (health professionals) in the same settings is vital to implementing dementia risk reduction programs. However, most studies have only focused on one level. Thus, this was the aim of our study.

Public Health.

Background: Dementia has sparked interest in identifying modifiable risk factors. It has been proposed that the number of teeth could play a crucial role in cognitive decline, suggesting possible mechanisms such as nutritional influence, inflammation, and neuronal feedback.

Methods: We performed a systematic literature search in January 2024 in PubMed, Scopus and Embase to search observational studies that reported the association between number of teeth and dementia or cognitive decline.

Public Health.

Background: Although ethnic and cultural aspects can influence health behaviors, no studies have compared views about dementia and brain health between Indigenous and non-Indigenous people living in the same territory. Therefore, we contrasted beliefs and knowledge about dementia risk reduction between Indigenous (Mapuche) and non-Indigenous older adults in Chile.

Method: An exploratory qualitative study was conducted with people 60 years and older, self-identified as Mapuche ('people of the land') or non-Mapuche, with no dementia.

Public Health.

Background: International collaboration is crucial to the future of research in dementia with Lewy bodies (DLB). Although it is hoped that a single global DLB cohort can be created through combination of data from the many longitudinal studies conducted internationally, a high likelihood of phenotypic heterogeneity may prohibit harmonisation and analysis of datasets. Our primary objective is to determine whether significant heterogeneity is observed in the sociodemographic and clinical characteristics of people with DLB globally.

Public Health.

Background: Approximately 35-40% of new patients at memory clinics are cognitively intact individuals concerned about their dementia risk. The demand for personalized risk profiling and preventive strategies for those at higher dementia risk is in need of innovative infrastructures. However, disclosing dementia risk estimates raises concerns about potential negative emotional impacts.

Public Health.

Background: Cardiovascular risk factors (CVRF) are among the main modifiable risk factors for dementia in Latin America (LA). Therefore, improving cardiovascular health (CVH) is one of the main objectives of the LatAm-FINGERS trial, the largest non-pharmacological (lifestyle improvement) randomized trial in LA. But, to fully comprehend CVH it is necessary to explore its relation with the social determinants of health (SDH), that are closely associated with lifestyle.

Public Health.

Background: The prevalence of dementia in Peru's northern regions is poorly documented, largely due to the scarcity of studies employing validated assessment tools for the elderly. Notably, this area is marked by pronounced disparities, encompassing a wide range of socioeconomic statuses and predominantly low educational attainment. The confluence of risk factors, including educational and socioeconomic deprivation, prevalent diseases, suboptimal health conditions, chronic stress, and lifelong malnutrition, poses a significant risk of escalating dementia cases over the next two decades.

Public Health.

Background: Adhering to lifestyle-based multimodal interventions to prevent cognitive decline is crucial for their success, but limited evidence exists on determinants of adherence. This gap may stem from inconsistent adherence measurement and reporting across studies. Additionally, uncertainties persist regarding the optimal intervention intensity needed for meaningful cognitive benefits.

Public Health.

Background: In Chile, the cases of cognitive impairment and dementia are on the rise and are expected to triple by 2050. Additionally, older adults face life changes that may contribute to depression onset. We studied the relationship between cognitive impairment (CI), functional decline (FD) and depression with the risk of all-cause and cardiovascular event mortality in the Chilean population aged ≥60 years.

Public Health.

Background: Cognitive resilience research in African Americans (AA) shows that higher educational attainment (EA) can mitigate the impact of Alzheimer disease pathology (ADP). However, this mitigating effect is less pronounced in APOEε4 carriers. This finding suggests a disparity in resilience influenced by an interplay of educational and genetic factors.

Biomarkers.

Background: Deep learning models based on convolutional neural networks (CNNs) have been used to classify Alzheimer's disease or infer dementia severity from T1-weighted brain MRI. Here we tested the added value of incorporating information from 3D diffusion-weighted MRI - a technique sensitive to microstructural differences - alongside traditional 3D T1-weighted images. We evaluated our classifier's performance on cohorts from India and North America.

Biomarkers.

Background: Amyloid-β (Aβ) pathology affects resting state functional connectivity (RSFC), even in cognitively unimpaired (CU) individuals. However, the impact of such an aberrant RSFC on cognitive decline is yet to be determined. Moreover, most prior research focused on fibrillary Aβ deposition to predict RSFC, while early Aβ dysmetabolism as reflected by cerebrospinal fluid (CSF) concentrations has received less attention.

Biomarkers.

Background: Alzheimer's disease (AD) is a complex neurodegenerative disorder characterized by early changes in brain structure and cognitive function before the age of onset. This study investigated whether the genetic load for clinical AD and AD pathology predicts AD-related brain and cognitive changes over a 3-year period, targeting the preclinical phase in cognitively unimpaired (CU) middle-aged individuals.

Method: The sample of the study was defined by 429 CU middle-aged participants at risk of AD from the ALFA+ nested cohort with available information on genetics, brain imaging markers and cognitive data [Table 1].

Biomarkers.

Background: Subjective cognitive decline (SCD), or a person's perception of changes in their cognitive abilities, has been identified as a possible early marker of preclinical Alzheimer's disease (AD) in non-Hispanic Whites; however, research is lacking about the clinical utility of SCD in diverse populations. This study investigated the associations of self and informant reports of SCD, plasma biomarker profiles of AD, and objective cognitive performance in Hispanic older adults living in Miami.

Method: Hispanic participants enrolled in the 1Florida Alzheimer's Disease Research Center who completed neuropsychological testing and blood draws for biomarker analysis were eligible.