Title
Dementia in Latin America: Paving the way toward a regional action plan
Date Issued
01 February 2021
Access level
open access
Resource Type
journal article
Author(s)
Parra M.A.
Baez S.
Sedeño L.
Gonzalez Campo C.
Santamaría-García H.
Aprahamian I.
Bertolucci P.H.F.
Bustin J.
Camargos Bicalho M.A.
Cano-Gutierrez C.
Caramelli P.
Chaves M.L.F.
Cogram P.
Beber B.C.
Court F.A.
de Souza L.C.
Damian A.
de la Cruz M.
Diehl Rodriguez R.
Brucki S.M.D.
Fajersztajn L.
Farías G.A.
De Felice F.G.
Ferrari R.
de Oliveira F.F.
Ferreira S.T.
Ferretti C.
Figueredo Balthazar M.L.
Ferreira Frota N.A.
Fuentes P.
García A.M.
de Gobbi Porto F.H.
Duque Peñailillo L.
Engler H.W.
Maier I.
Mata I.F.
Gonzalez-Billault C.
Lopez O.L.
Morelli L.
Nitrini R.
Quiroz Y.T.
Guerrero Barragan A.
Huepe D.
Pio F.J.
Suemoto C.K.
Kochhann R.
Kochen S.
Kumfor F.
Lanata S.
Miller B.
Mansur L.L.
Hosogi M.L.
Lillo P.
Llibre Guerra J.
Lopera F.
Comas A.
Avila-Funes J.A.
Sosa A.L.
Ramos C.
Resende E.d.P.F.
Snyder H.M.
Tarnanas I.
Yokoyama J.
Llibre J.
Cardona J.F.
Possin K.
Kosik K.S.
Moguilner S.
Solis P.C.L.
Ferretti-Rebustini R.E.d.L.
Ramirez J.M.
Matallana D.
Mbakile-Mahlanza L.
Marques Ton A.M.
Tavares R.M.
Miotto E.C.
Muniz-Terrera G.
Muñoz-Nevárez L.A.
Orozco D.
Okada de Oliveira M.
Piguet O.
Pintado Caipa M.
Piña Escudero S.D.
Schilling L.P.
Rodrigues Palmeira A.L.
Yassuda M.S.
Santacruz-Escudero J.M.
Serafim R.B.
Smid J.
Slachevsky A.
Serrano C.
Takada L.T.
Grinberg L.T.
Teixeira A.L.
Barbosa M.T.
Publisher(s)
John Wiley and Sons Inc.
Abstract
Across Latin American and Caribbean countries (LACs), the fight against dementia faces pressing challenges, such as heterogeneity, diversity, political instability, and socioeconomic disparities. These can be addressed more effectively in a collaborative setting that fosters open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking, and translational research) and align them to current global strategies to translate regional knowledge into transformative actions. Then we characterize key sources of complexity (genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions), map them to the above challenges, and provide the basic mosaics of knowledge toward a KtAF. Finally, we describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF. Validation of this framework in hubs of the LAC‐CD that can provide the level of evidence required by the Amyloid + Tau + Neurodegeneration (A/T/N) framework. These protocols, which have been preliminarily tested in LACs, can be easily implemented in institutions hosting the required infrastructure, where validation of these novel approaches against canonical biomarkers can be undertaken. LAC‐CD has currently implemented an ongoing survey, which aims to characterize the biomarker landscape in LAC. This will pave the way to future strategies of the LAC‐BF. Through this process, these protocols will continue to be refined to reflect appropriate approaches for biomarker use (Challenges: access and coverage, cost of biomarkers). Strengthening LAC‐CD partnership with the Alzheimer's Association and the National Institute of Health/National Institute on Aging (NIH/NIA) toward the validation of the LAC‐BF. The combination of these stakeholders, as well as local leadership, will help address shortage of local funds and also expand available networks. One example is the Multi‐partner Consortium to Expand Dementia Research in Latin America (ReDLat), supported by the Alzheimer's Association, the NIH/NIA, the Tau Consortium, and the GBHI. This platform aims to identify the genetic and socioeconomic/SDH risks of dementia (the cohort involves >4000 participants from LACs and a US team). It will also provide access to blood biomarkers and is already supporting local parallel grant applications in Argentina, Chile, Colombia, Brazil, Peru, and Mexico. Available initiatives from NIA/NIH in the region can be synergistically connected with other available multinational stakeholders (ie, Horizon 2020, Newton UK‐Latin American programs). For instance, the Newton funds program has developed bilateral opportunities to address social priorities for LACs (Brazil, Chile, Colombia, Mexico, and Peru). Collaboration with the NIA/NIH, the Alzheimer's Association, and the GBHI in a global context will be key to validate and disseminate the LAC‐BF (Challenges: access and coverage, cost of biomarkers). Introduction of complementary affordable biomarkers based on cognitive assessment, eye‐tracking, noninvasive peripheral markers (ie,plasma markers such as AB‐42, ptau1, , and so on), and multimodal neuroimaging (eg, EEG, MRI, fMRI, DTI), combined with machine‐ and deep‐learning algorithms. In a second stage, newly validated tools and technical knowledge will be made freely available via online platforms (eg, LAC‐CD website, local institutions) (Challenges: access and coverage, cost of biomarkers). LAC‐BF will help identify new causal mechanisms and improve our understanding of the relationship between genotypes, clinical phenotypes, and the severity of neurodegeneration via ongoing and forthcoming initiatives (eg, DIAN Latin America, ADNI, RedLat). (Challenge: complexity of causal mechanisms). 80 107–109 The authors thank Laura Bleiler from the Alzheimer's Association (AA) for proofreading the article. The authors also thank the Inter‐American Development Bank (IDB) and the the MULTI‐PARTNER CONSORTIUM TO EXPAND DEMENTIA RESEARCH IN LATIN AMERICA [ReDLat, supported by National Institutes of Health, National Institutes of Aging (R01 AG057234), Alzheimer's Association (SG‐20‐725707), Tau Consortium, and Global Brain Health Institute] and the grant Alzheimer's Association GBHI ALZ UK‐20‐639295. The contents of this publication are solely the responsibility of the authors and do not represent the official views of these institutions.
Start page
295
End page
313
Volume
17
Issue
2
Language
English
OCDE Knowledge area
Neurología clínica Psiquiatría
Scopus EID
2-s2.0-85095422362
PubMed ID
Source
Alzheimer's and Dementia
ISSN of the container
15525260
Sponsor(s)
The Expert Meeting was supported by Alzheimer's Society UK grants awarded to MP in collaboration with AI (AS‐R42303, AS‐SF‐14‐008). AS is supported by CONICYT / FONDAP /15150012; Conicyt/ Fondecyt Regular/ 1140423 and Basal Funds for Centers of Excellence, Project FB 0003 from the Associative Research Program of CONICYT. FL is supported by a grant API COLOMBIA funded by GENENTECH and Banner Institute. FK is supported by a National Health and Medical Research Council of Australia (NHMRC)‐Australian Research Council Dementia Research Development Fellowship (APP1097026). OP is supported by an NHMRC Senior Research Fellowship (APP1103258). FFDO is supported by FAPESP ‐ The State of São Paulo Research Foundation (grant #2015/10109‐5). The support from Alzheimer´s Scotland Dementia Research and the Centre for Cognitive Ageing and Cognitive Epidemiology part of the cross council Lifelong Health and Wellbeing Initiative (MR/K026992/1) both from the University of Edinburgh is also acknowledged. FS is supported by Geroscience Center for Brain Health and Metabolism (FONDAP‐15150012) and Fondo Nacional de Desarrollo Científico y Tecnológico (FONDECYT, No. 1150766). RAV is supported by CONICYT AFB 170008 and by Faculty of Sciences, University of Chile, PAIFAC grant. PC is supported by CNPq, Brazil (bolsa de produtividade em pesquisa). PL is supported by FONDAP Program Grant 15150012 & by Conicyt/Fondecyt Regular/ 1160940. STF is supported by National Institute for Translational Neuroscience (Brazil, Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq/Brazil) and Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ/Brazil). BCB is supported by Alzheimer's Association and Global Brain Health Institute (GBHI_ALZ‐18‐542347). LTG is supported by NIH K24AG053435. MLFC is supported by CNPq (bolsa de produtividade em pesquisa). RDR is supported by FAPESP (2016/24326‐0) and the Alzheimer´s Association (AARF‐18‐566005). LD is partially supported by Neuromedicenter. RF is supported by Alzheimer's Society (grant # 284). LCS is supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq/Brazil). MSY is supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq/Brazil) and São Paulo Research Foundation (FAPESP/BRAZIL). MACB is supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq/Brazil) and Minas Gerais Research Foundation (FAPEMIG/BRAZIL). IA receives National public grant level 2 from the National Council for Scientific and Technological Development (Ministry of Science, Technology, Innovation and Communications, Brazil). HMS is a full‐time employee of the Alzheimer's Association. AI is partially supported by grants from CONICET, FONCyT‐PICT 2017‐1818, FONCyT‐PICT 2017‐1820, FONDAP 15150012, the Interamerican Development Bank (IDB), Alzheimer's Association GBHI ALZ UK‐20‐639295, and the MULTI‐PARTNER CONSORTIUM TO EXPAND DEMENTIA RESEARCH IN LATIN AMERICA [ReDLat, supported by National Institutes of Health, National Institute on Aging (R01 AG057234), Alzheimer's Association (SG‐20‐725707), Tau Consortium, and Global Brain Health Institute)]. The contents of this publication are solely the responsibility of the authors and do not represent the official views of these Institutions. The other authors declare no conflict of interests.
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