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Gustafson D, Kalaria R, O'Brien J, van den Brink H, Hilal S, Marseglia A, ter Telgte A, Skoog I. VasCog 2023: 20 years of research on vascular behavioural and cognitive disorders. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2024; 6:100224. [PMID: 38868624 PMCID: PMC11167242 DOI: 10.1016/j.cccb.2024.100224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 05/03/2024] [Indexed: 06/14/2024]
Abstract
This Commentary describes the 20th Anniversary of VasCog 2023, held in Gothenburg, Sweden.
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Affiliation(s)
- D.R. Gustafson
- Department of Neurology, State University of New York Downstate Health Sciences University, MSC 1213, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - R. Kalaria
- Translational and Clinical Research Institute, Newcastle University, United Kingdom
| | - J. O'Brien
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, United Kingdom
| | - H. van den Brink
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - S. Hilal
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - A. Marseglia
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - A. ter Telgte
- VASCage – Center on Clinical Stroke Research, Innsbruck, Austria
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - I. Skoog
- Center for Ageing and Health, Institute for Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Yalley S, Essuman A, Adjei P, Lawlor B, Romero-Ortuno R. Age-friendly initiatives - GHANA. J Nutr Health Aging 2024; 28:100246. [PMID: 38669857 DOI: 10.1016/j.jnha.2024.100246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024]
Abstract
The global increase in the population of older persons has profound inter-sectoral implications, necessitating the development of age-friendly initiatives at the global and national levels. While progress has been relatively slower across Sub-Saharan African countries, highlighting existing commendable initiatives is essential to identify the current gaps and promote the development of strategies and interventions to promote age-friendly societies. This mini-review highlights some of the key initiatives in Ghana in the areas of policy, healthcare, finance, social services, education and research and in promoting dementia-friendly communities.
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Affiliation(s)
- Sally Yalley
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland; Alzheimer's and Related Disorders Association of Ghana, Tema, Ghana.
| | - Akye Essuman
- University of Health and Allied Sciences, Ho, Ghana; Ghana College of Physicians and Surgeons, Accra, Ghana
| | - Patrick Adjei
- University of Ghana Medical School, Accra, Ghana; Korle Bu Teaching Hospital, Accra, Ghana
| | - Brian Lawlor
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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Mfene XP, Pillay BJ. Screening for dementia and associated factors in older adults from low socioeconomic communities in iLembe, KwaZulu-Natal. Health SA 2024; 29:2437. [PMID: 38726059 PMCID: PMC11079343 DOI: 10.4102/hsag.v29i0.2437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/31/2023] [Indexed: 05/12/2024] Open
Abstract
Background Dementia is one of the leading non-communicable causes of disability and mortality in older adults, with recent research showing that it is increasing in low-middle-income countries compared to high-income countries. As such, multidisciplinary efforts are needed to effectively reduce the prevalence and risk of dementia through quick screening, diagnosis, and management of those with dementia and those at risk. Aim The study's objectives were to estimate the prevalence of dementia and measure the sociodemographic and clinical risks in older adults in low socioeconomic communities. Setting The study was conducted among older adults aged ≥ 60 years from the iLembe district in South Africa. Methods This cross-sectional, one-phased, household study was conducted to screen for dementia over 8 months between October 2018 and October 2019. Demographic and clinical data were collected using a semi-structured questionnaire. In addition, the Mini-Mental Status Exam, Ascertain Dementia Eight-item questionnaire and Instrumental Activities of Daily Living Scale were administered to a multi-stage cluster sample of 320 participants to ascertain dementia prevalence. Frequencies and multivariate logistic regression were conducted to determine risk factors correlated with dementia. Results The prevalence of dementia was 13.4%. Participants aged 80 years and above were 2.73 times more likely to develop dementia than participants younger than 80 years. Those with an education level of Grade 1-7 had a 69% less chance of developing dementia than those without formal education. Single participants showed an almost seven-fold increase in dementia. Lastly, depression increased the risk of dementia by two-fold. Conclusion Dementia was probable in over one-sixth of the sample. Dementia risk factors were both modifiable and non-modifiable. Contribution Dementia prevalence in South Africa is increasing and therefore it is crucial to develop a dementia plan that is specific to the South African context which will include strategies for early identification of the disease, reducing modifiable risks and strategic management of dementia associated medical conditions such as depression and vascular diseases.
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Affiliation(s)
- Xoli P Mfene
- Department of Psychology, Faculty of Applied Human Sciences, University of KwaZulu Natal, Pietermaritzburg, South Africa
| | - Basil J Pillay
- Department of Behavioural Medicine, Faculty of Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa
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Nwamekang Belinga L, Espourteille J, Wepnyu Njamnshi Y, Zafack Zeukang A, Rouaud O, Kongnyu Njamnshi A, Allali G, Richetin K. Circulating Biomarkers for Alzheimer's Disease: Unlocking the Diagnostic Potential in Low- and Middle-Income Countries, Focusing on Africa. NEURODEGENER DIS 2024:1-15. [PMID: 38555638 DOI: 10.1159/000538623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/28/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is emerging as a significant public health challenge in Africa, with predictions indicating a tripling in incidence by 2050. The diagnosis of AD on the African continent is notably difficult, leading to late detection that severely limits treatment options and significantly impacts the quality of life for patients and their families. SUMMARY This review focuses on the potential of high-sensitivity specific blood biomarkers as promising tools for improving AD diagnosis and management globally, particularly in Africa. These advances are particularly pertinent in the continent, where access to medical and technical resources is often limited. KEY MESSAGES Identifying precise, sensitive, and specific blood biomarkers could contribute to the biological characterization and management of AD in Africa. Such advances promise to improve patient care and pave the way for new regional opportunities in pharmaceutical research and drug trials on the continent for AD.
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Affiliation(s)
- Luc Nwamekang Belinga
- Department of Psychiatry, Center for Psychiatric Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Jeanne Espourteille
- Department of Psychiatry, Center for Psychiatric Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Yembe Wepnyu Njamnshi
- Department of Translational Neuroscience, Brain Research Africa Initiative (BRAIN), Geneva, Switzerland
| | - Ariole Zafack Zeukang
- Department of Translational Neuroscience, Brain Research Africa Initiative (BRAIN), Geneva, Switzerland
| | - Olivier Rouaud
- Leenaards Memory Center, Department of Clinical Neurosciences, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Alfred Kongnyu Njamnshi
- Department of Translational Neuroscience, Brain Research Africa Initiative (BRAIN), Geneva, Switzerland
| | - Gilles Allali
- Leenaards Memory Center, Department of Clinical Neurosciences, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Kevin Richetin
- Department of Psychiatry, Center for Psychiatric Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
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Musyimi CW, Ndetei DM, Muyela LA, Masila J, Farina N. Dementia Screening in Rural Kenya: The Prevalence and Impact of Screening Positive for Dementia. Neuroepidemiology 2024; 58:174-181. [PMID: 38479366 DOI: 10.1159/000536012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/14/2023] [Indexed: 06/06/2024] Open
Abstract
INTRODUCTION In Kenya, there is a lack of data on the number of people with dementia. In this article, we aim to estimate the number of community-dwelling older adults (aged 60 years and above) that are potentially living with dementia in rural Kenya. METHODS Recruitment of older adults occurred through adopting a convenience approach based on the catchment areas served by ten trained community health workers. Screening was conducted using the Brief Community Screening Instrument for Dementia (CSI-D), in which prevalence ratios were reported. Regression analyses were run to understand the association between screening outcome and wellbeing, social isolation, and employment status (adjusted for age, sex, literacy, geography, and social status). RESULTS Of the 3,546 older adults who were screened for dementia, 652 screened positive (PR = 0.18, 95% CIs: 0.17-0.20). Back estimating screen positives based on established sensitivity and specificity of the tool against a gold standard (clinical diagnosis), yielded a prevalence of 9.4% (0.09, 95% CIs: 0.08-0.11). Screening positive for dementia was associated with poorer quality of life (B = -0.17, p < 0.001) and loneliness (B = 0.28, p < 0.001). CONCLUSION There are potentially 258,000 older adults living with dementia in Kenya, who likely have poorer outcomes. We need to encourage a timely diagnosis and develop better ways to support people living with dementia in Kenya and other resource-limited settings.
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Affiliation(s)
| | - David M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
- University of Nairobi, Nairobi, Kenya
| | - Levi A Muyela
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Joe Masila
- Makueni County Referral Hospital, Makueni, Kenya
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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Tawfik AA, Hamza SA, Adly NN, Abdel Kader RM. Pattern of cognitive impairment among community-dwelling elderly in Egypt and its relation to socioeconomic status. J Egypt Public Health Assoc 2024; 99:4. [PMID: 38326578 PMCID: PMC10850041 DOI: 10.1186/s42506-023-00147-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/18/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Cognitive decline is one of the aging health problems that strongly affects daily functioning and quality of life of older adults and threatens their independence. The aim of this study was to assess the prevalence and pattern of cognitive impairment (CI) among community-dwelling elderly in Egypt and the contribution of socioeconomic status to inequality in cognitive impairment. METHODS A cross-sectional study involved 470 community-dwelling elderly aged 60 years or older living in Kafr El-Sheikh Governorate, Egypt. Subjects were recruited from home visits, geriatric clubs, and outpatient clinics. The Montreal Cognitive Assessment tools (MoCA & MoCA-B) were used to assess the prevalence of cognitive impairment, Hachinski ischemic score (HIS) to investigate the type of cognitive impairment, Ain Shams Cognitive Assessment (ASCA) tool to assess the pattern of specific cognitive domain affection, and an Egyptian socioeconomic status (SES) scale to classify the SES of the study participants. RESULTS The prevalence of cognitive impairment was 50.2% distributed as 37.7% for mild cognitive impairment (MCI) and 12.5% for dementia. The most common type of cognitive impairment was the degenerative type (47.9%). Pattern of specific domain affection among cognitively impaired subjects ranged from 94% for visuospatial function to 12.7% for abstraction. Cognitive impairment was significantly higher with increasing age, female sex, marital status (single or widow), low education, higher number of comorbidities, and positive family history of cognitive impairment (p < 0.001). Also, cognitive impairment was concentrated mainly among participants with low socioeconomic score (p < 0.001). CONCLUSION In Egypt, cognitive impairment is significantly prevalent and concentrated among those who are in low socioeconomic status. Patients with mild CI were more than those with dementia, and the most common type of CI was the degenerative type. Increasing educational level of low SES population and improving their access to healthcare services are highly recommended to improve the inequity of cognitive impairment.
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Affiliation(s)
- Amany A Tawfik
- Department of Geriatrics and Gerontology, Faculty of Medicine, Helwan University, Cairo, Egypt.
| | - Sarah A Hamza
- Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nermien N Adly
- Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Radwa M Abdel Kader
- Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Oyinlola O, Mahmoud K, Adeoti AB, Abiodun AA. COVID-19: Experiences of Social Workers Supporting Older Adults With Dementia in Nigeria. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241239844. [PMID: 38500245 PMCID: PMC10949545 DOI: 10.1177/00469580241239844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/05/2024] [Accepted: 02/28/2024] [Indexed: 03/20/2024]
Abstract
Amidst the COVID-19 pandemic, numerous public health protocols were instituted by government agencies to safeguard individuals with dementia, their family caregivers, and formal care providers. While these preventive measures were implemented with good intentions, they inadvertently imposed significant challenges on medical social workers in Nigeria. This paper explored the experiences of medical social workers caring for people with dementia during the COVID-19 pandemic in Nigeria. Twenty-six medical social workers from 6 government hospitals in Southwestern Nigeria participated in an in-depth interview. The research reveals 3 pivotal aspects: Firstly, the escalating demands within the work environment, where medical social workers grapple with the intricate task of conveying sensitive information about dementia diagnosis and COVID-19 prevention protocol, managing expectations regarding dementia diagnoses, and navigating resource constraints for individuals with dementia during the pandemic. Secondly, discernible impacts on the work climate and interprofessional relationships shed light on the challenges these professionals face in collaborating with other healthcare providers. Lastly, the reverberations on social workers' personal lives underscore the pandemic's toll on their well-being. Thus, the findings underscore the need for proactive measures to equip medical social workers to face the distinctive challenges in dementia care during future pandemics. Recognizing the potential resurgence of global health crises, the research highlights the need for strategic preparedness to mitigate the impact of future pandemics on the well-being of individuals with dementia and the professionals dedicated to their care.
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Affiliation(s)
- Oluwagbemiga Oyinlola
- School of Social Work, McGill University, Montreal, QC, Canada
- Medical Social Services Department, University College Hospital, Ibadan, Oyo, Nigeria
| | - Kafayat Mahmoud
- Center for Innovation in Social Science, Boston University, Boston, MA, USA
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Wogu E, Filima P, Caron B, Levitas D, Herholz P, Leal C, Mehboob MF, Hayashi S, Akintoye S, Ogoh G, Godwin T, Eke D, Pestilli F. A labeled Clinical-MRI dataset of Nigerian brains. ARXIV 2023:arXiv:2311.04425v1. [PMID: 37986723 PMCID: PMC10659454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
We describe a Magnetic Resonance Imaging (MRI) dataset from individuals from the African nation of Nigeria. The dataset contains pseudonymized structural MRI (T1w, T2w, FLAIR) data of clinical quality. Dataset contains data from 36 images from healthy control subjects, 32 images from individuals diagnosed with age-related dementia and 20 from individuals with Parkinson's disease. There is currently a paucity of data from the African continent. Given the potential for Africa to contribute to the global neuroscience community, this first MRI dataset represents both an opportunity and benchmark for future studies to share data from the African continent.
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Affiliation(s)
- Eberechi Wogu
- University of Port Harcourt, Choba, Rivers State, Nigeria
| | - Patrick Filima
- University of Port Harcourt, Choba, Rivers State, Nigeria
| | | | | | | | | | | | | | | | - George Ogoh
- Center for Computing and Social Responsibility, De Montfort University, UK
| | - Tawe Godwin
- Lifebridge medical diagnostic Center, Garki 2, Abuja Nigeria
| | - Damian Eke
- Center for Law, Justice and Society, De Montfort University, UK
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Kihumuro RB, Kellen P, Chun S, Wakida EK, Obua C, Ainamani HE. Cognitive impairment and the associated factors among women with a history of pregnancy complications in rural southwestern Uganda. PLoS One 2023; 18:e0293258. [PMID: 37906567 PMCID: PMC10617700 DOI: 10.1371/journal.pone.0293258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/09/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Worldwide, there is a growing concern about the rising number of people with declining cognitive functioning. However, findings on this phenomenon are inconclusive. Our study aimed to assess the prevalence of cognitive impairment and the associated factors in women with a history of pregnancy complications in rural southwestern Uganda. METHODS This was a cross-sectional study carried out among women above 40 years of age in the greater Kabale district of southwestern Uganda between March and April 2022. Study participants were identified using a consecutive sampling method. Predictor variables included pregnancy complications and other social demographic factors that were assessed by semi-structured interviews while cognitive functioning as an outcome variable was assessed by Montreal Cognitive Assessment (MoCA-B) tool. Data were analyzed using STATA at a 95% Confidence level. Logistic regression analyses were selected for statistical modelling while odds ratios were calculated to assess the strength of associations between the predictor and outcome variables. RESULTS In total, 75% (212/280) of participants had some form of cognitive impairment, with 45% (123/280) falling into mild CI, 31% (86/280) moderate CI and 4% (10/280) severe CI. Twenty-three percent (68/280) of participants fell into category of normal cognitive functioning. Participants with >65 years of age had higher odds of developing cognitive impairment (OR = 2.94; 95%CI: 0.96-9.04, p = 0.06) than those with < 65 years of age. Protective factors to cognitive impairment include delivering from a health facility (OR = 0.31,95% CI:0.16-0.60, p = < .001), primary and post primary levels of education (OR = 0.05; 95% CI: 0.02-0.13, p<0.001, OR = 0.04; 95%CI: 0.02-0.23, p<0.001) respectively. CONCLUSION Results from this study show a high prevalence of cognitive impairment among women with a history of pregnancy complications in rural southwestern Uganda. Interventions geared toward preventing cognitive impairment among females with a history of pregnancy complications should be emphasized.
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Affiliation(s)
| | - Peace Kellen
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
- Office of Research Administration, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Sarah Chun
- Department of Medicine, California University of Science and Medicine, Northridge, California, United States of America
| | - Edith K. Wakida
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
- Office of Research Administration, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Medicine, California University of Science and Medicine, Northridge, California, United States of America
- California University of Science and Medicine, Northridge, California, United States of America
| | - Celestino Obua
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Pharmacology and Therapeutic, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Herbert E. Ainamani
- Department of Mental Health, Kabale University School of Medicine, Kabale, Uganda
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Doumatey AP, Bentley AR, Akinyemi R, Olanrewaju TO, Adeyemo A, Rotimi C. Genes, environment, and African ancestry in cardiometabolic disorders. Trends Endocrinol Metab 2023; 34:601-621. [PMID: 37598069 PMCID: PMC10548552 DOI: 10.1016/j.tem.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/21/2023]
Abstract
The past two decades have been characterized by a substantial global increase in cardiometabolic diseases, but the prevalence and incidence of these diseases and related traits differ across populations. African ancestry populations are among the most affected yet least included in research. Populations of African descent manifest significant genetic and environmental diversity and this under-representation is a missed opportunity for discovery and could exacerbate existing health disparities and curtail equitable implementation of precision medicine. Here, we discuss cardiometabolic diseases and traits in the context of African descent populations, including both genetic and environmental contributors and emphasizing novel discoveries. We also review new initiatives to include more individuals of African descent in genomics to address current gaps in the field.
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Affiliation(s)
- Ayo P Doumatey
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Rufus Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training and Centre for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria; Department of Neurology, University College Hospital, Ibadan, Nigeria
| | - Timothy O Olanrewaju
- Division of Nephrology, Department of Medicine, University of Ilorin & University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Charles Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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Britton GB, Huang L, Villarreal AE, Levey A, Philippakis A, Hu C, Yang CC, Mushi D, Oviedo DC, Rangel G, Ho JS, Thompson L, Khemakhem M, Ross M, Carreira MB, Kim N, Joung P, Albastaki O, Kuo PC, Low S, Paddick S, Kuan Y, Au R. Digital phenotyping: An equal opportunity approach to reducing disparities in Alzheimer's disease and related dementia research. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12495. [PMID: 38034851 PMCID: PMC10687344 DOI: 10.1002/dad2.12495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 07/12/2023] [Accepted: 09/25/2023] [Indexed: 12/02/2023]
Abstract
A rapidly aging world population is fueling a concomitant increase in Alzheimer's disease (AD) and related dementias (ADRD). Scientific inquiry, however, has largely focused on White populations in Australia, the European Union, and North America. As such, there is an incomplete understanding of AD in other populations. In this perspective, we describe research efforts and challenges of cohort studies from three regions of the world: Central America, East Africa, and East Asia. These cohorts are engaging with the Davos Alzheimer's Collaborative (DAC), a global partnership that brings together cohorts from around the world to advance understanding of AD. Each cohort is poised to leverage the widespread use of mobile devices to integrate digital phenotyping into current methodologies and mitigate the lack of representativeness in AD research of racial and ethnic minorities across the globe. In addition to methods that these three cohorts are already using, DAC has developed a digital phenotyping protocol that can collect ADRD-related data remotely via smartphone and/or in clinic via a tablet to generate a common data elements digital dataset that can be harmonized with additional clinical and molecular data being collected at each cohort site and when combined across cohorts and made accessible can provide a global data resource that is more racially/ethnically represented of the world population.
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Affiliation(s)
- Gabrielle B. Britton
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP)Panamá CityPanama
- Universidad Santa María La Antigua, Vía Ricardo J. AlfaroPanamá CityPanama
| | - Li‐Kai Huang
- Taipei Medical University Shuang‐Ho HospitalTaipeiTaiwan
| | - Alcibiades E. Villarreal
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP)Panamá CityPanama
| | - Allan Levey
- Emory University School of MedicineAtlantaGeorgiaUSA
| | - Anthony Philippakis
- Broad Institute at Massachusetts Institute of Technology and Harvard UniversityCambridgeMassachusettsUSA
| | - Chaur‐Jong Hu
- Taipei Medical University Shuang‐Ho HospitalTaipeiTaiwan
| | | | - Declare Mushi
- Kilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Diana C. Oviedo
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP)Panamá CityPanama
- Universidad Santa María La Antigua, Vía Ricardo J. AlfaroPanamá CityPanama
| | - Giselle Rangel
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP)Panamá CityPanama
| | - Jor Sam Ho
- Davos Alzheimer's CollaborativeWaynePennsylvaniaUSA
- Boston University School of Public HealthBostonMassachusettsUSA
| | - Louisa Thompson
- Davos Alzheimer's CollaborativeWaynePennsylvaniaUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | | | - Makayla Ross
- Davos Alzheimer's CollaborativeWaynePennsylvaniaUSA
- Boston University School of Public HealthBostonMassachusettsUSA
| | - María B. Carreira
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP)Panamá CityPanama
| | - Nicole Kim
- Davos Alzheimer's CollaborativeWaynePennsylvaniaUSA
| | - Philip Joung
- Davos Alzheimer's CollaborativeWaynePennsylvaniaUSA
| | | | - Po Chih Kuo
- National Tsing Hua University, East DistrictHsinChuTaiwan
| | - Spencer Low
- Davos Alzheimer's CollaborativeWaynePennsylvaniaUSA
- Boston University School of Public HealthBostonMassachusettsUSA
- Boston University Chobanian and Avedisian School of MedicineBostonMassachusettsUSA
- Boston University Alzheimer's Disease CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | | | - Yi‐Chun Kuan
- Taipei Medical University Shuang‐Ho HospitalTaipeiTaiwan
| | - Rhoda Au
- Davos Alzheimer's CollaborativeWaynePennsylvaniaUSA
- Boston University School of Public HealthBostonMassachusettsUSA
- Boston University Chobanian and Avedisian School of MedicineBostonMassachusettsUSA
- Boston University Alzheimer's Disease CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- The Framingham Heart StudyBoston University Chobanian & Avedisian School of Medicine, Boston University School of Public HealthFraminghamMassachusettsUSA
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Naheed A, Hakim M, Islam MS, Islam MB, Tang EY, Prodhan AA, Amin MR, Stephan BC, Mohammad QD. Prevalence of dementia among older age people and variation across different sociodemographic characteristics: a cross-sectional study in Bangladesh. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 17:100257. [PMID: 37849932 PMCID: PMC10577143 DOI: 10.1016/j.lansea.2023.100257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 04/06/2023] [Accepted: 07/19/2023] [Indexed: 10/19/2023]
Abstract
Background Dementia is a significant global health issue, particularly for low-income and middle-income countries which majorly contribute to the dementia cases reported globally (67%). We estimated the prevalence of dementia among older people in Bangladesh and compared the estimate across different sociodemographic characteristics and divisions. Methods A cross-sectional study was conducted in 2019 among individuals aged 60 years or older in seven administrative divisions in Bangladesh. Equal numbers of male and female participants were recruited from each division through a multi-stage random sampling technique. Recruitment was proportionally distributed in urban and rural areas in each division. Following consent, the Mini Mental State Examination (MMSE) was performed on all participants. Dementia was defined as an MMSE score of <24 out of 30. Data on age, sex, education, marital status, occupation, socioeconomic status, and type of community (urban or rural) were obtained using a structured questionnaire to compare the prevalence of dementia across different sociodemographic characteristics. Findings Between January and December 2019, 2795 individuals were recruited including ∼400 from each of the seven administrative divisions. The mean age was 67 years (SD: 7), 68% were from rural areas and 51% were female. The prevalence of dementia was 8.0% (95% CI: 7.0-8.9%) with variations across age, sex, education, marital status, occupation, and division. No variations in prevalence were observed across urban/rural locations or socioeconomic status. After adjusting for age, sex, education, occupation and marital status, the odds of dementia was two times higher in females than males (OR: 2.15, 95% CI: 1.43-3.28); nine times higher in people aged ≥90 years than people aged 60-69 years (OR: 9.62, 95% CI: 4.79-19.13), and three times higher in people with no education compared to those who had completed primary school (OR: 3.10, 95% CI: 1.95-5.17). Interpretations The prevalence of dementia is high in Bangladesh and varies across sociodemographic characteristics with a higher prevalence among females, older people, and people with no education. There is an urgent need to identify the key risk factors for dementia in developing countries, such as Bangladesh, to inform the development of context-relevant risk reduction and prevention strategies. Funding None.
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Affiliation(s)
- Aliya Naheed
- Initiative for Non Communicable Diseases, Health Systems and Population Studies Division, icddr,b, Mohakhali, Dhaka, 1000, Bangladesh
| | - Maliha Hakim
- National Institute of Neurosciences & Hospital, Dhaka, 1207, Bangladesh
| | - Md Saimul Islam
- Initiative for Non Communicable Diseases, Health Systems and Population Studies Division, icddr,b, Mohakhali, Dhaka, 1000, Bangladesh
| | - Md Badrul Islam
- Laboratory Science and Services Division, icddr,b, Mohakhali, Dhaka, 1000, Bangladesh
| | | | - Abdul Alim Prodhan
- Non Communicable Disease Control Program, Directorate General of Health Services, Dhaka, 1212, Bangladesh
| | - Mohammad Robed Amin
- Non Communicable Disease Control Program, Directorate General of Health Services, Dhaka, 1212, Bangladesh
- Department of Medicine, Dhaka Medical College and Hospital, Dhaka, 1000, Bangladesh
| | - Blossom C.M. Stephan
- Institute of Mental Health, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Dementia Centre of Excellence, Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
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14
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Kantawala B, Zahra N, Oseili T, Jawad A, Ouardouz S, Nazir A, Wojtara M, Uwishema O. Dementia challenges in Africa: Journeying through forgetfulness. Health Sci Rep 2023; 6:e1561. [PMID: 37701353 PMCID: PMC10494639 DOI: 10.1002/hsr2.1561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 08/25/2023] [Indexed: 09/14/2023] Open
Affiliation(s)
- Burhan Kantawala
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Faculty of General MedicineYerevan State Medical UniversityYerevanArmenia
| | - Najwa Zahra
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Faculty of MedicineBeirut Arab UniversityBeirutLebanon
| | - Taha Oseili
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Faculty of MedicineBeirut Arab UniversityBeirutLebanon
| | - Ali Jawad
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Faculty of MedicineDamascus UniversityDamascusSyria
| | - Souhail Ouardouz
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Faculty of Medicine and PharmacyCadi Ayyad UniversityMarrakechMorocco
| | - Abubakar Nazir
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Department of MedicineKing Edward Medical UniversityLahorePakistan
| | - Magda Wojtara
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Department of MedicineUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Olivier Uwishema
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Department of MedicineClinton Global Initiative UniversityNew YorkNew YorkUSA
- Faculty of MedicineKaradeniz Technical UniversityTrabzonTurkey
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15
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Ikanga J, Reyes A, Kaba D, Akilimali P, Mampunza S, Epenge E, Gikelekele G, Kavugho I, Tshengele N, Hammers DB, Alonso A. Prevalence of suspected dementia in a sample of adults living in Kinshasa-Democratic Republic of the Congo. Alzheimers Dement 2023; 19:3783-3793. [PMID: 36880714 PMCID: PMC10483015 DOI: 10.1002/alz.13003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 01/10/2023] [Accepted: 01/22/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND The prevalence of dementia in Sub-Saharan Africa, particularly in French-speaking countries, has received limited attention. This study investigates the prevalence and risk factors of suspected dementia in elderly adults in Kinshasa, Democratic Republic of the Congo (DRC). METHODS A community-based sample of 355 individuals over 65 years old was selected using multistage probability sampling in Kinshasa. Participants were screened using the Community Screening Instrument for Dementia, Alzheimer's Questionnaire, Geriatric Depression Scale, Beck Anxiety Inventory, and Individual Fragility Questionnaire, followed by clinical interview and neurological examination. Suspected dementia diagnoses were made based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria including significant cognitive and functional impairments. Prevalence and odds ratios (ORs) with 95% confidence interval (CI) were calculated using, respectively, regression and logistic regression. RESULTS Among 355 participants (mean age 74, SD = 7; 51% male), the crude prevalence of suspected dementia was 6.2% (9.0% in women and 3.8% in men). Female sex was a significant factor associated with suspected dementia [OR = 2.81, 95% CI (1.08-7.41)]. The prevalence of dementia increased with age (14.0% after 75 years and 23.1% after 85 years), with age being significantly associated with suspected dementia [OR = 5.42, 95% CI (2.86-10.28)]. Greater education was associated with a lower prevalence of suspected dementia [OR = 2.36, 95% CI (2.14-2.94), comparing those with ≥7.3 years of education to those with <7.3 years of education]. Other factors associated with the prevalence of suspected dementia included being widowed (OR = 1.66, 95% CI (1.05-2.61), being retired or semi-retired (OR = 3.25, 95% CI (1.50-7.03)], a diagnosis of anxiety [OR = 2.56, 95% CI (1.05-6.13)], and death of a spouse or a relative after age 65 [OR = 1.73, 95% CI (1.58-1.92)]. In contrast, depression [OR = 1.92, 95% CI (0.81-4.57)], hypertension [OR = 1.16, 95% CI (0.79-1.71)], body mass index (BMI) [OR = 1.06, 95% CI (0.40-2.79)], and alcohol consumption [OR = 0.83, 95% CI (0.19-3.58)] were not significantly associated with suspected dementia. CONCLUSIONS This study found a prevalence of suspected dementia in Kinshasa/DRC similar to other developing countries and Central African countries. Reported risk factors provide information to identify high-risk individuals and develop preventive strategies in this setting.
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Affiliation(s)
- Jean Ikanga
- Emory University School of Medicine, Department of Rehabilitation Medicine, Atlanta, Georgia, 30322, USA
- University of Kinshasa and Catholic University of Congo, School of Medicine, Kinshasa, Department of Psychiatry, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Anny Reyes
- Emory University School of Medicine, Department of Rehabilitation Medicine, Atlanta, Georgia, 30322, USA
| | - Didine Kaba
- University of Kinshasa, School of Public Health, Department of Epidemiology, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Pierre Akilimali
- University of Kinshasa, School of Public Health, Department of Epidemiology, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Samuel Mampunza
- University of Kinshasa and Catholic University of Congo, School of Medicine, Kinshasa, Department of Psychiatry, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Emmanuel Epenge
- University of Kinshasa, Department of neurology, Kinshasa, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Guy Gikelekele
- University of Kinshasa and Catholic University of Congo, School of Medicine, Kinshasa, Department of Psychiatry, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Immaculee Kavugho
- Memory clinic of Kinshasa, Kinshasa, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Nathan Tshengele
- University of Kinshasa and Catholic University of Congo, School of Medicine, Kinshasa, Department of Psychiatry, B.P. 7463 Kinshasa I, Democratic Republic of Congo
| | - Dustin B. Hammers
- Indiana university, Department of neurology, Indianapolis, IN 46202, USA
| | - Alvaro Alonso
- Emory University, Department of Epidemiology, Rollins School of Public Health, Atlanta, GA, 30307, USA
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16
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Tunde Aborode A, Jesutofunmi Idowu N, Tundealao S, Jaiyeola J, Constance Chinyere E, Charles Ogunleye S, Olorunshola M, Adedayo Emmanuel O. Integrative Precision Medicine for Dementia and Alzheimer's Diseases in Africa. AGING BRAIN 2023; 4:100095. [PMID: 38098965 PMCID: PMC10719563 DOI: 10.1016/j.nbas.2023.100095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 12/17/2023] Open
Affiliation(s)
| | | | - Samuel Tundealao
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Joseph Jaiyeola
- Department of Demography, College for Health, Community and Policy, University of Texas at San Antonio
| | | | - Seto Charles Ogunleye
- Comparative Biomedical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, 39760, MS, USA
| | - Mercy Olorunshola
- Department of Biological Sciences, State University of New York at Binghamton, NewYork, USA
| | - Ogunware Adedayo Emmanuel
- Department of Neuroscience, Developmental, and Regenerative Biology, University of Texas at San Antonio, USA
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17
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Ray NR, Kunkle BW, Hamilton-Nelson K, Kurup JT, Rajabli F, Cosacak MI, Kizil C, Jean-Francois M, Cuccaro M, Reyes-Dumeyer D, Cantwell L, Kuzma A, Vance JM, Gao S, Hendrie HC, Baiyewu O, Ogunniyi A, Akinyemi RO, Lee WP, Martin ER, Wang LS, Beecham GW, Bush WS, Farrer LA, Haines JL, Byrd GS, Schellenberg GD, Mayeux R, Pericak-Vance MA, Reitz C. Extended genome-wide association study employing the African Genome Resources Panel identifies novel susceptibility loci for Alzheimer's Disease in individuals of African ancestry. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.29.23294774. [PMID: 37693582 PMCID: PMC10491365 DOI: 10.1101/2023.08.29.23294774] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
INTRODUCTION Despite a two-fold increased risk, individuals of African ancestry have been significantly underrepresented in Alzheimer's Disease (AD) genomics efforts. METHODS GWAS of 2,903 AD cases and 6,265 cognitive controls of African ancestry. Within-dataset results were meta-analyzed, followed by gene-based and pathway analyses, and analysis of RNAseq and whole-genome sequencing data. RESULTS A novel AD risk locus was identified in MPDZ on chromosome 9p23 (rs141610415, MAF=.002, P =3.68×10 -9 ). Two additional novel common and nine novel rare loci approached genome-wide significance at P <9×10 -7 . Comparison of association and LD patterns between datasets with higher and lower degrees of African ancestry showed differential association patterns at chr12q23.2 ( ASCL1 ), suggesting that the association is modulated by regional origin of local African ancestry. DISCUSSION Increased sample sizes and sample sets from Africa covering as much African genetic diversity as possible will be critical to identify additional disease-associated loci and improve deconvolution of local genetic ancestry effects.
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18
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Llibre-Guerra JJ, Heavener A, Brucki SMD, Marante JPD, Pintado-Caipa M, Chen Y, Behrens MI, Hardi A, Admirall-Sanchez A, Akinyemi R, Alladi S, Dorsman KA, Rodriguez-Salgado AM, Solorzano J, Babulal GM. A call for clinical trial globalization in Alzheimer's disease and related dementia. Alzheimers Dement 2023; 19:3210-3221. [PMID: 36840622 PMCID: PMC10450094 DOI: 10.1002/alz.12995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND The burden of Alzheimer's disease and related dementia (ADRD) is projected to disproportionally impact low-middle-income countries (LMICs). However, there is a systematic under-representation of LMICs in ADRD clinical trial platforms. METHODS We aimed to determine the global distribution of ADRD clinical trials and identify existing barriers for conducting clinical trials in LMICs. Primary data sources to identify trial distribution in LMICs included ClinicalTrials.gov and the International Trials Registry Platform. An additional systematic review and expert consensus interviews were conducted to identify barriers for conducting clinical trials in LMICs. FINDINGS Among 1237 disease-modifying therapies tested in ADRD clinical trials, only 11.6% have been or are conducted in emerging economies (upper-middle income [9.6%] and low-middle income [2.0%]). We identified several limitations for trial implementation including a lack of financial resources, low industry presence, regulatory obstacles, and operational barriers INTERPRETATION: Although LMICs bear the greatest burden of ADRD globally, substantial development of clinical trial platforms to address this inequity and health disparity is lacking.
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Affiliation(s)
- Jorge J Llibre-Guerra
- Department of Neurology, Washington University, School of Medicine, St. Louis, Missouri, USA
- Dominantly Inherited Alzheimer's Network Trial Unit, St. Louis, Missouri, USA
- Institute of Public Health, Washington University, St. Louis, Missouri, USA
| | - Anika Heavener
- Department of Global Health and Social Medicine, Harvard Medical School, St. Louis, Missouri, USA
| | - Sonia Maria Dozzi Brucki
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of Sao Paulo, São Paulo, Brazil
| | | | | | - Yaohua Chen
- Department of Geriatrics, Lille Neurosciences & Cognition, University of Lille, Lille, France
| | - María Isabel Behrens
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Independencia, Santiago, Chile
| | - Angela Hardi
- Becker Medical Library, Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - Rufus Akinyemi
- Centre for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Suvarna Alladi
- National Institute of Mental Health and Neuroscience, Bangalore, India
| | - Karen A Dorsman
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Joel Solorzano
- Department of Medicine, Hospital Antonio Luaces Iralola, Ciego de Avila, Cuba
| | - Ganesh M Babulal
- Department of Neurology, Washington University, School of Medicine, St. Louis, Missouri, USA
- Institute of Public Health, Washington University, St. Louis, Missouri, USA
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Department of Psychology, University of Johannesburg, Johannesburg, South Africa
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19
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Elahi FM, Alladi S, Black SE, Claassen JAHR, DeCarli C, Hughes TM, Moonen J, Pajewski NM, Price BR, Satizabal C, Shaaban CE, Silva NCBS, Snyder HM, Sveikata L, Williamson JD, Wolters FJ, Hainsworth AH. Clinical trials in vascular cognitive impairment following SPRINT-MIND: An international perspective. Cell Rep Med 2023; 4:101089. [PMID: 37343515 PMCID: PMC10314118 DOI: 10.1016/j.xcrm.2023.101089] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/19/2022] [Accepted: 05/24/2023] [Indexed: 06/23/2023]
Abstract
A large interventional trial, the Systolic Blood Pressure Intervention Trial sub-study termed Memory and Cognition in Decreased Hypertension (SPRINT-MIND), found reduced risk of cognitive impairment in older adults with intensive, relative to standard, blood-pressure-lowering targets (systolic BP < 120 vs. <140 mm Hg). In this perspective, we discuss key questions and make recommendations for clinical practice and for clinical trials, following SPRINT-MIND. Future trials should embody cognitive endpoints appropriate to the participant group, ideally with adaptive designs that ensure robust answers for cognitive and cardiovascular endpoints. Reliable data from diverse populations, including the oldest-old (age > 80 years), will maximize external validity and global implementation of trial findings. New biomarkers will improve phenotyping to stratify patients to optimal treatments. Currently no antihypertensive drug class stands out for dementia risk reduction. Multi-domain interventions, incorporating lifestyle change (exercise, diet) alongside medications, may maximize global impact. Given the low cost and wide availability of antihypertensive drugs, intensive BP reduction may be a cost-effective means to reduce dementia risk in diverse, aging populations worldwide.
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Affiliation(s)
- Fanny M Elahi
- Friedman Brain Institute, Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Suvarna Alladi
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka 560030, India
| | - Sandra E Black
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada
| | - Jurgen A H R Claassen
- Department of Geriatric Medicine and Donders Institute for Medical Neuroscience, Radboud University Medical Center, 6525 EN Nijmegen, the Netherlands
| | - Charles DeCarli
- Department of Neurology and Center for Neuroscience, University of California at Davis, Sacramento, CA 95817, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA
| | - Justine Moonen
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, the Netherlands
| | - Nicholas M Pajewski
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC 27154, USA
| | | | - Claudia Satizabal
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, Department of Population Health Sciences, UT Health San Antonio, San Antonio, TX 78229, USA
| | - C Elizabeth Shaaban
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Nárlon C B S Silva
- Djavad Mowafaghian Centre for Brain Health, Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Heather M Snyder
- Alzheimer's Association, 225 N Michigan Avenue, Chicago, IL 60603, USA
| | - Lukas Sveikata
- J.P. Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Genève, Switzerland; Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jeff D Williamson
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA; Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27154, USA
| | - Frank J Wolters
- Departments of Epidemiology and Radiology & Nuclear Medicine, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, the Netherlands
| | - Atticus H Hainsworth
- Neurology, St George's University Hospitals NHS Foundation Trust, London SW17 0QT, UK; Molecular and Clinical Sciences Research Institute, St George's University of London, London SW17 0RE, UK.
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20
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Reitz C, Pericak-Vance MA, Foroud T, Mayeux R. A global view of the genetic basis of Alzheimer disease. Nat Rev Neurol 2023; 19:261-277. [PMID: 37024647 PMCID: PMC10686263 DOI: 10.1038/s41582-023-00789-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 04/08/2023]
Abstract
The risk of Alzheimer disease (AD) increases with age, family history and informative genetic variants. Sadly, there is still no cure or means of prevention. As in other complex diseases, uncovering genetic causes of AD could identify underlying pathological mechanisms and lead to potential treatments. Rare, autosomal dominant forms of AD occur in middle age as a result of highly penetrant genetic mutations, but the most common form of AD occurs later in life. Large-scale, genome-wide analyses indicate that 70 or more genes or loci contribute to AD. One of the major factors limiting progress is that most genetic data have been obtained from non-Hispanic white individuals in Europe and North America, preventing the development of personalized approaches to AD in individuals of other ethnicities. Fortunately, emerging genetic data from other regions - including Africa, Asia, India and South America - are now providing information on the disease from a broader range of ethnicities. Here, we summarize the current knowledge on AD genetics in populations across the world. We predominantly focus on replicated genetic discoveries but also include studies in ethnic groups where replication might not be feasible. We attempt to identify gaps that need to be addressed to achieve a complete picture of the genetic and molecular factors that drive AD in individuals across the globe.
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Affiliation(s)
- Christiane Reitz
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Margaret A Pericak-Vance
- The John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
- The Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
- National Centralized Repository for Alzheimer's Disease and Related Dementias, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Richard Mayeux
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.
- The Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA.
- Department of Neurology, Columbia University, New York, NY, USA.
- Department of Epidemiology, Columbia University, New York, NY, USA.
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Musyimi CW, Muyela LA, Mutiso VN, Mutunga E, Ndetei DM. Understanding dementia care pathways for policy development and service planning in Kenya. DEMENTIA 2023:14713012231166743. [PMID: 37036049 DOI: 10.1177/14713012231166743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
BACKGROUND In Kenya, there is lack of evidence on existing dementia care pathways, with minimal or no presentation for dementia-related symptoms in health care settings. Understanding the services available for people with dementia as well as how communities access the services could offer a practical pattern for policy makers to identify strategies that encourage early detection, care and support for people with dementia and their families. OBJECTIVES To elucidate initial responses of individuals and their families to dementia and challenges encountered in help seeking through care pathways to inform dementia care-related policies and practice. METHODS The Strengthening Responses to dementia in Developing Countries (STRiDE) Kenya team adapted case vignettes (brief hypothetical stories meant to elicit responses on how the characters would behave) developed by the entire STRiDE team. A total of 29 stakeholders were then asked to provide feedback on the completed vignettes and summarize a common pathway to dementia care in Kenya while using the proposed case vignettes. FINDINGS We found four initial responses to dementia suspicion in Kenya where individuals:(i) Perceive symptoms as normal part of ageing, (ii) Consult a spiritual or traditional healer, (iii) Visit a private clinic or primary health care facilities, or (iv) No action taken. These were the first points within the care pathways which determined the care trajectory the person with dementia would follow. CONCLUSIONS Identification of dementia care pathways could form a basis for improving the way communities perceive dementia etiology and establish standard pathways to care whilst ensuring that some pathways do not further pose an impediment to care and treatment for dementia.
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Affiliation(s)
| | - Levi A Muyela
- 585760Africa Mental Health Research and Training Foundation, Kenya
| | | | | | - David M Ndetei
- 585760Africa Mental Health Research and Training Foundation, Kenya
- University of Nairobi, Kenya
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22
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Abondio P, Bruno F, Luiselli D. Apolipoprotein E (APOE) Haplotypes in Healthy Subjects from Worldwide Macroareas: A Population Genetics Perspective for Cardiovascular Disease, Neurodegeneration, and Dementia. Curr Issues Mol Biol 2023; 45:2817-2831. [PMID: 37185708 PMCID: PMC10137191 DOI: 10.3390/cimb45040184] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/22/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Human APOE is a 299-amino acid long protein expressed and secreted in several tissues and body districts, where it exerts different functions mainly related to lipid metabolism, with specific activities around cholesterol transport and absorption/elimination. It has three main isoforms, determined by the pair of mutations rs7412-C/T and rs429358-C/T, which gives rise to the functionally different APOE variants ε2, ε3, and ε4. These have a distinct impact on lipid metabolism and are differentially implicated in Alzheimer’s disease and neurodegeneration, cardiovascular disease, and dyslipidemia. A plethora of other single nucleotide variants along the sequence of the APOE gene have been studied in cohorts of affected individuals, where they also modulate the influence of the three main isoforms to determine the risk of developing the disease. However, no contextual analysis of gene-long haplotypes has been carried out so far, and never extensively in cohorts of healthy individuals from different worldwide populations. Leveraging a rich population genomics dataset, this study elucidates the distribution of APOE variants and haplotypes that are shared across populations and to specific macroareas, revealing a variety of risk-allele associations that distinguish specific ancestral backgrounds and can be leveraged for specific ancestry-informed screenings in medicine and public health.
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23
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Anazodo UC, Ng JJ, Ehiogu B, Obungoloch J, Fatade A, Mutsaerts HJMM, Secca MF, Diop M, Opadele A, Alexander DC, Dada MO, Ogbole G, Nunes R, Figueiredo P, Figini M, Aribisala B, Awojoyogbe BO, Aduluwa H, Sprenger C, Wagner R, Olakunle A, Romeo D, Sun Y, Fezeu F, Orunmuyi AT, Geethanath S, Gulani V, Nganga EC, Adeleke S, Ntobeuko N, Minja FJ, Webb AG, Asllani I, Dako F. A framework for advancing sustainable magnetic resonance imaging access in Africa. NMR IN BIOMEDICINE 2023; 36:e4846. [PMID: 36259628 DOI: 10.1002/nbm.4846] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
Magnetic resonance imaging (MRI) technology has profoundly transformed current healthcare systems globally, owing to advances in hardware and software research innovations. Despite these advances, MRI remains largely inaccessible to clinicians, patients, and researchers in low-resource areas, such as Africa. The rapidly growing burden of noncommunicable diseases in Africa underscores the importance of improving access to MRI equipment as well as training and research opportunities on the continent. The Consortium for Advancement of MRI Education and Research in Africa (CAMERA) is a network of African biomedical imaging experts and global partners, implementing novel strategies to advance MRI access and research in Africa. Upon its inception in 2019, CAMERA sets out to identify challenges to MRI usage and provide a framework for addressing MRI needs in the region. To this end, CAMERA conducted a needs assessment survey (NAS) and a series of symposia at international MRI society meetings over a 2-year period. The 68-question NAS was distributed to MRI users in Africa and was completed by 157 clinicians and scientists from across Sub-Saharan Africa (SSA). On average, the number of MRI scanners per million people remained at less than one, of which 39% were obsolete low-field systems but still in use to meet daily clinical needs. The feasibility of coupling stable energy supplies from various sources has contributed to the growing number of higher-field (1.5 T) MRI scanners in the region. However, these systems are underutilized, with only 8% of facilities reporting clinical scans of 15 or more patients per day, per scanner. The most frequently reported MRI scans were neurological and musculoskeletal. The CAMERA NAS combined with the World Health Organization and International Atomic Energy Agency data provides the most up-to-date data on MRI density in Africa and offers a unique insight into Africa's MRI needs. Reported gaps in training, maintenance, and research capacity indicate ongoing challenges in providing sustainable high-value MRI access in SSA. Findings from the NAS and focused discussions at international MRI society meetings provided the basis for the framework presented here for advancing MRI capacity in SSA. While these findings pertain to SSA, the framework provides a model for advancing imaging needs in other low-resource settings.
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Affiliation(s)
- Udunna C Anazodo
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Jinggang J Ng
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Boaz Ehiogu
- Lawson Health Research Institute, London, Ontario, Canada
| | | | | | - Henk J M M Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, The Netherlands
| | | | - Mamadou Diop
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Abayomi Opadele
- Molecular and Cellular Dynamics Research, Graduate School of Biomedical Science and Engineering, Hokkaido University, Hokkaido, Japan
| | | | - Michael O Dada
- Department of Physics, Federal University of Technology, Minna, Niger State, Nigeria
| | - Godwin Ogbole
- Department of Radiology, University College Hospital Ibadan, Ibadan, Nigeria
| | - Rita Nunes
- Department of Bioengineering, Instituto Superior, Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Patricia Figueiredo
- Department of Bioengineering, Instituto Superior, Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Matteo Figini
- Department of Computer Science, University College London, London, UK
| | | | - Bamidele O Awojoyogbe
- Department of Physics, Federal University of Technology, Minna, Niger State, Nigeria
| | | | - Christian Sprenger
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rachel Wagner
- Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Medical Biophysics, Western University, London, Ontario, Canada
| | | | - Dominic Romeo
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yusha Sun
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Francis Fezeu
- Neurosurgery & Neurology, BRAIN Global, Salisbury, Maryland, USA
| | - Akintunde T Orunmuyi
- Department of Nuclear Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Sairam Geethanath
- Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, USA
| | - Vikas Gulani
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Sola Adeleke
- Department of Oncology, Guy's & St Thomas' Hospital, London, UK
| | - Ntusi Ntobeuko
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Frank J Minja
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, USA
| | - Andrew G Webb
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Iris Asllani
- Department of Neuroscience, University of Sussex, Brighton, UK
- Department of Biomedical Engineering, Rochester Institute of Technology, Rochester, New York, USA
| | - Farouk Dako
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- RAD-AID International, Chevy Chase, Maryland, USA
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Chakraborty R, Kobayashi LC, Jock J, Wing C, Chen X, Phillips M, Berkman L, Kahn K, Kabudula CW, Rosenberg M. Child Support Grant expansion and cognitive function among women in rural South Africa: findings from a natural experiment in HAALSI cohort. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.02.18.23286130. [PMID: 36824712 PMCID: PMC9949209 DOI: 10.1101/2023.02.18.23286130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Cash transfers are a promising but understudied intervention that may protect cognitive function in adults by promoting their cognitive reserve. South Africa has a rapidly ageing population, however, less is known about the nature of association between cash transfers and cognitive function in this setting. We leveraged natural experiments from Child Support Grant (CSG) age-eligibility expansions to investigate the association between duration of CSG eligibility and cognitive function among biological mothers of child beneficiaries in South Africa. We analysed 2014/2015 baseline data from 944 women, aged 40 - 59 years with at least one CSG-eligible child, enrolled in the HAALSI cohort in Agincourt, South Africa. Duration of CSG eligibility for each mother was calculated based on the birth dates of all their children and the CSG age eligibility expansion years. Cognitive function was measured using a cognitive battery administered to the mothers at baseline interview. Linear regression was used to estimate the association between duration of CSG eligibility, dichotomized as low (≤10 years) and high (>10 years) eligibility, and cognitive function z-scores of the mothers. Our study finds that high duration of CSG eligibility, compared to low, was associated with higher cognitive function z-scores in the full sample [β: 0.15 SD; 95% CI: 0.04, 0.26; p-value = 0.01]. In mothers with one to four lifetime children, but not five or more, high duration of CSG eligibility, compared to low, was associated with higher cognitive function z-scores [β: 0.19 SD; 95% CI: 0.05, 0.34, p-value = 0.02]. Government cash transfers given to support raising children may confer substantial protective effect on cognitive function of mothers in their mid-life. Further studies are needed to understand how parity may influence this relationship. Our findings bring evidence to policymakers for designing income supplementation programmes to promote healthy cognitive ageing in low-income settings.
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Affiliation(s)
- Rishika Chakraborty
- Department of Environmental and Occupational Health, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, United States of America
| | - Lindsay C. Kobayashi
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Janet Jock
- O’Neill School of Public and Environmental Affairs, Indiana University-Bloomington, Bloomington, Indiana, United States of America
| | - Coady Wing
- O’Neill School of Public and Environmental Affairs, Indiana University-Bloomington, Bloomington, Indiana, United States of America
| | - Xiwei Chen
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, United States of America
| | - Meredith Phillips
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, United States of America
| | - Lisa Berkman
- Harvard Center for Population and Development Studies, Cambridge, Massachusetts, United States of America
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
| | - Chodziwadziwa Whiteson Kabudula
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Molly Rosenberg
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, United States of America
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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25
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Ayele BA, Ali S, Anbessie M, Zewde YZ, Yoseph S, Lee S, Valcour V, Miller B. The need for a tailored national dementia plan in Ethiopia: A call for action. Front Neurol 2023; 14:1126531. [PMID: 36925945 PMCID: PMC10011145 DOI: 10.3389/fneur.2023.1126531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 02/06/2023] [Indexed: 03/08/2023] Open
Abstract
Globally, a rapid demographic transition is occurring with a significant increment in the proportion of older individuals. For the first time in history, individuals aged 65 and above outnumber that of children under 5 years of age. In Ethiopia, the life expectancy has shown dramatic improvements in the past few decades and is expected to reach 74 years by mid-century. Older age is considered the most important non-modifiable risk factor for dementia. Likewise, other modifiable diseases such as infectious diseases, non-communicable diseases, particularly cardiovascular diseases, and traumatic brain injuries are associated with dementia. Despite, the high prevalence of dementia risk factors and impending economic and health impact from dementia, no country in the sub-Saharan Africa (SSA), including Ethiopia, has developed a standalone or an integrated national dementia strategic plan to guide the overall effort to improve dementia care in the country. It is vital to design and develop a national dementia plan in line with a framework outlined by the 2017 World Health Organization (WHO) global action plan. The health, social, and economic burden from dementia is expected to be high to the developing countries such as Ethiopia unless clear prevention and management strategies are designed at a national level to cascade the care to the primary care level. The planned strategic policy may focus on improving the knowledge and skills of health care professionals. Translation and cultural adaptation of cognitive, functional, and behavioral assessment batteries is of paramount importance in improving the diagnostic accuracy along with availability of advanced imaging, biomarkers, and dementia treatment.
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Affiliation(s)
- Biniyam A Ayele
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Department of Neurology, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Seid Ali
- Department of Neurology, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mohammed Anbessie
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
| | - Yared Z Zewde
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Department of Neurology, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Selam Yoseph
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Department of Psychiatry, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Suzee Lee
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Victor Valcour
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Bruce Miller
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
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26
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Adewale BA, Coker MM, Ogunniyi A, Kalaria RN, Akinyemi RO. Biomarkers and Risk Assessment of Alzheimer's Disease in Low- and Middle-Income Countries. J Alzheimers Dis 2023; 95:1339-1349. [PMID: 37694361 DOI: 10.3233/jad-221030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Dementia is a chronic syndrome which is common among the elderly and is associated with significant morbidity and mortality for patients and their caregivers. Alzheimer's disease (AD), the most common form of clinical dementia, is biologically characterized by the deposition of amyloid-β plaques and neurofibrillary tangles in the brain. The onset of AD begins decades before manifestation of symptoms and clinical diagnosis, underlining the need to shift from clinical diagnosis of AD to a more objective diagnosis using biomarkers. Having performed a literature search of original articles and reviews on PubMed and Google Scholar, we present this review detailing the existing biomarkers and risk assessment tools for AD. The prevalence of dementia in low- and middle-income countries (LMICs) is predicted to increase over the next couple of years. Thus, we aimed to identify potential biomarkers that may be appropriate for use in LMICs, considering the following factors: sensitivity, specificity, invasiveness, and affordability of the biomarkers. We also explored risk assessment tools and the potential use of artificial intelligence/machine learning solutions for diagnosing, assessing risks, and monitoring the progression of AD in low-resource settings. Routine use of AD biomarkers has yet to gain sufficient ground in clinical settings. Therefore, clinical diagnosis of AD will remain the mainstay in LMICs for the foreseeable future. Efforts should be made towards the development of low-cost, easily administered risk assessment tools to identify individuals who are at risk of AD in the population. We recommend that stakeholders invest in education, research and development targeted towards effective risk assessment and management.
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Affiliation(s)
- Boluwatife Adeleye Adewale
- Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training (IAMRAT), College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Motunrayo Mojoyin Coker
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training (IAMRAT), College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adesola Ogunniyi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training (IAMRAT), College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Neurology, University College Hospital, Ibadan, Nigeria
| | - Rajesh N Kalaria
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training (IAMRAT), College of Medicine, University of Ibadan, Ibadan, Nigeria
- Translational and Clinical Research Institute, Newcastle University, United Kingdom
| | - Rufus Olusola Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training (IAMRAT), College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Neurology, University College Hospital, Ibadan, Nigeria
- Centre for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Translational and Clinical Research Institute, Newcastle University, United Kingdom
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27
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Akinyemi RO, Owolabi MO, Okubadejo N, Ogunniyi A, Kalaria RN. The African Dementia Consortium. Lancet Neurol 2023; 22:28-29. [PMID: 36517165 PMCID: PMC10022738 DOI: 10.1016/s1474-4422(22)00475-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/11/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Rufus O Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan 200212, Nigeria; Neurovascular Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
| | - Mayowa O Owolabi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan 200212, Nigeria
| | - Njideka Okubadejo
- Neurology Unit, Department of Medicine, University of Lagos, Lagos, Nigeria
| | - Adesola Ogunniyi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan 200212, Nigeria
| | - Raj N Kalaria
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan 200212, Nigeria; Neurovascular Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
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28
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Heng X, Liu X, Li N, Lin J, Zhou X. Spatial disparity and factors associated with dementia mortality: A cross-sectional study in Zhejiang Province, China. Front Public Health 2023; 11:1100960. [PMID: 37033083 PMCID: PMC10080143 DOI: 10.3389/fpubh.2023.1100960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/07/2023] [Indexed: 04/11/2023] Open
Abstract
Objective Evidence of spatial disparity in dementia mortality in China has been found to have higher dementia mortality in eastern and rural China. Regional factors of physical and social features may be influencing this spatial disparity. However, the extent of spatial difference in dementia mortality across small regional localities is unclear. This study aims to investigate the geographic variations in mortality and risk of all dementia subtypes and identify the effect of the associated environmental risk factors. Methods We used surveillance data on death reports from Alzheimer's disease and other forms of dementia in Zhejiang province from 2015 to 2019. We estimated the relative risk of dementia mortality using a Bayesian spatial model. We mapped predicted relative risk to visualize the risk of death from different types of dementia and to identify risk factors associated with dementia. Results Thirty thousand three hundred and ninety-eight deaths attributable to dementia as the underlying or related cause (multiple causes) were reported during 2015-2019. Counties and districts in the southeast and west of Zhejiang province had significantly higher standardized mortality ratios than others. Counties and districts with a smaller proportion of residents aged 60 years or older, poorer economic status, insufficient health resources, and worse pollution had a higher risk of deaths due to dementia. Conclusion Higher risks of dementia mortality were found in counties and districts with poorer economic status, insufficient health resources, and worse pollution in Zhejiang. Our study adds new evidence on the association between socioeconomic and environmental factors and the mortality risk due to dementia.
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Affiliation(s)
- Xiaotian Heng
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Xiaoting Liu
- School of Public Affairs, Zhejiang University, Hangzhou, China
| | - Na Li
- Department of Chronic Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- *Correspondence: Na Li,
| | - Jie Lin
- School of Public Affairs, Zhejiang University, Hangzhou, China
- Jie Lin,
| | - Xiaoyan Zhou
- Department of Chronic Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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29
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Abondio P, Bruno F, Bruni AC, Luiselli D. Rare Amyloid Precursor Protein Point Mutations Recapitulate Worldwide Migration and Admixture in Healthy Individuals: Implications for the Study of Neurodegeneration. Int J Mol Sci 2022; 23:ijms232415871. [PMID: 36555510 PMCID: PMC9781461 DOI: 10.3390/ijms232415871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/30/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
Genetic discoveries related to Alzheimer's disease and other dementias have been performed using either large cohorts of affected subjects or multiple individuals from the same pedigree, therefore disregarding mutations in the context of healthy groups. Moreover, a large portion of studies so far have been performed on individuals of European ancestry, with a remarkable lack of epidemiological and genomic data from underrepresented populations. In the present study, 70 single-point mutations on the APP gene in a publicly available genetic dataset that included 2504 healthy individuals from 26 populations were scanned, and their distribution was analyzed. Furthermore, after gametic phase reconstruction, a pairwise comparison of the segments surrounding the mutations was performed to reveal patterns of haplotype sharing that could point to specific cross-population and cross-ancestry admixture events. Eight mutations were detected in the worldwide dataset, with several of them being specific for a single individual, population, or macroarea. Patterns of segment sharing reflected recent historical events of migration and admixture possibly linked to colonization campaigns. These observations reveal the population dynamics of the considered APP mutations in worldwide human groups and support the development of ancestry-informed screening practices for the improvement of precision and personalized approaches to neurodegeneration and dementia.
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Affiliation(s)
- Paolo Abondio
- Laboratory of Ancient DNA, Department of Cultural Heritage, University of Bologna, Via degli Ariani 1, 48121 Ravenna, Italy
- Laboratory of Molecular Anthropology and Center for Genome Biology, Department of Biological, Geological and Environmental Sciences, University of Bologna, Via Selmi 3, 40126 Bologna, Italy
| | - Francesco Bruno
- Regional Neurogenetic Center (CRN), Department of Primary Care, ASP Catanzaro, 88046 Lamezia Terme, Italy
- Association for Neurogenetic Research (ARN), 88046 Lamezia Terme, Italy
- Correspondence:
| | - Amalia Cecilia Bruni
- Regional Neurogenetic Center (CRN), Department of Primary Care, ASP Catanzaro, 88046 Lamezia Terme, Italy
| | - Donata Luiselli
- Laboratory of Ancient DNA, Department of Cultural Heritage, University of Bologna, Via degli Ariani 1, 48121 Ravenna, Italy
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30
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Okubadejo NU, Okunoye O, Ojo OO, Arabambi B, Akinyemi RO, Osaigbovo GO, Abubakar SA, Iwuozo EU, Wahab KW, Agabi OP, Agulanna U, Imarhiagbe FA, Abiodun OV, Achoru CO, Adebowale AA, Adeniji O, Akpekpe JE, Ali MW, Ani-Osheku I, Arigbodi O, Balarabe SA, Bello AH, Ekenze OS, Erameh CO, Farombi TH, Fawale MB, Komolafe MA, Nwani PO, Nwazor EO, Nyandaiti Y, Obehighe EE, Obiabo YO, Odeniyi OA, Odiase FE, Ojini FI, Onwuegbuzie GA, Osemwegie N, Oshinaike OO, Otubogun FM, Oyakhire SI, Taiwo FT, Williams UE, Ozomma S, Zubair Y, Hernandez D, Bandres-Ciga S, Blauwendraat C, Singleton A, Houlden H, Hardy J, Rizig M. APOE E4 is associated with impaired self-declared cognition but not disease risk or age of onset in Nigerians with Parkinson's disease. NPJ Parkinsons Dis 2022; 8:155. [PMID: 36371506 PMCID: PMC9653490 DOI: 10.1038/s41531-022-00411-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/11/2022] [Indexed: 11/15/2022] Open
Abstract
The relationship between APOE polymorphisms and Parkinson's disease (PD) in black Africans has not been previously investigated. We evaluated the association between APOE polymorphic variability and self-declared cognition in 1100 Nigerians with PD and 1097 age-matched healthy controls. Cognition in PD was assessed using the single item cognition question (item 1.1) of the MDS-UPDRS. APOE genotype and allele frequencies did not differ between PD and controls (p > 0.05). No allelic or genotypic association was observed between APOE and age at onset of PD. In PD, APOE ε4/ε4 conferred a two-fold risk of cognitive impairment compared to one or no ε4 (HR: 2.09 (95% CI: 1.13-3.89; p = 0.02)), while APOE ε2 was associated with modest protection against cognitive impairment (HR: 0.41 (95% CI 0.19-0.99, p = 0.02)). Of 773 PD with motor phenotype and APOE characterized, tremor-dominant (TD) phenotype predominated significantly in ε2 carriers (87/135, 64.4%) compared to 22.2% in persons with postural instability/gait difficulty (PIGD) (30/135) and 13.3% in indeterminate (ID) (18/135, 13.3%) (p = 0.037). Although the frequency of the TD phenotype was highest in homozygous ε2 carriers (85.7%), the distribution of motor phenotypes across the six genotypes did not differ significantly (p = 0.18). Altogether, our findings support previous studies in other ethnicities, implying a role for APOE ε4 and ε2 as risk and protective factors, respectively, for cognitive impairment in PD.
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Affiliation(s)
- Njideka U Okubadejo
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos State, Nigeria.
- Neurology Unit, Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria.
| | - Olaitan Okunoye
- Department of Molecular Neuroscience, University College London Institute of Neurology, Queen Square, London, UK
| | - Oluwadamilola O Ojo
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos State, Nigeria
- Neurology Unit, Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Babawale Arabambi
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Rufus O Akinyemi
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Sani A Abubakar
- Department of Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Emmanuel U Iwuozo
- Neurology Unit, Benue State University & Benue State University Teaching Hospital, Makurdi, Benue State, Nigeria
| | - Kolawole W Wahab
- Department of Medicine, University of Ilorin & University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Osigwe P Agabi
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos State, Nigeria
- Neurology Unit, Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Uchechi Agulanna
- Neurology Unit, Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Frank A Imarhiagbe
- University of Benin & University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | | | | | - Akintunde A Adebowale
- Neurology Unit, Department of Medicine, Obafemi Awolowo University & Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | | | | | | | - Ifeyinwa Ani-Osheku
- Asokoro District Hospital, Asokoro, Abuja, Federal Capital Territory, Nigeria
| | - Ohwotemu Arigbodi
- Department of Internal Medicine, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria
| | - Salisu A Balarabe
- Department of Medicine, College of Health Sciences, Usmanu Danfodiyo University & Usmanu Danfodiyo University Teaching Hospital, Sokoto, Sokoto State, Nigeria
| | - Abiodun H Bello
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Oluchi S Ekenze
- Neurology Unit, Department of Medicine, Faculty of Medical Sciences, University of Nigeria & University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | | | - Temitope H Farombi
- Chief Tony Anenih Geriatrics Center, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Michael B Fawale
- Neurology Unit, Department of Medicine, Obafemi Awolowo University & Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Morenikeji A Komolafe
- Neurology Unit, Department of Medicine, Obafemi Awolowo University & Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Paul O Nwani
- Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Ernest O Nwazor
- Department of Medicine, Madonna University College of Medical Sciences, Elele, Rivers State & Federal Medical Center, Owerri, Imo State, Nigeria
| | - Yakub Nyandaiti
- University of Maiduguri & University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
| | | | - Yahaya O Obiabo
- Department of Internal Medicine, Delta State University & Delta State University Teaching Hospital, Oghara, Delta State, Nigeria
| | | | - Francis E Odiase
- University of Benin & University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Francis I Ojini
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos State, Nigeria
- Neurology Unit, Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Gerald A Onwuegbuzie
- University of Abuja & University of Abuja Teaching Hospital, Gwagwalada, Abuja, Federal Capital Territory, Nigeria
| | - Nosakhare Osemwegie
- University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - Olajumoke O Oshinaike
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, Lagos State University College of Medicine, Ikeja, Lagos State, Nigeria
| | | | - Shyngle I Oyakhire
- Department of Internal Medicine, National Hospital, Abuja, Federal Capital Territory, Nigeria
| | - Funlola T Taiwo
- Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Uduak E Williams
- Department of Internal Medicine, University of Calabar/University of Calabar Teaching Hospital, Calabar, Cross Rivers State, Nigeria
| | - Simon Ozomma
- Department of Internal Medicine, University of Calabar/University of Calabar Teaching Hospital, Calabar, Cross Rivers State, Nigeria
| | - Yusuf Zubair
- Department of Internal Medicine, National Hospital, Abuja, Federal Capital Territory, Nigeria
| | - Dena Hernandez
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Sara Bandres-Ciga
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center For Alzheimer's and Related Dementias, NIA, NIH, Bethesda, MD, USA
| | - Cornelis Blauwendraat
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center For Alzheimer's and Related Dementias, NIA, NIH, Bethesda, MD, USA
| | - Andrew Singleton
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center For Alzheimer's and Related Dementias, NIA, NIH, Bethesda, MD, USA
| | - Henry Houlden
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
- Neurogenetics Laboratory, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
| | - John Hardy
- Department of Molecular Neuroscience, University College London Institute of Neurology, Queen Square, London, UK
| | - Mie Rizig
- Department of Molecular Neuroscience, University College London Institute of Neurology, Queen Square, London, UK
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Harerimana NV, Goate AM, Bowles KR. The influence of 17q21.31 and APOE genetic ancestry on neurodegenerative disease risk. Front Aging Neurosci 2022; 14:1021918. [DOI: 10.3389/fnagi.2022.1021918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
Advances in genomic research over the last two decades have greatly enhanced our knowledge concerning the genetic landscape and pathophysiological processes involved in multiple neurodegenerative diseases. However, current insights arise almost exclusively from studies on individuals of European ancestry. Despite this, studies have revealed that genetic variation differentially impacts risk for, and clinical presentation of neurodegenerative disease in non-European populations, conveying the importance of ancestry in predicting disease risk and understanding the biological mechanisms contributing to neurodegeneration. We review the genetic influence of two important disease-associated loci, 17q21.31 (the “MAPT locus”) and APOE, to neurodegenerative disease risk in non-European populations, touching on global population differences and evolutionary genetics by ancestry that may underlie some of these differences. We conclude there is a need to increase representation of non-European ancestry individuals in genome-wide association studies (GWAS) and biomarker analyses in order to help resolve existing disparities in understanding risk for, diagnosis of, and treatment for neurodegenerative diseases in diverse populations.
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Ballerini C, Njamnshi AK, Juliano SL, Kalaria RN, Furlan R, Akinyemi RO. Non-Communicable Neurological Disorders and Neuroinflammation. Front Immunol 2022; 13:834424. [PMID: 35769472 PMCID: PMC9235309 DOI: 10.3389/fimmu.2022.834424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/10/2022] [Indexed: 12/04/2022] Open
Abstract
Traumatic brain injury, stroke, and neurodegenerative diseases represent a major cause of morbidity and mortality in Africa, as in the rest of the world. Traumatic brain and spinal cord injuries specifically represent a leading cause of disability in the younger population. Stroke and neurodegenerative disorders predominantly target the elderly and are a major concern in Africa, since their rate of increase among the ageing is the fastest in the world. Neuroimmunology is usually not associated with non-communicable neurological disorders, as the role of neuroinflammation is not often considered when evaluating their cause and pathogenesis. However, substantial evidence indicates that neuroinflammation is extremely relevant in determining the consequences of non-communicable neurological disorders, both for its protective abilities as well as for its destructive capacity. We review here current knowledge on the contribution of neuroinflammation and neuroimmunology to the pathogenesis of traumatic injuries, stroke and neurodegenerative diseases, with a particular focus on problems that are already a major issue in Africa, like traumatic brain injury, and on emerging disorders such as dementias.
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Affiliation(s)
- Clara Ballerini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alfred K. Njamnshi
- Brain Research Africa Initiative (BRAIN); Neurology Department, Central Hospital Yaounde/Faculty of Medicine and Biomedical Sciences (FMBS), The University of Yaounde 1, Yaounde, Cameroon
| | - Sharon L. Juliano
- Neuroscience, Uniformed Services University Hebert School (USUHS), Bethesda, MD, United States
| | - Rajesh N. Kalaria
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Roberto Furlan
- Clinical Neuroimmunology Unit, Institute of Experimental Neurology, Division of Neuroscience, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milan, Italy
- *Correspondence: Roberto Furlan, ; Rufus O. Akinyemi,
| | - Rufus O. Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- *Correspondence: Roberto Furlan, ; Rufus O. Akinyemi,
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33
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Howlett WP. Rapidly progressive dementia: limitations in Africa. Pract Neurol 2022; 22:342-343. [DOI: 10.1136/practneurol-2022-003385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2022] [Indexed: 11/04/2022]
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