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Crivelli L, Calandri IL, Kimie Suemoto C, Salinas RM, Velilla LM, Yassuda MS, Caramelli P, Lopera F, Nitrini R, Sevlever GE, Sosa AL, Acosta D, Baietti AMC, Cusicanqui MI, Custodio N, De Simone SD, Derio CD, Duque-Peñailillo L, Duran JC, Jiménez-Velázquez IZ, Leon-Salas JM, Bergamo Y, Clarens MF, Damian A, Demey I, Helou MB, Márquez C, Martin ME, Martin MDGM, Querze D, Surace EI, Acosta-Egea S, Aguirre-Salvador E, de Souza LC, Cançado GHDCP, Brucki SMD, Friedlaender CV, Gomes KB, Gutierrez M, Ríos CL, Galindo JGM, Montesinos R, Nuñez-Herrera A, Ospina-Henao S, Rodríguez G, Masson VR, Sánchez M, Schenk CE, Soto L, Barbosa MT, Tosatti JAG, Vicuña Y, Espeland M, Hakansson K, Kivipelto M, Baker L, Snyder H, Carrillo M, Allegri RF. Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline (LatAm-FINGERS): Study design and harmonization. Alzheimers Dement 2023; 19:4046-4060. [PMID: 37204054 PMCID: PMC11021182 DOI: 10.1002/alz.13101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline (LatAm-FINGERS) is the first non-pharmacological multicenter randomized clinical trial (RCT) to prevent cognitive impairment in Latin America (LA). Our aim is to present the study design and discuss the strategies used for multicultural harmonization. METHODS This 1-year RCT (working on a 1-year extension) investigates the feasibility of a multi-domain lifestyle intervention in LA and the efficacy of the intervention, primarily on cognitive function. An external harmonization process was carried out to follow the FINGER model, and an internal harmonization was performed to ensure this study was feasible and comparable across the 12 participating LA countries. RESULTS Currently, 1549 participants have been screened, and 815 randomized. Participants are ethnically diverse (56% are Nestizo) and have high cardiovascular risk (39% have metabolic syndrome). DISCUSSION LatAm-FINGERS overcame a significant challenge to combine the region's diversity into a multi-domain risk reduction intervention feasible across LA while preserving the original FINGER design.
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Affiliation(s)
- Lucia Crivelli
- Department of Cognitive Neurology, Fleni, Buenos Aires, Argentina
| | | | | | - Rosa María Salinas
- Laboratorio de Demencias del Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Ciudad de México, México
| | - Lina Marcela Velilla
- Neuroscience Group of Antioquia Medical School, Antioquia University, Medellín, Colombia
| | - Mônica Sanches Yassuda
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of Såo Paulo School of Medicine, Såo Paulo, Brazil
- Gerontology, School of Arts, Sciences, and Humanities, University of Såo Paulo, Såo Paulo, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Francisco Lopera
- Neuroscience Group of Antioquia Medical School, Antioquia University, Medellín, Colombia
| | - Ricardo Nitrini
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of Såo Paulo School of Medicine, Såo Paulo, Brazil
| | | | - Ana Luisa Sosa
- Laboratorio de Demencias del Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Ciudad de México, México
| | - Daisy Acosta
- Internal Medicine Department, Universidad Nacional Pedro Henriquez Urena (UNPHU), Santo Domingo, Dominican Republic
| | - Ana María Charamelo Baietti
- Clínica de la Memoria-Hospital Británico, Montevideo, Uruguay
- Departamento de Neuropsicología, Facultad de Medicina-Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | | | - Nilton Custodio
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Perú
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Perú
| | - Sergio Dansilio De Simone
- Departamento de Neuropsicología, Facultad de Medicina-Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - Carolina Delgado Derio
- Unidad de Cerebro Saludable, Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | | | | | - Ivonne Z. Jiménez-Velázquez
- Centro de Investigación en Geriatría, Departamento de Medicina Interna, Recinto de Ciencias Médicas, Universidad de Puerto Rico, San Juan, Puerto Rico
| | - Jorge Mario Leon-Salas
- Departamento de Investigación Clínica, Life Science Research Institute, Hospital Clínica Bíblica, San José, Costa Rica
| | - Yanina Bergamo
- Department of Diagnostic Imaging, Fleni, Buenos Aires, Argentina
| | | | - Andrés Damian
- CUDIM Centro Uruguayo de Imagenología Molecular, Montevideo, Uruguay
| | - Ignacio Demey
- Department of Cognitive Neurology, Fleni, Buenos Aires, Argentina
| | | | - Carlos Márquez
- Instituto de Nutricion y Tecnología de los Alimentos, Universidad de Chile, Santiago de Chile, Chile
| | | | | | - Diego Querze
- Department of Neurology, Fleni, Buenos Aires, Argentina
| | | | - Sabrina Acosta-Egea
- Departamento de Investigación Clínica, Life Science Research Institute, Hospital Clínica Bíblica, San José, Costa Rica
| | | | - Leonardo Cruz de Souza
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Sonia Maria Dozzi Brucki
- Cognitive and Behavioral Neurology Unit, Department of Neurology, University of Såo Paulo School of Medicine, Såo Paulo, Brazil
| | | | - Karina Braga Gomes
- Faculdade de Farmícia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Myriam Gutierrez
- Unidad de Cerebro Saludable, Departamento de Neurociencia, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile
| | | | - Joyce Graciela Martinez Galindo
- Laboratorio de Demencias del Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Ciudad de México, México
| | - Rosa Montesinos
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Perú
| | | | - Sebastián Ospina-Henao
- Facultad de Medicina, Universidad de Ciencias Médicas, Instituto de Investigación en Ciencias Médicas, San José, Costa Rica
| | - Guillermina Rodríguez
- Department of Demography and Biostatistics, Ministry of Public Health, Santo Domingo, Dominican Republic
| | | | - Mónica Sánchez
- Cognitive Disorders Unit–Neuromedicenter, Quito, Ecuador
| | - Christian E. Schenk
- Neurology Division, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Ligia Soto
- Cognitive Disorders Unit–Neuromedicenter, Quito, Ecuador
| | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jéssica Abdo Gonçalves Tosatti
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Yosselin Vicuña
- Inbiomed (Instituto de Investigacion en Biomedicina), Universidad Central del Ecuador, Quito, Ecuador
| | - Mark Espeland
- Departments of Internal Medicine and Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Krister Hakansson
- Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Karolinska Institutet and Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - Laura Baker
- Departments of Internal Medicine, Neurology, and Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | | | | | - Ricardo Francisco Allegri
- Department of Cognitive Neurology, Fleni, Buenos Aires, Argentina
- Department of Neurosciences, Universidad de la Costa (CUC), Barranquilla, Colombia
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Babulal GM, Torres VL, Acosta D, Agüero C, Aguilar-Navarro S, Amariglio R, Ussui JA, Baena A, Bocanegra Y, Brucki SMD, Bustin J, Cabrera DM, Custodio N, Diaz MM, Peñailillo LD, Franco I, Gatchel JR, Garza-Naveda AP, González Lara M, Gutiérrez-Gutiérrez L, Guzmán-Vélez E, Hanseeuw BJ, Jimenez-Velazquez IZ, Rodríguez TL, Llibre-Guerra J, Marquine MJ, Martinez J, Medina LD, Miranda-Castillo C, Morlett Paredes A, Munera D, Nuñez-Herrera A, de Oliveira MO, Palmer-Cancel SJ, Pardilla-Delgado E, Perales-Puchalt J, Pluim C, Ramirez-Gomez L, Rentz DM, Rivera-Fernández C, Rosselli M, Serrano CM, Suing-Ortega MJ, Slachevsky A, Soto-Añari M, Sperling RA, Torrente F, Thumala D, Vannini P, Vila-Castelar C, Yañez-Escalante T, Quiroz YT. The impact of COVID-19 on the well-being and cognition of older adults living in the United States and Latin America. EClinicalMedicine 2021; 35:100848. [PMID: 33997742 PMCID: PMC8100067 DOI: 10.1016/j.eclinm.2021.100848] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In the COVID-19 pandemic, older adults from vulnerable ethnoracial groups are at high risk of infection, hospitalization, and death. We aimed to explore the pandemic's impact on the well-being and cognition of older adults living in the United States (US), Argentina, Chile, Mexico, and Peru. METHODS 1,608 (646 White, 852 Latino, 77 Black, 33 Asian; 72% female) individuals from the US and four Latin American countries aged ≥ 55 years completed an online survey regarding well-being and cognition during the pandemic between May and September 2020. Outcome variables (pandemic impact, discrimination, loneliness, purpose of life, subjective cognitive concerns) were compared across four US ethnoracial groups and older adults living in Argentina, Chile, Mexico, and Peru. FINDINGS Mean age for all participants was 66.7 (SD = 7.7) years and mean education was 15.4 (SD = 2.7) years. Compared to Whites, Latinos living in the US reported greater economic impact (p < .001, ηp 2 = 0.031); while Blacks reported experiencing discrimination more often (p < .001, ηp 2 = 0.050). Blacks and Latinos reported more positive coping (p < .001, ηp 2 = 0.040). Compared to Latinos living in the US, Latinos in Chile, Mexico, and Peru reported greater pandemic impact, Latinos in Mexico and Peru reported more positive coping, Latinos in Argentina, Mexico, and Peru had greater economic impact, and Latinos in Argentina, Chile, and Peru reported less discrimination. INTERPRETATION The COVID-19 pandemic has differentially impacted the well-being of older ethnically diverse individuals in the US and Latin America. Future studies should examine how mediators like income and coping skills modify the pandemic's impact. FUNDING Massachusetts General Hospital Department of Psychiatry.
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Affiliation(s)
| | - Valeria L. Torres
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Daisy Acosta
- Universidad Nacional Pedro Henriquez Urena, Santo Domingo, Dominican Republic
| | - Cinthya Agüero
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Sara Aguilar-Navarro
- Department of Geriatrics. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubiran” Mexico City, Mexico
| | - Rebecca Amariglio
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Juliana Aya Ussui
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Ana Baena
- Washington University School of Medicine, St Louis, MO, USA
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellin, Colombia
| | - Yamile Bocanegra
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellin, Colombia
| | | | - Julian Bustin
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, CONICET, Buenos Aires, Argentina
| | | | - Nilton Custodio
- Unit Cognitive Impairment and Dementia Prevention, Peruvian Institute of Neurosciences, Lima, Peru
| | - Monica M. Diaz
- Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Idalid Franco
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Jennifer R. Gatchel
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Ana Paola Garza-Naveda
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | | | - Lidia Gutiérrez-Gutiérrez
- Department of Geriatrics. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubiran” Mexico City, Mexico
| | - Edmarie Guzmán-Vélez
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Bernard J. Hanseeuw
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
- Neurology Department, Cliniques Universitaires Saint-Luc, Belgium
| | - Ivonne Z. Jimenez-Velazquez
- Geriatrics Division, Internal Medicine Department, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Tomás León Rodríguez
- Memory and Neuropsychiatric Clinic (CMYN), Neurology Department, Del Salvador Hospital and University of Chile School of Medicine, Santiago, Chile
| | | | - María J. Marquine
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
| | - Jairo Martinez
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Luis D. Medina
- University of Houston, Department of Psychology, Houston, TX, USA
| | - Claudia Miranda-Castillo
- Faculty of Nursing Universidad Andres Bello, Millennium Institute for Research in Depression and Personality, Santiago, Chile
| | | | - Diana Munera
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | | | | | | | | | | | - Celina Pluim
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Liliana Ramirez-Gomez
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Dorene M. Rentz
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | | | | | - Cecilia M Serrano
- Neurology Department, Cesar Milstein Hospital, Buenos Aires, Argentina
| | - Maria Jose Suing-Ortega
- Department of Geriatrics. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubiran” Mexico City, Mexico
| | - Andrea Slachevsky
- Memory and Neuropsychiatric Clinic (CMYN), Neurology Department, Del Salvador Hospital and University of Chile School of Medicine, Santiago, Chile
| | | | - Reisa A. Sperling
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Fernando Torrente
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, CONICET, Buenos Aires, Argentina
| | - Daniela Thumala
- Psychology Department, Social Sciences Faculty, University of Chile, Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Patrizia Vannini
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | - Clara Vila-Castelar
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
| | | | - Yakeel T. Quiroz
- Massachusetts General Hospital, Harvard Medical School, 1st Avenue, Suite 101, Boston 02129, MA, USA
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