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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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