Browsing by Author "Parra, Mario A."

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    Biomarkers for dementia in Latin American countries: Gaps and opportunities
    (2023) Parra, Mario A.; Orellana, Paulina; Leon, Tomas; Victoria, Cabello G.; Henriquez, Fernando; Gomez, Rodrigo; Avalos, Constanza; Damian, Andres; Slachevsky, Andrea; Ibanez, Agustin; Zetterberg, Henrik; Tijms, Betty M.; Yokoyama, Jennifer S.; Pina-Escudero, Stefanie D.; Cochran, J. Nicholas; Matallana, Diana L.; Acosta, Daisy; Allegri, Ricardo; Arias-Suarez, Bianca P.; Barra, Bernardo; Behrens, Maria Isabel; Brucki, SoniaM. D.; Busatto, Geraldo; Caramelli, Paulo; Castro-Suarez, Sheila; Contreras, Valeria; Custodio, Nilton; Dansilio, Sergio; De la Cruz-Puebla, Myriam; de Souza, Leonardo Cruz; Diaz, Monica M.; Duque, Lissette; Farias, Gonzalo A.; Ferreira, Sergio T.; Guimet, Nahuel Magrath; Kmaid, Ana; Lira, David; Lopera, Francisco; Meza, Beatriz Mar; Miotto, Eliane C.; Nitrini, Ricardo; Nunez, Alberto; O'Neill, Santiago; Ochoa, John; Pintado-Caipa, Maritza; Resende, Elisa de Paula Franca; Risacher, Shannon; Rojas, Luz Angela; Sabaj, Valentina; Schilling, Lucas; Sellek, Allis F.; Sosa, Ana; Takada, Leonel T.; Teixeira, Antonio L.; Unaucho-Pilalumbo, Martha; Duran-Aniotz, Claudia
    Limited knowledge on dementia biomarkers in Latin American and Caribbean (LAC) countries remains a serious barrier. Here, we reported a survey to explore the ongoing work, needs, interests, potential barriers, and opportunities for future studies related to biomarkers. The results show that neuroimaging is the most used biomarker (73%), followed by genetic studies (40%), peripheral fluids biomarkers (31%), and cerebrospinal fluid biomarkers (29%). Regarding barriers in LAC, lack of funding appears to undermine the implementation of biomarkers in clinical or research settings, followed by insufficient infrastructure and training. The survey revealed that despite the above barriers, the region holds a great potential to advance dementia biomarkers research. Considering the unique contributions that LAC could make to this growing field, we highlight the urgent need to expand biomarker research. These insights allowed us to propose an action plan that addresses the recommendations for a biomarker framework recently proposed by regional experts.
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    The Latin America and the Caribbean Consortium on Dementia (LAC-CD): From Networking to Research to Implementation Science
    (2021) Ibanez, Agustin; Parra, Mario A.; Butler, Christopher
    In comparison with other regions, dementia prevalence in Latin America is growing rapidly, along with the consequent clinical, social, and economic burden upon patients and their families. The combination of fragile health care systems, large social inequalities, and isolated clinical and research initiatives makes the coordination of efforts imperative. The Latin America and the Caribbean Consortium on Dementia (LAC-CD) is a regional organization overseeing and promoting clinical and research activities on dementia. Here, we first provide an overview of the consortium, highlighting the antecedents and current mission. Then, we present the consortium's regional research, including the multi-partner consortium to expand dementia research in Latin America (ReDLat), which aims to identify the unique genetic, social, and economic factors that drive Alzheimer's and frontotemporal dementia presentation in LAC relative to the US. We describe an extension of ReDLat which aims to develop affordable markers of disease subtype and severity using high density EEG. We introduce current initiatives promoting regional diagnosis, visibility, and capacity, including the forthcoming launch of the Latin American Brain Health Institute (BrainLat). We discuss LAC-CD-led advances in brain health diplomacy, including an assessment of responses to the impact of COVID-19 on people with dementia and examining the knowledge of public policies among experts in the region. Finally, we present the current knowledge-to-action framework, which paves the way for a future regional action plan. Coordinated actions are crucial to forging strong regional bonds, supporting the implementation of regional dementia plans, improving health systems, and expanding research collaborations across Latin America.
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    The limitations and challenges in the assessment of executive dysfunction associated with real-world functioning: The opportunity of serious games
    (2023) Martinez-Pernia, David; Olavarria, Loreto; Fernandez-Manjon, Baltasar; Cabello, Victoria; Henriquez, Fernando; Robert, Philippe; Alvarado, Luis; Barria, Silvia; Antivilo, Andres; Velasquez, Juan; Cerda, Mauricio; Farias, Gonzalo; Torralva, Teresa; Ibanez, Agustin; Parra, Mario A.; Gilbert, Sam; Slachevsky, Andrea
    Nowadays, there is a broad range of methods for detecting and evaluating executive dysfunction ranging from clinical interview to neuropsychological evaluation. Nevertheless, a critical issue of these assessments is the lack of correspondence of the neuropsychological test's results with real-world functioning. This paper proposes serious games as a new framework to improve the neuropsychological assessment of real-world functioning. We briefly discuss the contribution and limitations of current methods of evaluation of executive dysfunction (paper-and-pencil tests, naturalistic observation methods, and Information and Communications Technologies) to inform on daily life functioning. Then, we analyze what are the limitations of these methods to predict real-world performance: (1) A lack of appropriate instruments to investigate the complexity of real-world functioning, (2) the vast majority of neuropsychological tests assess well-structured tasks, and (3) measurement of behaviors are based on simplistic data collection and statistical analysis. This work shows how serious games offer an opportunity to develop more efficient tools to detect executive dysfunction in everyday life contexts. Serious games provide meaningful narrative stories and virtual or real environments that immerse the user in natural and social environments with social interactions. In those highly interactive game environments, the player needs to adapt his/her behavioral performance to novel and ill-structured tasks which are suited for collecting user interaction evidence. Serious games offer a novel opportunity to develop better tools to improve diagnosis of the executive dysfunction in everyday life contexts. However, more research is still needed to implement serious games in everyday clinical practice.