Brain clocks capture diversity and disparities in aging and dementia

Brain clocks, which quantify discrepancies between brain age and chronological age, hold promise for understanding brain health and disease. However, the impact of diversity (including geographical, socioeconomic, sociodemographic, sex and neurodegeneration) on the brain-age gap is unknown. We analyzed datasets from 5,306 participants across 15 countries (7 Latin American and Caribbean countries (LAC) and 8 non-LAC countries). Based on higher-order interactions, we developed a brain-age gap deep learning architecture for functional magnetic resonance imaging (2,953) and electroencephalography (2,353). The datasets comprised healthy controls and individuals with mild cognitive impairment, Alzheimer disease and behavioral variant frontotemporal dementia. LAC models evidenced older brain ages (functional magnetic resonance imaging: mean directional error = 5.60, root mean square error (r.m.s.e.) = 11.91; electroencephalography: mean directional error = 5.34, r.m.s.e. = 9.82) associated with frontoposterior networks compared with non-LAC models. Structural socioeconomic inequality, pollution and health disparities were influential predictors of increased brain-age gaps, especially in LAC (R² = 0.37, F² = 0.59, r.m.s.e. = 6.9). An ascending brain-age gap from healthy controls to mild cognitive impairment to Alzheimer disease was found. In LAC, we observed larger brain-age gaps in females in control and Alzheimer disease groups compared with the respective males. The results were not explained by variations in signal quality, demographics or acquisition methods. These findings provide a quantitative framework capturing the diversity of accelerated brain aging.</p

Brain clocks capture diversity and disparities in aging and dementia across geographically diverse populations

Peer reviewe

World guidelines for falls prevention and management for older adults: a global initiative

Background: falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. Current guidelines are inconsistent, with no up-to-date, globally applicable ones present. Objectives: to create a set of evidence- and expert consensus-based falls prevention and management recommendations applicable to older adults for use by healthcare and other professionals that consider: (i) a person-centred approach that includes the perspectives of older adults with lived experience, caregivers and other stakeholders; (ii) gaps in previous guidelines; (iii) recent developments in e-health and (iv) implementation across locations with limited access to resources such as low- and middle-income countries. Methods: a steering committee and a worldwide multidisciplinary group of experts and stakeholders, including older adults, were assembled. Geriatrics and gerontological societies were represented. Using a modified Delphi process, recommendations from 11 topic-specific working groups (WGs), 10 ad-hoc WGs and a WG dealing with the perspectives of older adults were reviewed and refined. The final recommendations were determined by voting. Recommendations: all older adults should be advised on falls prevention and physical activity. Opportunistic case finding for falls risk is recommended for community-dwelling older adults. Those considered at high risk should be offered a comprehensive multifactorial falls risk assessment with a view to co-design and implement personalised multidomain interventions. Other recommendations cover details of assessment and intervention components and combinations, and recommendations for specific settings and populations. Conclusions: the core set of recommendations provided will require flexible implementation strategies that consider both local context and resources

Interfaces entre a história da violência e a constituição do território no Ceará: um esforço de síntese e periodização

A violência interpessoal fatal é um dos principais problemas de saúde pública no Brasil. Para a compreensão desse fenômeno complexo, é necessário esforço interdisciplinar. O objetivo deste artigo é investigar o papel desempenhado pela violência no processo histórico de construção do território no Ceará. O materialismo histórico foi utilizado como matriz teórica para estabelecer uma periodização crítica da violência. A articulação entre modo de produção e superestrutura permitiu uma aproximação da categoria formação social, no contexto do território. Foi possível estabelecer cinco blocos históricos relativamente homogêneos. A violência é um dos principais vetores da constituição do território cearense. Observa-se que esse fenômeno foi transformado em mais uma mercadoria, concreta e simbólica. A proximidade entre o perfil de jovem morto pela violência e o perfil de jovens desempregados não se deve ao acaso. Ambos sobrevivem nas periferias urbanas brasileiras carentes de políticas de proteção social. A persistência do modo de produção capitalista requer esse contingente populacional, que garante o baixo custo da força de trabalho, um dos pilares do desenvolvimento econômico no Ceará

Dementia in Latin America : paving the way towards a regional action plan

Regional challenges faced by Latin American and Caribbean countries (LACs) to fight dementia, such as heterogeneity, diversity, political instabilities, and socioeconomic disparities, can be addressed more effectively grounded in a collaborative setting based on the open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking and translational research) and align them to current global strategies to translate regional knowledge into actions with transformative power. Then, by characterizing genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions and mapping these to the above challenges, we provide the basic mosaics of knowledge that will pave the way towards a KtAF. We describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF

Evaluación de la pulpa de café deshidratada en pollos de engorde durante los periodos de iniciación y engorde (0-7 semanas)

204 one-day-old Indian River male chicks were distributed in a complete randomized design to evaluate the effect of different levels (0, 10, 20, 30%) of dehydrated coffee pulp (DCP) included in their diet during the starting (4 weeks) and finishing (3 weeks) periods. The diets were balanced isonitrogenous and isocaloric using a corn-soybean meal basal diet according to the animal nutritional requirements for each period. Feed and water were offered ad libitum. Weight gain, feed intake and feed conversion were evaluated. The results show that the use of DCP at levels over 20% of the diet of broilers in both periods had negative effects on feed intake, weight gain and feed conversion. It can be concluded also that the animals develop a higher capacity of DCP utilization as they grow older and that the highest level of DCP that can be included in both the starter and finisher diets of boilers with no negative effects on their performance is between 3.75 and 19.50% of the diet.204 pollos sexados (machos) de 1 día de edad del híbrido Indian River fueron distribuidos en un diseño irrestricto al azar con 4 tratamientos y 4 repeticiones para evaluar el efecto de diferentes niveles (0, 10, 20, 30%) de pulpa de café deshidratada en la dieta durante las etapas de iniciación (4 semanas) y engorde (3 semanas). Las dietas se balancearon isoproteicas e isocalóricas sobre una base de maíz y soya de acuerdo con los requerimientos nutricionales de los animales para cada etapa. El agua y el alimento fueron ofrecidos ad labitum. Se evaluaron las variables de ganancia de peso, consumo de alimento  y conversión alimenticia. Los resultados obtenidos en este trabajo demuestran que la utilización de pulpa de café deshidratada a niveles mayores  de 20% de la dieta de pollo de engorde, en ambas etapas, tuvo efectos negativos sobre el consumo de alimento ganancia de peso y conversión alimenticia. También se concluye que los animales tienden a desarrollar una mayor capacidad de utilización de la pulpa en la dieta conforme aumentan de edad y que el nivel máximo de pulpa que se puede incluir en la dieta de pollos de engorde, tanto en iniciación como engorde, sin causar efectos negativos sobre su rendimiento está entre 3,75 y 19.50% de la dieta

Evaluación de la pulpa de café deshidratada en pollos de engorde durante los periodos de iniciación y engorde (0-7 semanas)

204 pollos sexados (machos) de 1 día de edad del híbrido Indian River fueron distribuidos en un diseño irrestricto al azar con 4 tratamientos y 4 repeticiones para evaluar el efecto de diferentes niveles (0, 10, 20, 30%) de pulpa de café deshidratada en la dieta durante las etapas de iniciación (4 semanas) y engorde (3 semanas). Las dietas se balancearon isoproteicas e isocalóricas sobre una base de maíz y soya de acuerdo con los requerimientos nutricionales de los animales para cada etapa. El agua y el alimento fueron ofrecidos ad labitum. Se evaluaron las variables de ganancia de peso, consumo de alimento  y conversión alimenticia. Los resultados obtenidos en este trabajo demuestran que la utilización de pulpa de café deshidratada a niveles mayores  de 20% de la dieta de pollo de engorde, en ambas etapas, tuvo efectos negativos sobre el consumo de alimento ganancia de peso y conversión alimenticia. También se concluye que los animales tienden a desarrollar una mayor capacidad de utilización de la pulpa en la dieta conforme aumentan de edad y que el nivel máximo de pulpa que se puede incluir en la dieta de pollos de engorde, tanto en iniciación como engorde, sin causar efectos negativos sobre su rendimiento está entre 3,75 y 19.50% de la dieta