Frontotemporal Dementias in Latin America: History, Epidemiology, Genetics, and Clinical Research

Introduction: The historical development, frequency, and impact of frontotemporal dementia (FTD) are less clear in Latin America than in high-income countries. Although there is a growing number of dementia studies in Latin America, little is known collectively about FTD prevalence studies by country, clinical heterogeneity, risk factors, and genetics in Latin American countries. Methods: A systematic review was completed, aimed at identifying the frequency, clinical heterogeneity, and genetics studies of FTD in Latin American populations. The search strategies used a combination of standardized terms for FTD and related disorders. In addition, at least one author per Latin American country summarized the available literature. Collaborative or regional studies were reviewed during consensus meetings. Results: The first FTD reports published in Latin America were mostly case reports. The last two decades marked a substantial increase in the number of FTD research in Latin American countries. Brazil (165), Argentina (84), Colombia (26), and Chile (23) are the countries with the larger numbers of FTD published studies. Most of the research has focused on clinical and neuropsychological features (n = 247), including the local adaptation of neuropsychological and behavioral assessment batteries. However, there are little to no large studies on prevalence (n = 4), biomarkers (n = 9), or neuropathology (n = 3) of FTD. Conclusions: Future FTD studies will be required in Latin America, albeit with a greater emphasis on clinical diagnosis, genetics, biomarkers, and neuropathological studies. Regional and country-level efforts should seek better estimations of the prevalence, incidence, and economic impact of FTD syndromes

Caregiving for Patients With Frontotemporal Dementia in Latin America

Latin America is a vast heterogeneous territory where chronic diseases such as mild cognitive impairment or dementia are becoming higher. Frontotemporal dementia (FTD) prevalence in this region is estimated to be around 12-18 cases per thousand persons. However, this prevalence is underestimated given the lack of awareness of FTD even among healthcare professionals. Family members are responsible for the care of patients with FTD at home. These caregivers deliver care despite being ill-equipped and living in the context of austerity policies and social inequities. They often face unsurmountable financial and social burdens that are specific to the region. The most important step to support caregivers in Latin America is to increase awareness of the disease at all levels. Healthcare diplomacy is fundamental to create joint efforts that push policies forward to protect caregivers of FTD patients

Neurodegenerative Disease and the Experience of Homelessness.

Introduction: Today, half of the American homeless population is older than 50 years of age. This shift in age distribution among people experiencing homelessness has challenged our long-held views of the causes of homelessness. Age-related neurological diseases, especially neurodegenerative diseases of the brain (NDDB), may play a role eliciting homelessness in a significant proportion of vulnerable older adults. This article aims to explore relationships between homelessness and NDDB in a cohort of research participants enrolled in observational studies on NDDB at an academic center. Methods: We reviewed charts of the Memory and Aging Center (MAC) of the University of California, San Francisco's database searching for research participants with NDDB that had direct relationship to homelessness. We reviewed all research visits conducted between 2004 and 2018 (N = 5,300). Research participants who had any relationship to homelessness were included in this analysis. NDDB was diagnosed via comprehensive neurological, functional, neuropsychological, and biomarker assessments. Non-parametric tests were used for analysis. Thirteen participants were found to have a direct relationship with homelessness. Seven were female and the median of education was 16 (IR: 12.0-19.5) years. Participants were divided into two groups: Those who experienced homelessness while symptomatic from a NDDB but before formal diagnosis (n = 5, Group 1); and participants with formally diagnosed NDDB who exhibited a new propensity toward homelessness (n = 8, Group 2). Compared to Group 2, participants in Group 1 were younger (p = 0.021) and showed similar results in the neuropsychological evaluation. In both groups, the most prevalent diagnosis was frontotemporal dementia. In Group 1, the majority of participants became homeless in the setting of a fragile socioeconomic situation and informants believed that NDDB contributed or caused their homeless state. In Group 2, a new propensity toward homelessness became manifest in different ways and it stood out that all of these participants were well-supported by family and friends during their illness. Conclusions and Relevance: This case series highlights the role that NDDB may have in precipitating homelessness among vulnerable older adults, particularly in the setting of challenging socioeconomic circumstances and unsupportive living environments. Social ramifications of these findings, particularly pertaining to challenges around rehousing these individuals is discussed

Anton syndrome after subarachnoid hemorrhage and delayed cerebral ischemia: A case report

We report the case of a patient with ruptured middle cerebral artery aneurysm, subarachnoid hemorrhage and frontal intracerebral hemorrhage, who secondarily presented with delayed cerebral ischemia and bilateral occipital infarcts, with complete vision loss, visual anosognosia, and confabulations as the main symptoms. Additionally, the patient had defined features of Cotard syndrome, as revealed by persistent nihilistic delusions. The brain imaging studies showed a bilateral occipital ischemic lesion, as well as frontal and parietal hemorrhagic lesions in the right hemisphere. We address the general theories of anosognosia, confabulation and the problem of why a bilateral occipital lesion is not enough for these metacognitive defects to exist. The presence of right frontal and or parietal hemisphere lesions could be necessary features in most cases

The Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat): Driving Multicentric Research and Implementation Science

Dementia is becoming increasingly prevalent in Latin America, contrasting with stable or declining rates in North America and Europe. This scenario places unprecedented clinical, social, and economic burden upon patients, families, and health systems. The challenges prove particularly pressing for conditions with highly specific diagnostic and management demands, such as frontotemporal dementia. Here we introduce a research and networking initiative designed to tackle these ensuing hurdles, the Multi-partner consortium to expand dementia research in Latin America (ReDLat). First, we present ReDLat's regional research framework, aimed at identifying the unique genetic, social, and economic factors driving the presentation of frontotemporal dementia and Alzheimer's disease in Latin America relative to the US. We describe ongoing ReDLat studies in various fields and ongoing research extensions. Then, we introduce actions coordinated by ReDLat and the Latin America and Caribbean Consortium on Dementia (LAC-CD) to develop culturally appropriate diagnostic tools, regional visibility and capacity building, diplomatic coordination in local priority areas, and a knowledge-to-action framework toward a regional action plan. Together, these research and networking initiatives will help to establish strong cross-national bonds, support the implementation of regional dementia plans, enhance health systems' infrastructure, and increase translational research collaborations across the continent

The Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat): Driving Multicentric Research and Implementation Science.

Dementia is becoming increasingly prevalent in Latin America, contrasting with stable or declining rates in North America and Europe. This scenario places unprecedented clinical, social, and economic burden upon patients, families, and health systems. The challenges prove particularly pressing for conditions with highly specific diagnostic and management demands, such as frontotemporal dementia. Here we introduce a research and networking initiative designed to tackle these ensuing hurdles, the Multi-partner consortium to expand dementia research in Latin America (ReDLat). First, we present ReDLat's regional research framework, aimed at identifying the unique genetic, social, and economic factors driving the presentation of frontotemporal dementia and Alzheimer's disease in Latin America relative to the US. We describe ongoing ReDLat studies in various fields and ongoing research extensions. Then, we introduce actions coordinated by ReDLat and the Latin America and Caribbean Consortium on Dementia (LAC-CD) to develop culturally appropriate diagnostic tools, regional visibility and capacity building, diplomatic coordination in local priority areas, and a knowledge-to-action framework toward a regional action plan. Together, these research and networking initiatives will help to establish strong cross-national bonds, support the implementation of regional dementia plans, enhance health systems' infrastructure, and increase translational research collaborations across the continent

The Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat): Driving Multicentric Research and Implementation Science.

Dementia is becoming increasingly prevalent in Latin America, contrasting with stable or declining rates in North America and Europe. This scenario places unprecedented clinical, social, and economic burden upon patients, families, and health systems. The challenges prove particularly pressing for conditions with highly specific diagnostic and management demands, such as frontotemporal dementia. Here we introduce a research and networking initiative designed to tackle these ensuing hurdles, the Multi-partner consortium to expand dementia research in Latin America (ReDLat). First, we present ReDLat's regional research framework, aimed at identifying the unique genetic, social, and economic factors driving the presentation of frontotemporal dementia and Alzheimer's disease in Latin America relative to the US. We describe ongoing ReDLat studies in various fields and ongoing research extensions. Then, we introduce actions coordinated by ReDLat and the Latin America and Caribbean Consortium on Dementia (LAC-CD) to develop culturally appropriate diagnostic tools, regional visibility and capacity building, diplomatic coordination in local priority areas, and a knowledge-to-action framework toward a regional action plan. Together, these research and networking initiatives will help to establish strong cross-national bonds, support the implementation of regional dementia plans, enhance health systems' infrastructure, and increase translational research collaborations across the continent

The Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat): Driving Multicentric Research and Implementation Science

Dementia is becoming increasingly prevalent in Latin America, contrasting with stable or declining rates in North America and Europe. This scenario places unprecedented clinical, social, and economic burden upon patients, families, and health systems. The challenges prove particularly pressing for conditions with highly specific diagnostic and management demands, such as frontotemporal dementia. Here we introduce a research and networking initiative designed to tackle these ensuing hurdles, the Multi-partner consortium to expand dementia research in Latin America (ReDLat). First, we present ReDLat's regional research framework, aimed at identifying the unique genetic, social, and economic factors driving the presentation of frontotemporal dementia and Alzheimer's disease in Latin America relative to the US. We describe ongoing ReDLat studies in various fields and ongoing research extensions. Then, we introduce actions coordinated by ReDLat and the Latin America and Caribbean Consortium on Dementia (LAC-CD) to develop culturally appropriate diagnostic tools, regional visibility and capacity building, diplomatic coordination in local priority areas, and a knowledge-to-action framework toward a regional action plan. Together, these research and networking initiatives will help to establish strong cross-national bonds, support the implementation of regional dementia plans, enhance health systems' infrastructure, and increase translational research collaborations across the continent.Fil: Ibañez, Agustin Mariano. University of California; Estados Unidos. Trinity College Dublin; Irlanda. Universidad de San Andrés; Argentina. Universidad Adolfo Ibañez; Chile. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Yokoyama, Jennifer S.. University of California; Estados Unidos. Trinity College Dublin; IrlandaFil: Possin, Katherine L.. University of California; Estados Unidos. Trinity College Dublin; IrlandaFil: Matallana, Diana. Pontificia Universidad Javeriana; Colombia. Hospital Universitario San Ignacio; Colombia. Hospital Universitario Santa Fe de Bogotá; ColombiaFil: Lopera, Francisco. Universidad de Antioquia; ColombiaFil: Nitrini, Ricardo. Universidade de Sao Paulo; BrasilFil: Takada, Leonel T.. Universidade de Sao Paulo; BrasilFil: Custodio, Nilton. Instituto Peruano de Neurociencias; PerúFil: Sosa Ortiz, Ana Luisa. Universidad Nacional Autónoma de México; MéxicoFil: Avila Funes, José Alberto. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; México. Université de Bordeaux; FranciaFil: Behrens, Maria Isabel. Universidad de Chile; Chile. Universidad del Desarrollo; ChileFil: Slachevsky, Andrea. Universidad del Desarrollo; Chile. Centro de Gerociencia para la Salud Cerebral y el Metabolismo; Chile. Instituto de Ciencias Biomédicas, Neurociencias y Neurociencias de Oriente; Chile. Universidad de Chile; ChileFil: Myers, Richard M.. Hudson Alpha Institute for Biotechnology; Estados UnidosFil: Cochran, J. Nicholas. Hudson Alpha Institute for Biotechnology; Estados UnidosFil: Brusco, Luis Ignacio. Universidad de Buenos Aires. Facultad de Medicina; Argentina. ALZAR; ArgentinaFil: Brusco, Luis Ignacio. Universidad de Buenos Aires. Facultad de Medicina; Argentina. ALZAR; ArgentinaFil: Bruno, Martin. Universidad Nacional de Cuyo. Facultad de Ciencias Medicas. Departamento de Neurociencias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; ArgentinaFil: Brucki, Sonia M. D.. Hospital Santa Marcelina; Brasil. Universidade de Sao Paulo; BrasilFil: Pina Escudero, Stefanie Danielle. University of California; Estados Unidos. Trinity College Dublin; IrlandaFil: Okada de Oliveira, Maira. University of California; Estados Unidos. Trinity College Dublin; Irlanda. Universidade de Sao Paulo; Brasil. Hospital Santa Marcelina; BrasilFil: Donnelly Kehoe, Patricio Andres. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Centro Internacional Franco Argentino de Ciencias de la Información y de Sistemas. Universidad Nacional de Rosario. Centro Internacional Franco Argentino de Ciencias de la Información y de Sistemas; ArgentinaFil: García, Adolfo Martín. University of California; Estados Unidos. Trinity College Dublin; Irlanda. Universidad de San Andrés; Argentina. Universidad Catolica de Cuyo. Facultad de Educacion.; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Cardona Londoño, Juan Felipe. Universidad del Valle; Colombia. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Santamaria Garcia, Hernando. Hospital Universitario San Ignacio; Colombia. Pontificia Universidad Javeriana; Colombia. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Moguilner, Sebastian. University of California; Estados Unidos. Trinity College Dublin; IrlandaFil: Duran Aniotz, Claudia. Universidad Adolfo Ibañez; ChileFil: Tagliazucchi, Enzo Rodolfo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Física de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Física de Buenos Aires; ArgentinaFil: Maito, Marcelo. Universidad de San Andrés; ArgentinaFil: Longoria Ibarrola, Erika Mariana. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; MéxicoFil: Pintado Caipa, Maritza. Trinity College Dublin; Irlanda. University of California; Estados Unidos. Instituto Peruano de Neurociencias; PerúFil: Godoy, Maria Eugenia. Universidad de San Andrés; ArgentinaFil: Bakman, Vera. University of California; Estados Unidos. Trinity College Dublin; IrlandaFil: Javandel, Shireen. University of California; Estados UnidosFil: Kosik, Kenneth. University of California; Estados UnidosFil: Valcour, Victor. University of California; Estados Unidos. Trinity College Dublin; IrlandaFil: Miller, Bruce L.. University of California; Estados Unidos. Trinity College Dublin; Irland