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

Evolving Classifiers to Inform Clinical Assessment of Parkinson’s Disease

Abstract—We describe the use of a genetic programming system to induce classifiers that can discriminate between Parkinson’s disease patients and healthy age-matched controls. The best evolved classifer achieved an AUC of 0.92, which is comparable with clinical diagnosis rates. Compared to previous studies of this nature, we used a relatively large sample of 49 PD patients and 41 controls, allowing us to better capture the wide diversity seen within the Parkinson’s population. Classifiers were induced from recordings of these subjects ’ movements as they carried out repetitive finger tapping, a standard clinical assessment for Parkinson’s disease. For ease of interpretability, we used a relatively simple window-based classifier architecture which captures patterns that occur over a single tap cycle. Analysis of window matches suggested the importance of peak closing deceleration as a basis for classification. This was supported by a follow-up analysis of the data set, showing that closing deceleration is more discriminative than features typically used in clinical assessment of finger tapping. I

The German version of the tablet-based UCSF Brain Health Assessment is sensitive to early symptoms of neurodegenerative disorders.

INTRODUCTION: Cognition often remains unassessed in primary care. To improve early diagnosis of neurocognitive disorder (NCD) in Switzerland, the tablet-based UCSF brain health assessment (BHA) and brain health survey (BHS) were validated. METHODS: The German BHA, BHS, and Montreal Cognitive Assessment (MoCA) were administered to 67 patients with mild/major NCD and 50 controls. BHA includes subtests of memory, executive, visuospatial, and language functioning, and informant-based BHS asks about behavior and motor functioning. RESULTS: The complete instrument (BHA + BHS) was most accurate at detecting mild NCD (AUC = 0.95) and NCD without amyloid pathology (AUC = 0.96), followed by the BHA. All measures were accurate (all AUCs > 0.95) at distinguishing major NCD and NCD with amyloid pathology (Alzheimers disease [AD]) from controls. DISCUSSION: The German BHA and BHS are more sensitive to mild NCD and non-AD presentations than the MoCA and thus have a high potential to identify patients with NCD in primary care earlier than currently used screens