Ana Luisa Sosa-Ortiz

Instituto Nacional de Neurología y Neurocirugía | INNN · Laboratorio de Demencias

Objectives: Population ageing will lead to a dramatic increase in dementia prevalence globally. Recent evidence suggests a decline in dementia incidence in HIC due to increasing education levels and improvements in cardiovascular health. Although, most of the increase will occur in low and middle-income countries (LMICs), there are no recent estima...

Introduction: Transcranial Direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) are neuromodulatory techniques capable of modifying the altered cerebral hyperexcitability in amnestic mild cognitive impairment (aMCI). Cortical excitability can be estimated with motor evoked potentials (MEPs) and synaptic plastici...

Objectives: Leveraging the non-monolithic structure of Latin America, which represents a large variability in social determinants of health (SDoH) and high levels of genetic admixture, we aim to evaluate the relative contributions of SDoH and genetic ancestry in predicting dementia risk in Latin American populations Methods: Community-dwelling part...

Objectives: Because of the continued transition to older populations, various strategies have been developed to estimate the social impact and burden of health care. Regarding mental health, a strategy in the elderly is the measurement of neuropsychiatric symptoms (NPS), these include a wide range of behavioral and psychological manifestations. The...

Objectives: Studies in PD have traditionally focused on motor features, however, interest in non-motor manifestations has increased resulting in improved knowledge regarding the prognosis of the disease. Although several studies have explored the incidence of dementia in PD cohorts, these studies have been conducted mainly in reference centers in h...

Background: Limited knowledge exists about the association between Parkinsonism or Parkinson’s disease (PD) and cognitive impairment and dementia in Latin America. Objectives: The study aimed to determine the cross-sectional and prospective associations between Parkinsonism and PD with cognitive impairment and dementia in a large multi-country coho...

Introduction: Mild behavioral impairment (MBI), and particularly its impulse dyscontrol domain, has been linked to brain alterations suggestive of Alzheimer’s disease (AD) in subjects without dementia. We aimed to analyze the association of impulse dyscontrol with the loss of integrity in white-matter brain tracts in a group of cognitively normal o...

Objectives: Dementia presents a growing public health challenge globally and its impact is significantly pronounced in low and middle-income countries (LMICs), including those in Latin America. This symposium aims to present recent findings on the prevalence, impact, and underlying factors of cognitive impairment and neuropsychiatric symptoms in ag...

Background Little is known about the relationship between parkinsonism or Parkinson's disease (PD) and frailty in Latin America. Objective The study aimed to determine the cross‐sectional and prospective associations between parkinsonism and PD with frailty in a large multi‐country cohort in Latin America. Frailty was assessed using three differen...

This manuscript describes and summarizes the Dominantly Inherited Alzheimer Network Observational Study (DIAN Obs), highlighting the wealth of longitudinal data, samples, and results from this human cohort study of brain aging and a rare monogenic form of Alzheimers disease (AD). DIAN Obs is an international collaborative longitudinal study initiat...

INTRODUCTION Leveraging the nonmonolithic structure of Latin America, which represents a large variability in social determinants of health (SDoH) and high levels of genetic admixture, we aim to evaluate the relative contributions of SDoH and genetic ancestry in predicting dementia prevalence in Latin American populations. METHODS Community‐dwelli...

INTRODUCTION While Latin America (LatAm) is facing an increasing burden of dementia due to the rapid aging of the population, it remains underrepresented in dementia research, diagnostics, and care. METHODS In 2023, the Alzheimer's Association hosted its eighth satellite symposium in Mexico, highlighting emerging dementia research, priorities, and...

Background Multicentric initiatives to study brain cognition in the elderly offers us a unique collection of brain imaging data accompanied by detailed neuroclinical and neuropsychological evaluations. U.S. POINTER and LatAm‐FINGERS, part of the World Wide FINGERS, are both large‐scale investigations of lifestyle interventions and its impact on cog...

Background Population ageing will lead to a dramatic increase in dementia prevalence globally. Recent evidence suggest a decline in dementia incidence in High Income Countries due to increasing education levels and improvements in cardiovascular health. Although, most of the increase will occur in low and middle‐income countries (LMICs), there are...

Background Multidomain lifestyle interventions hold great promise world‐wide as interventions to slow cognitive aging, and delay and prevent Alzheimer’s Disease and Related Disorders (ADRD). To have the greatest reach, they must be tailored for and assessed within local cultures in clinical trials. For trials to have the greatest impact, it’s impor...

Background Older adult participation in lifestyle‐based programs has been described round 80%. (Lee et al., 2018). Participation at dementia prevention programs has been influenced by age, gender, marital status, and interest in receiving health education (Coley et al., 2021). The aim of this study is to evaluate the participation and adoption of l...

Background the study of the medium and long‐term consequences of coronavirus infection (SARS‐CoV‐2) is of great relevance from the clinical and public health perspective. Recent evidence has shown that patients may present cognitive complaints after overcoming the acute stage of infection, particularly memory disturbances. Although significant prog...

Background Loneliness is defined as the feeling of being alone and can be considered as persistent, unavoidable and unpleasant. Social isolation is characterized by low frequency of contact with the social network, which may or may not include family members. The study of each of these entities is important because of their high frequency in OA and...

Background The proportion of older people have consequences for labor and financial market. Older adults (OA) can consume economic resources that they cannot afford, total health care spending is three times greater in households with at least one OA with a disability, 70% of the costs of caring for someone with dementia are borne by families and r...

Background LatAm‐FINGERS is the first non‐pharmacological multicenter randomized clinical trial to prevent cognitive impairment in Latin America (LA). The trial congregates the effort of 12 Countries, including Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Peru, Puerto Rico, and Uruguay. The main aim...

Background Computerized training has been used to improve cognitive functioning and has been shown to be effective in a wide range of populations. However, its use in elders can be complicated due to many factors including schooling, motivation, perception of difficulty and unfamiliarity with the technology. For the multidomain dementia prevention...

Background MIND diet is a hybrid diet designed from Mediterranean and DASH which emphasizes natural, plant‐based foods, promoting increased consumption of foods have been shown a positive impact on brain health and cognitive performance. Thus, understanding the food consumption habits is important. Method We analyzed elders cognitively healthy who...

Background “Brain-predicted age” estimates biological age from complex, nonlinear features in neuroimaging scans. The brain age gap (BAG) between predicted and chronological age is elevated in sporadic Alzheimer disease (AD), but is underexplored in autosomal dominant AD (ADAD), in which AD progression is highly predictable with minimal confounding...

Background Little is known about the burden of parkinsonism and Parkinson’s disease (PD) in Latin America. Better understanding of health service use and clinical outcomes in PD is needed to improve its prognosis. Objective The aim of the study was to estimate the burden of parkinsonism and PD in six Latin American countries. Methods 12,865 parti...

Background: Neuropsychiatric symptoms (NPSs) are common in neurodegenerative diseases; however, little is known about the prevalence of NPSs in Hispanic populations. Methods: Using data from community-dwelling participants age 65 years and older enrolled in the 10/66 study (N = 11,768), we aimed to estimate the prevalence of NPSs in Hispanic pop...

Objectives To report the first Mexican case with two novel AARS2 mutations causing primary ovarian failure, uterus infantilis, and early-onset dementia secondary to leukoencephalopathy. Methods Detailed clinical, clinimetric, neuroimaging features, muscle biopsy with biochemical assays of the main oxidative phosphorylation complexes activities, an...

Background The neuropsychiatric symptoms (NPS) are common clinical manifestation in older adults with amnestic mild cognitive impairment (aMCI). Global prevalence of 35%‐85% is estimated, though there are inconsistencies across the studies. There are reports of its prevalence in clinical and community‐based studies but few comparisons between them....

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....

More than 300 variants in the presenilin 1 (PSEN1), presenilin 2 (PSEN2), or amyloid precursor protein (APP) genes have been reported to cause Dominantly Inherited Alzheimer Disease (DIAD). However, most of these reports come from non‐Hispanic whites and the full extent of DIAD remains understudied in Latin American (LatAm) countries. Here we descr...

Objective: The cognitive characterization of Alzheimer’s disease risk states, such as amnestic mild cognitive impairment (aMCI) and subjective cognitive decline (SCD), is fundamental for timely diagnosis and interventions. The Face Name Associative Memory Exam (FNAME) is sensitive to early Alzheimer’s disease brain changes, and an extended version...

Introduction Evidence on the incidence and risk factors of frailty in low- and middle-income countries is very limited. We aimed to compare the incidence of frailty and explore its determinants in rural and urban areas in six Latin American countries and China. Methods The 10/66 is a multi-site cohort study in older adults. We conducted baseline a...

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...

Background In fewer than 1% of patients, AD is caused by autosomal dominant mutations in either the presenilin 1 ( PSEN1 ), presenilin 2 ( PSEN2 ), or amyloid precursor protein ( APP ) genes. The full extent of familial AD and frequency of these variants remains understudied in Latin American (LatAm) countries. Due to the rare nature of these varia...

Background: Age and gender specific prevalence rates for parkinsonism and Parkinson's disease (PD) are important to guide research, clinical practice, and public health planning; however, prevalence estimates in Latin America (LatAm) are limited. We aimed to estimate the prevalence of parkinsonism and PD and examine related risk factors in a cohor...

El cambio demográfico que viven las sociedades actuales, permite vislumbrar en los años del nuevo siglo, la dinámica poblacional propiciará que México quede inmerso en una sociedad envejecida con los requerimientos y demandas propios de la misma. En el rubro de la atención a la salud, las personas adultas mayores dadas sus características biopsicos...

Although the presence of anosognosia in amnestic mild cognitive impairment (aMCI) may be predictive of conversion to Alzheimer’s disease (AD), little is known about its neural correlates in AD and aMCI. Four different groups were compared using volumetric and diffusion magnetic resonance imaging metrics in regions of interest (hippocampus and cingu...

Es fundamental que en el área del envejecimiento se dispongan de pruebas cognitivas específicas, sensibles, válidas transculturalmente y útiles, tanto en investigación como en el ámbito clínico (Patterson, 2018). Varios trabajos han sugerido que la prueba de memoria asociativa cara-nombre (FNAME) podría ser una herramienta válida, fiable y sensibl...

Background The World Health Organization (WHO) has reframed health and healthcare for older people around achieving the goal of healthy ageing. The recent WHO Integrated Care for Older People (ICOPE) guidelines focus on maintaining intrinsic capacity, i.e., addressing declines in neuromusculoskeletal, vitality, sensory, cognitive, psychological, an...

Dementia has been recognized by the World Health Organization as a public health problem since 2012 (WHO, 2012). According to estimates from the World Alzheimer Report from Alzheimer’s Disease International (ADI), in 2015, 46.8 million people worldwide had dementia, a number that is expected to increase to 74.7 million by 2030 and 131.5 million by...

The world’s population is currently aging at an astonishing rate. It is estimated that the global proportion of older adults (age 60+ years) will almost double between 2015 and 2050, from 12% to 22%. This constitutes an increase from approximately 900 million older adults to 2 billion. It is worth noting that the current population of people age 80...

The prevalence of dementia in Latin America and the Caribbean is growing rapidly, increasing the burden placed on caregivers. Exacerbated by fragile health-care systems, unstable economies, and extensive inequalities, caregiver burden in this region is among the highest in the world. We reviewed the major challenges to caregiving in Latin America a...

Objectives: This study was designed to explore prevalence and correlates of self-reported loneliness and to investigate whether loneliness predicts mortality among older adults (aged 65 or above) in Latin America, China and India. Methods: The study investigated population-based cross-sectional (2003–2007) and longitudinal surveys (follow-up 2007–2...

Across Latin American and Caribbean countries (LACs), the fight against dementia faces pressing challenges, such as heterogeneity, diversity, political instability, and socioeconomic disparities. These can be addressed more effectively in a collaborative setting that fosters open exchange of knowledge. In this work, the Latin American and Caribbean...

Introduction Neuroinflammation is involved in the pathophysiology of various neurological disorders, in particular Alzheimer disease (AD) and Parkinson’s disease (PD). Alterations in the blood-brain barrier may allow peripheral blood lymphocytes to enter the central nervous system; these may participate in disease pathogenesis. Objective To evalua...

Introduction The increasing evidence of SARS‐CoV‐2 impact on the central nervous system (CNS) raises key questions on its impact for risk of later life cognitive decline, Alzheimer's disease (AD), and other dementia. Methods The Alzheimer's Association and representatives from more than 30 countries—with technical guidance from the World Health...

Introduction: The increasing evidence of SARS-CoV-2 impact on the central nervous system (CNS) raises key questions on its impact for risk of later life cognitive decline, Alzheimer's disease (AD), and other dementia. Methods: The Alzheimer's Association and representatives from more than 30 countries-with technical guidance from the World Healt...

Background Dementia prevalence in Mexico is 9% over 65 years old, 28% of those patients live in rural areas, dementia care in rural communities face special challenges due to often geographical, economical, sociocultural, functional and inaccessibility ¹ . Although in the country dementia care is mostly family dependent and locally integrated there...

Background Due to the high impact of dementia it is a priority to focus on the well‐being of those with this condition, enabling participation, inclusion and better functioning of people with this disease. In the research context it’s increasing the interest on documenting the needs reported by those living with dementia. The aim of this study was...

Background CAIDE (Cardiovascular Risk Factors, Aging, and dementia) Dementia Risk Score was developed to identify subjects with risk for developing dementia; using cardiovascular risk factors for dementia. CAIDE has showed to have a good predictive value. Mexican elders have different risk factors for dementia; the use of this type of score could b...

Background Social isolation (SI) (defined as infrequent social contact or people with limited social networks) has been association with cognitive impairment, however, some authors has argued there is not a relationship between both. In line with the World Health Organization (WHO). Dementia is a syndrome affecting memory, thinking, orientation, co...

Background More than 300 pathogenic variants in APP , PSEN1 and PSEN2 genes have been reported causing Dominant Inhered Alzheimer Disease (DIAD); most of these reports come from Northern hemisphere countries. In recent years, a growing number of familial AD cases have become known in Central and South American countries; however, little is known ab...

Background Subjective cognitive decline (SCD) represents a state in which a participant perceives a decline in cognitive functions, yet standardized psychological tests remain within expected performance compared to age‐ and education‐matched controls. SCD is growingly recognized as a risk state for mild cognitive decline (MCI), and eventually, dem...

Background Most people with dementia live in Low and Middle Income Countries (LMICs), where little research on dementia risk prediction modelling has occurred. This study aimed to develop new models to simply predict all‐cause dementia, suitable for use in LMICs. Country‐specific models were expected, due to different risk profiles. Method Data wa...

Background Posterior cortical atrophy (PCA) is a cognitive behavioral syndrome characterized by visual and cognitive alterations that is associated with neurodegeneration of the posterior cerebral cortex (occipital, parietal and posterior temporal). 95% of these cases also present neuropsychiatric symptoms (NPS), as anxiety, depression and irritabi...

Background The cognitive‐motor syndrome (CMS) describes the association of cognitive and gait alterations, being potentially useful for predicting dementia. The criteria proposed for the CMS are: cognitive complaint, decrease in gait speed, preservation of daily life activities, and absence of dementia. Method This work is a population‐based cohor...

Background Given the deleterious consequences for patients and families with autosomal dominant AD, it is necessary to identify individuals at risk in preclinical phases, with the objective of include them in clinical intervention trials Method We included 11 DNA samples from patients diagnosed with FAD and 9 DNA samples with of patients with EAD,...

Background Type 2 diabetes mellitus (T2D) and depression have both become pandemics over the last years. Both of these conditions have also been associated with signs of systemic inflammation, decreased insulin sensitivity, and autonomic dysfunction, all identified as risk factors for cognitive impairment and dementia. Our aim in this study was to...

Background The highest proportion of deaths occurs in people over 65 years. Factors related to mortality differ between clinical and community population. In Mexico there are few population‐based studies that explore sociodemographic factors, comorbidities, cognitive status and disability, associated with mortality in community elders. Method This...

Background The Face‐Name Associative Memory Exam (FNAME) has been shown to detect memory deficits early in the spectrum of Alzheimer’s disease. In this study, we used a newly developed and further extended version of the FNAME, to evaluate the discriminating ability of this test in amnestic cognitive decline (aMCI), amnestic subjective cognitive de...

Background: Decreased levels of repressor element-1 silencing transcription (REST) factor in the brain, plasma, and neuronderived exosomes are associated with Alzheimer's disease (AD). Objective: The objective of the study was to test the viability of serum REST as a possible blood-based biomarker for AD, comparing serum REST levels in AD patien...

Background: A growing number of studies have explored how features of the neighbourhood environment can be related to cognitive health in later life. Yet few have focused on low- and middle-income countries and compared the results across different settings. The aim of this study is to investigate the cross-sectional associations between neighbour...

Objective Describe the protocol sample and instruments of the Cognitive Aging Ancillary Study in Mexico (Mex-Cog). The study performs an in-depth cognitive assessment in a subsample of older adults of the ongoing Mexican Health and Aging Study (MHAS). The Mex-Cog is part of the Harmonized Cognitive Assessment Protocol (HCAP) design to facilitate cr...

Background To date, dementia prediction models have been exclusively developed and tested in high-income countries (HICs). However, most people with dementia live in low-income and middle-income countries (LMICs), where dementia risk prediction research is almost non-existent and the ability of current models to predict dementia is unknown. This st...

Background Research carried out in high income countries suggests that loneliness may be a common experience among older adults living in these settings. Loneliness is correlated with poor socioeconomic status, living alone, being widowed and is associated with adverse health outcomes, including mortality. There is still a lack of evidence about th...

One of the characteristics of the cerebral aging process is the presence of chronic inflammation through glial cells, which is particularly significant in neurodegeneration. On the other hand, it has been demonstrated that the aryl hydrocarbon receptor (AHR) participates in the inflammatory response. Currently, evidence in animal models shows that...

Objectives: Depression and anxiety are common mental disorders in later life. Few population-based studies have investigated their potential impacts on mortality in low- and middle-income countries (LMICs). The aim of this study is to examine the associations between depression, anxiety, their comorbidity and mortality in later life using a popula...

Background The World Health Organization has reframed health and healthcare for older people around achieving the goal of healthy ageing. Recent evidence-based guidelines on Integrated Care for Older People focus on maintaining intrinsic capacity, addressing declines in mobility, nutrition, vision and hearing, cognition, mood and continence aiming...

World population is experiencing a demographic transition, which introduces changes in the workforce structure, such as increasing retirement. At the same time, retirement produces several life-style modifications that significantly influence well-being and can lead to depression. Thereby, this study aimed to estimate the association between retire...

Background: Alzheimer disease presents a complex set of assessment problems, including early and accurate diagnosis, development of sensitive but efficient cognitive measures, in addition to the need of brief measures in individuals with cognitive impairment that can have difficulties for tolerating long assessment procedures. So, the aim of this s...