Browsing by Author "Montesinos, R"

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Association between nutritional status and dementia staging among Alzheimer’s disease patients in Peru: Preliminary results of the Genetic of Alzheimer’s Disease in Peruvian Population Study
(John Wiley and Sons Inc, 2022) Montesinos, R; Chambergo-Michilot, D; Malaga, D; Ore-Gomez, MF; Rivera-Fernandez, C; Soto-Añari, M; Reyes-Dumeyer, D; Failoc-Rojas, VE; Casavilca-Zambrano, S; Custodio, N; Tosto, G
Background: Alzheimer’s Disease Related Dementias (ADRD) is estimated to increase up to 152 million in 2050. Dementia-related mortality increases with older age, male sex, neuropsychiatric symptoms, faster cognitive decline, physical impairment and disease severity. Malnutrition is an important ADRD complication due to its impact on several domains. Prior studies showed that malnutrition is associated with behavioral and cognitive impairment (emotional disinhibition and behavior disturbance, memory impairment) and higher mortality risk among ADRD patients. Prevalence of malnutrition is heterogeneous and may depend on disease severity. We aimed to assess the association between malnutrition and dementia severity in an outpatient cohort of Peruvians, part of the Genetic of Alzheimer’s Disease in Peruvian Population (GAPP) Study. Method: A cross-sectional study was carried out in three different sites of different altitude in Peru. We included individuals aged >50 years who attended memory clinics. We used the Mini-Nutritional Assessment (MNA) scale to assess the nutritional status, and the Clinical Dementia Rating (CDR) to grade the dementia. We stratified the nutritional status in normal (MNA score: 12-14) and malnourished or risk of malnourished (MNA: 11 or less). Result: We assessed 295 patients mean age was 71.9 (SD: 8.3) and 68.8% were females proportion of demented (CDR> = 1) was 23%. Prevalence of malnourishment and risk of malnourishment was 6.4% and 35%, respectively. When adjusted by demographic covariates and geographical recruitment site, we found malnourishment scores significantly associated with CDR scores (e.g. CDR 2-3: PR 2.27, 95% CI: 1.95-2.62). Malnourishment was not associated with cardiovascular risk factors or diseases. Conclusion: In our Peruvian cohort, malnourishment or risk of malnourishment was found associated with higher risk of ADRD. Prevalence of malnourishment or risk of malnourishment was in line with those reported in other South American countries. Further longitudinal studies should confirm this association.
Fagofobia Como Síntoma Inicial de Demencia Frontotemporal: Reporte de Caso
(Asociacion Colombiana de Psiquiatria, 2022) Custodio, N; Vences, MA; Baca, F; Montesinos, R; Failoc-Rojas, VE; Cuenca, J; Lira, D
Introduction: Frontotemporal dementia is an important cause of dementia, and its diagnosis is complex due to the multiple neurocognitive manifestations that patients present. Eating disorders associated with this pathology have been reported, but phagophobia is an atypical manifestation. Case report: We present the case of a 74-year-old adult patient with onset of phagophobia associated with a progressive and significant loss of executive functions, compromised spatial orientation, presenting in parallel a marked compromise in instrumental daily activities, psychotic symptoms, apathy, gait disturbance and sleep problems. Conclusions: It is important that adult and older patients with eating disorders, particularly those who also present cognitive, behavioural and social dysfunction are evaluated to rule out the broad spectrum of frontotemporal dementia, since timely diagnosis and treatment can improve quality of life or slow its progression.
The Memory Alteration Test Is Correlated with Clinical, Cerebrospinal Fluid, and Brain Imaging Markers of Alzheimer Disease in Lima, Peru
(S. Karger AG, 2024) Custodio, N; Malaga, M; Montesinos, R; Chambergo-Michilot, D; Baca, F; Carbajal, JC; Huilca, JC; Herrera-Perez, E; Lira, D; Diaz, MM; Lanata, S
Introduction: As disease-modifying therapies become available for Alzheimer’s disease (AD), detection of AD in early stages of illness (mild cognitive impairment [MCI], early dementia) becomes increasingly important. Biomarkers for AD in low- and middle-income countries (LMICs) are costly and not widely available; hence, it is important to identify cognitive tests that correlate well with AD biomarker status. In this study, we evaluated the memory alteration test (M@T) to detect biomarker-proven AD and quantify its correlation with neurodegeneration and cerebrospinal fluid (CSF) AD biomarkers in a cohort of participants from Lima, Peru. Methods: This is a secondary analysis of a cohort of 185 participants: 63 controls, 53 with amnestic MCI (aMCI), and 69 with dementia due to AD. Participants underwent testing with M@T and a gold standard neuropsychological battery. We measured total tau (t-tau), phosphorylated tau (p-tau), and beta-amyloid (β-amyloid) in CSF, and evaluated neurodegeneration via medial temporal atrophy score in MRI. We used receiver-operator curves to determine the discriminative capacity of the total M@T score and its subdomains. We used the Pearson coefficient to correlate M@T score and CSF biomarkers. Results: The M@T had an area under the curve (AUC) of 0.994 to discriminate between controls and cognitively impaired (aMCI or AD) patients, and an AUC of 0.98 to differentiate between aMCI and AD patients. Free-recall and cued recall had the highest AUCs of all subdomains. Total score was strongly correlated with t-tau (−0.77) and p-tau (−0.72), and moderately correlated with β-amyloid (0.66). The AUC for discrimination of neurodegeneration was 0.87. Conclusion: The M@T had excellent discrimination of aMCI and dementia due to AD. It was strongly correlated with CSF biomarkers and had good discrimination of neurodegeneration. In LMICs, the M@T may be a cost-effective screening tool for aMCI and dementia caused by AD.