Neurología Cognitiva.pósters

Beyond Genetics: The Influence of Socioeconomic Status on Dominantly Inherited Alzheimer’s Disease Progression

2026-09-28T16:25:24Z

Beyond Genetics: The Influence of Socioeconomic Status on Dominantly Inherited Alzheimer’s Disease Progression Clarens, María Florencia; Fernández, Rodrigo Sebastián; Karch, Celeste M.; McDade, Eric; Llibre Guerra, Jorge J.; Allegri, Ricardo Francisco; Chrem Méndez, Patricio Alexis; Dominantly Inherited Alzheimer Network (DIAN) Background: Social inequalities are key health determinants shaping Alzheimer’s disease (AD) progression. In dominantly inherited Alzheimer’s disease (DIAD), where genetic causes are established, the influence of socioeconomic status (SES) on cognitive and functional outcomes remains underexplored. This study examines how SES impacts DIAD progression, offering insights into the role of social risk factors in a genetically defined AD model. Method: Data from 421 participants in the Dominantly Inherited Alzheimer Network (DIAN) across 10 countries was analyzed, including 158 non‐mutation carriers (nMC), 170 asymptomatic mutation carriers (aMC), and 93 symptomatic mutation carriers (sMC). Using hierarchical linear mixed models, we evaluated the longitudinal effects of SES, measured by the Hollingshead Social Class Index (SC), on cognition (DIAN Cognitive Composite) and function (Clinical Dementia Rating Scale Sum of Boxes, CDR‐SB). We identified an optimal change point (CP) near estimated years from onset (EYO) to detect when mutation carriers diverged from non‐carriers. Interactions among SC, mutation status, time, and proximity to symptomatic onset were modeled. Result: Cognitive trajectories revealed a significant four‐way interaction (Mutation × Time × Baseline EYO × SC, p < 0.020), indicating SES moderates the combined effects of mutation status, time, and proximity to onset. Another interaction (Mutation × Time × CP_EYO_final × SC; p < 0.017) confirmed SES’s role in influencing cognitive decline. Lower SES was consistently associated with greater cognitive decline among mutation carriers, as verified through simple slopes analyses and Johnson‐Neyman intervals (p < 0.05, Figure 1). Analyses of CDR‐SB revealed consistent patterns, indicating that SES similarly affects functional outcomes (Figure 2). Conclusion: SES significantly affects cognitive and functional trajectories in DIAD, highlighting the role of social determinants in disease variability. These findings suggest social inequalities exacerbate DIAD progression, finding that could be extrapolated to sporadic AD. Addressing social determinants of health is critical in genetically defined populations to improve outcomes and mitigate disparities.

Integrating city design into lifestyle trials: urban greenness shapes physical activity levels across 12 cities in the LatAm FINGERS trial.

2026-09-28T16:02:14Z

Integrating city design into lifestyle trials: urban greenness shapes physical activity levels across 12 cities in the LatAm FINGERS trial. Spiousas, Ignacio; Coldeira, María Florencia; Suemoto, Claudia Kimie; Baena, Ana Y.; Salinas Contreras, Rosa María; Caramelli, Paulo; Brucki, Sonia; Nitrini, Ricardo; Sosa, Ana Luisa; Crivelli, Lucía; Sevlever, Gustavo Emilio; Custodio, Nilton; Acosta, Daisy; Charamelo, Ana; Delgado, Carolina; Cusicanqui, María Isabel; Jiménez Velázquez, Ivonne; Duque Peñailillo, Lissette; Calandri, Ismael Luis; LatAm-FINGERS Consortium Background: LatAm FINGERS is a feasibility trial aimed at preventing cognitive decline in individuals at risk through lifestyle changes in Latin America, with its objectives aligned with the RE‐AIM (Reach, Effectiveness, Adoption and Implementation) framework. An essential component of this framework is adoption, which emerges from the interaction between participants, the trial procedures, and their environment. Given that the intervention focuses on lifestyle modifications, it is crucial to consider an often‐overlooked factor: the city where participants live and its influence on behavior. A clear example is the relationship between physical activity and the availability of spaces that support it. Urban greenness refers to the collection of green spaces within a city. We aimed to examine how accessibility to green spaces influences the amount of physical activity performed by participants before starting the LatAm‐FINGERS trial. Method: We geolocated the residences of 1,800 screened individuals from 12 Latin American cities. Using publicly available data, we estimated isochrones, or areas reachable within a 15‐minute walk (3.4 km/h), along city pathways. As a measure of greenness, we calculated the surface area of public green spaces within each isochrone and the distance to the nearest green space. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) and converted into metabolic equivalent of task (MET) units. A generalized linear mixed‐effects model assessed whether weekly physical activity levels (in METs/week) were associated with walkable green space availability. The model was adjusted for socioeconomic status, education, sex, mobility assistance needs, depression, smoking, and co‐morbid conditions. Result: Walking was the most common physical activity, with weekly METs averaging 126.5 (SD=108.4), representing 70.2% (SD=10.8%) of total physical activity. While the total green space area had a minimal effect on walking (β=−0.0004, 95%CI=‐0.0017, 0.0001), distance to the nearest green space influenced walking levels (β=‐0.0440, 95%CI=‐0.1874, 0.0982). For each block farther a participant's home was from a green space, weekly walking METs decreased by 3%. Conclusion: These results highlight the importance of green spaces in promoting physical activity. Future steps will explore whether urban greenness also influences intervention adherence to the physical activity program and other measures of wellbeing.

Can the Cognitive Function Index identify cognitive impairment in Latin America?

2026-09-29T16:36:35Z

Can the Cognitive Function Index identify cognitive impairment in Latin America? Sanchez Yossuda, Monica; Crivelli, Lucía; Calandri, Ismael Luis; Suemoto, Claudia Kimie; Sevlever, Gustavo Emilio; Salinas-Contreras, Rosa María; Caramelli, Paulo; Dozzi Brucki, Sonia Maria; Cançado, Gustavo Henrique; Vigil-Martínez, Ana; Martin, María Eugenia; Surace, Ezequiel Ignacio; Martin, Maria Da Graça Morais; Damian, Andrés; Custodio, Belén; Corvalán, Nicolás; Fernandez Slezak, Diego; Velilla, Lina Marcela; Lima Carreira, Luzia; Studart Neto, Adalberto; Allegri, Ricardo Francisco Background: The Cognitive Function Index (CFI) was developed to identify individuals with Subjective Cognitive Decline (SCD), which is defined by the self‐perception of cognitive impairment, not detected in neuropsychological tests. Limited research has been done with this tool in Latin America (LA). We aimed to investigate the association between CFI and global cognition and to investigate whether CFI scores can identify participants with cognitive performance below 1.0 standard deviation (SD) of the sample mean. Method: The LatAm‐FINGERS study is a dementia prevention feasibility study in 12 LA countries. For the present analysis, 815 participants with complete cognitive data (604 women, 74.1%; 436 mestizo 53.5%; mean age=67.5, SD=4.8; mean education = 13.0, SD=3.6; mean GDS=2.7, SD=2.8) were included. The CFI is a 14‐item self‐report measure of cognitive change; higher scores indicate higher concerns. CFI total score was normalized into a z‐score, as some questions were not applicable to all participants and total score differed among them. Cognition was assessed with the Preclinical Alzheimer Cognitive Composite (PACC‐5) ‐ Mini‐Mental State Examination; Logical Memory Delayed Recall; Free and Cued Selective Reminding Test; Digit Symbol Substitution Test; and Animal Category Fluency. Participants were classified into those with PACC‐5 at or above 1 SD from the mean (n = 764) and those below (n = 51). Bivariate and partial correlations (controlling for sex, age, education and GDS score) were used to assess the association b tween the CFI and PACC‐5 scores. Receiver operating characteristic (ROC) analyses were used to assess CFI accuracy to identify participants with PACC‐5 scores below 1 SD. Result: CFI and PACC‐5 scores were negatively associated with each other (r = ‐0.27; p <0.001; partial r = ‐0.12; p <0.001). ROC analyses indicated an area under the curve (AUC) of 0.71 (sensitivity=0.64; specificity=0.70) with an optimal threshold of 0.36 (Youden Index=0.35) as a suggested cutoff score for the normalized CFI score. Conclusion: The CFI may be added to cognitive screening protocols to identify individuals who may need further assessment. Integrating the CFI into screening strategies in LA could play a pivotal role in reducing cognitive health disparities and advancing tailored dementia prevention initiatives that address the region's specific sociocultural and healthcare challenges.

Characterization of individuals fulfilling clinical criteria for limbic-predominant age-related TDP43 encephalopathy (LATE) in a tertiary memory clinic

2026-09-25T17:54:34Z

Characterization of individuals fulfilling clinical criteria for limbic-predominant age-related TDP43 encephalopathy (LATE) in a tertiary memory clinic Groot, Colin; Calandri, Ismael Luis; Bader, Ilse; Bocancea, Diana I.; de Bruin, Hannah; Carrigan, Maria; Kamps, Suzie; de Koning, Lotte A.; Mastenbroek, Sophie E.; Rikken, Roos M.; van Tol, Bastiaan G. J.; Vermeiren, Marie R.; Wesseling, Alex; Xia, Ye; Teunissen, Charlotte E.; van de Giessen, Elsmarieke; Barkhof, Frederik; Jonkman, Laura E.; van der Lee, Sven J.; de Boer, Casper Background Limbic-predominant age-related TDP-43 encephalopathy (LATE) clinically mimics and often co-occurs with Alzheimer's disease (AD). Expert consensus criteria have been proposed for the LATE clinical diagnosis, integrating clinical and radiological features, and AD biomarkers. Here, we applied the newly proposed criteria in a tertiary memory clinic population. Method We included participants from the Amsterdam Dementia Cohort aged >50 years who received a diagnosis of MCI or dementia between 1997-2024. Following the LATE consensus criteria scheme (Figure 1), we categorized participants as “Probable LATE”, “Possible LATE” or “Possible LATE-AD” (i.e. LATE clinical and radiological profile with AD biomarker profile). Participants not fulfilling criteria for LATE but fulfilling NIA-AA criteria for AD were categorized as AD. We compared the LATE groups with AD on cognitive decline (N = 1046, N Mean time=2.7[1.8] years) and atrophy (N = 208, Mean time=2.1[1.6]) using linear-mixed effects models, and on mortality rates using Cox proportional hazard models. Result Of the 3367 individuals, 1920 were classified into one of the four groups. Fifty-one (1.5%) were classified as Probable LATE, 102 (3.0%) as Possible LATE, 122 (3.6%) as Possible LATE-AD, and 1645 (48.8%) as AD (Table 1). Compared to AD, Probable LATE showed an attenuated cognitive decline (b[SE] for MMSE=0.12[0.05], p = 0.02) and lower mortality rates (HR[95% CI]=0.75[0.58-0.95], p = 0.02), while individuals with Possible LATE-AD had faster cognitive decline (b for MMSE=-0.12[0.05], p = 0.01) and higher mortality rates (HR=1.55[1.25-1.92], p <0.001, Figure 2). Compared to AD, Probable LATE had, at baseline, lower hippocampal volumes (b=-0.83[0.27], p <0.01), and higher inferior-temporal to hippocampal volume ratios (b=0.81[0.27], p <0.01). Furthermore, in Probable LATE, atrophy in a whole-brain region-of-interest was slower compared to AD (b=0.14[0.08], p = 0.04). Possible LATE-AD had, at baseline, thinner whole-brain cortex (b=-0.69[0.30], p = 0.02), lower hippocampal volumes (b=-1.54[0.31], p <0.01), and higher inferior-temporal to hippocampal volume ratios (b=1.73[0.30], p <0.01) than AD, but there was no difference in atrophy rates between Possible LATE-AD and the other groups (Figure 3). Conclusion In a tertiary memory clinic population, the newly proposed clinical LATE criteria reveal clinical and atrophy trajectories that are distinct from AD, especially for Probable LATE and Possible LATE-AD. Differential clinical and biological disease trajectories highlight the relevance of the LATE classification for diagnostic and prognostic purposes