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Article: Predictors of neurological deficit after endovascular treatment of cerebral arteriovenous malformations and functional repercussions in prospective follow-up.

Jordan, Jose / Llibre, Juan Carlos / Vazquez, Frank

2014 Volume 27, Issue 6, Page(s) 718–724

Abstract: Endovascular therapy is a well-established approach to the treatment of cerebral arteriovenous malformations (AVMs). The objective of this study was to determine the predictive factors of neurological deficit following endovascular procedures. Seventy- ... ...

Abstract	Endovascular therapy is a well-established approach to the treatment of cerebral arteriovenous malformations (AVMs). The objective of this study was to determine the predictive factors of neurological deficit following endovascular procedures. Seventy-one patients with cerebral AVMs who underwent 147 embolization sessions from 2006 to 2011 were followed up prospectively (average 31.1 ± 17.5 months). Functional neurological condition was documented by means of the modified Rankin scale. Factors found to be predictors of neurological deficit were the partial obstruction of drainage veins (OR = 197.6; IC = 2.76 -1416.0; P = 0.015), a positive result in the Propofol test (OR = 50.2; IC = 6.18 - 566.5; P = 0.000), AVM diameter under 3 cm (OR = 21.3; IC: 1.71 - 265.6; P = 0.018), the presence of intranidal aneurysms (OR = 11.2; IC = 1.09 - 114.2; P = 0.042), the absence of post-procedure hypotension (OR = 10.2; IC = 1.35 - 77.7; P = 0.003), deep venous drainage (OR = 7.14; IC = 1.15 - 44.4; P = 0.035), and devascularization in excess of 40% per session (OR = 3.3; IC = 1.11 - 16.8; P = 0.056). Fifty-six patients (78.9%) did not experience changes in their neurological condition after the treatment and 13 patients (18.3%) showed a new neurological deficit related to the treatment; 95.8 % of the patients did not show significant long-term incapacity. Partial obstruction of drainage veins, small AVMs, intranidal aneurysms, faulty hemodynamic control and extensive devascularization were found to be predictors of neurological deficit. A significant number of patients with neurological deficit improved in the long term.
MeSH term(s)	Embolization, Therapeutic/adverse effects ; Endovascular Procedures/adverse effects ; Female ; Follow-Up Studies ; Humans ; Intracranial Arteriovenous Malformations/therapy ; Male ; Nervous System Diseases/etiology ; Prospective Studies ; Risk Factors ; Treatment Outcome
Language	English
Publishing date	2014-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2257770-1
ISSN	1971-4009 ; 1120-9976
ISSN	1971-4009 ; 1120-9976
DOI	10.15274/NRJ-2014-10095
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Predictors of total obliteration in endovascular treatment of cerebral arteriovenous malformations.

Jordan, José Antonio / Llibre, Juan Carlos / Vazquez, Frank / Rodríguez, Raul Marino

The neuroradiology journal

2014 Volume 27, Issue 1, Page(s) 108–114

Abstract: Endovascular therapy is a therapeutic option that can achieve total obliteration of cerebral arteriovenous malformations (AVMs). The objective of this study was to determine the predictive factors of total obliteration in the endovascular treatment of ... ...

Abstract	Endovascular therapy is a therapeutic option that can achieve total obliteration of cerebral arteriovenous malformations (AVMs). The objective of this study was to determine the predictive factors of total obliteration in the endovascular treatment of AVMs. A prospective study was carried out in 71 patients with cerebral AVMs having undergone 147 embolization sessions with n-BCA, performed between 2006 and 2011. A univariate analysis was carried out, followed by a logistic regression analysis to determine the predictive factors of total obliteration. Total obliteration was achieved in 18.3% of the patients and angiographic control after 12 months showed the permanency of total occlusion in 100% of the AVMs with initial total obliteration. Angiographic characteristics found favorable for total eradication were: AVM size under 3 cm and the presence of a single arterial pedicle. Predictive factors of total obliteration were an AVM diameter smaller than 3 cm (OR: 50.9; IC: 7.41 - 349, 0; P = 0.000), and opposing factors, a 3-6 cm diameter (OR: 11.7; IC: 2.49 - 55, 4; P = 0.002) and afferences of more than two vessels of the Willis polygon (OR: 7.0; IC: 1.12-43.9; P = 0.038). An AVM diameter smaller than 3 cm is a predictive factor of total obliteration. Total postembolization obliteration persisted in 100% of the cases after 12 months.
MeSH term(s)	Adolescent ; Adult ; Aged ; Angiography, Digital Subtraction ; Cerebral Angiography ; Cerebral Revascularization ; Child ; Embolization, Therapeutic ; Endovascular Procedures/methods ; Female ; Humans ; Intracranial Arteriovenous Malformations/surgery ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2014-02-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2257770-1
ISSN	1971-4009 ; 1120-9976
ISSN	1971-4009 ; 1120-9976
DOI	10.15274/NRJ-2014-10013
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Article ; Online: Psychometric properties of EURO-D, a geriatric depression scale: a cross-cultural validation study.

Guerra, Mariella / Ferri, Cleusa / Llibre, Juan / Prina, A Matthew / Prince, Martin

BMC psychiatry

2015 Volume 15, Page(s) 12

Abstract: Background: Many of the assessment tools used to study depression among older people are adaptations of instruments developed in other cultural setting. There is a need to validate those instruments in low and middle income countries (LMIC).: Methods!# ...

Abstract	Background: Many of the assessment tools used to study depression among older people are adaptations of instruments developed in other cultural setting. There is a need to validate those instruments in low and middle income countries (LMIC). Methods: A one-phase cross-sectional survey of people aged [greater than or equal to] 65 years from LMIC. EURO-D was checked for psychometric properties. Calibration with clinical diagnosis was made using ICD-10. Optimal cutpoint was determined. Concurrent validity was assessed measuring correlations with WHODAS 2.0. Results: 17,852 interviews were completed in 13 sites from nine countries. EURO-D constituted a hierarchical scale in most sites. The most commonly endorsed symptom in Latin American sites was depression; in China was sleep disturbance and tearfulness; in India, irritability and fatigue and in Nigeria loss of enjoyment. Two factor structure (affective and motivation) were demonstrated. Measurement invariance was demonstrated among Latin American and Indian sites being less evident in China and Nigeria. At the 4/5 cutpoint, sensitivity for ICD-10 depressive episode was 86% or higher in all sites and specificity exceeded 84% in all Latin America and Chinese sites. Concurrent validity was supported, at least for Latin American and Indian sites. Conclusions: There is evidence for the cross-cultural validity of the EURO-D scale at Latin American and Indian settings and its potential applicability in comparative epidemiological studies.
MeSH term(s)	Aged ; China ; Cross-Cultural Comparison ; Cross-Sectional Studies ; Depression/diagnosis ; Female ; Geriatric Assessment/methods ; Humans ; India ; Latin America ; Male ; Nigeria ; Psychometrics
Language	English
Publishing date	2015-02-05
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Validation Study
ZDB-ID	2050438-X
ISSN	1471-244X ; 1471-244X
ISSN (online)	1471-244X
ISSN	1471-244X
DOI	10.1186/s12888-015-0390-4
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Article: Predictors of hemorrhagic complications from endovascular treatment of cerebral arteriovenous malformations.

Jordan, José A / Llibre, Juan Carlos / Vázquez, Frank / Rodríguez, Raúl / Prince, José A / Ugarte, José Carlos

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences

2014 Volume 20, Issue 1, Page(s) 74–82

Abstract: Post-embolization hemorrhage is the most severe, dramatic and morbidity-mortality-related complication in the treatment of endovascular arteriovenous malformations (AVMs). The objective of this study was to determine predictive factors of post- ... ...

Abstract	Post-embolization hemorrhage is the most severe, dramatic and morbidity-mortality-related complication in the treatment of endovascular arteriovenous malformations (AVMs). The objective of this study was to determine predictive factors of post-embolization hemorrhage. This is a retrospective study in 71 patients with cerebral AVMs having undergone 147 embolization sessions with n-butyl cyanoacrylate (n-BCA), carried out between 2006 and 2011. Clinical-demographic, morphological and treatment data as well as results were recorded. The relationship of post-procedure hemorrhage with demographic and morphological factors, percentage devascularization per session, venous drainage and whether or not post-procedure hypotension had been induced was investigated. Six post-embolization hemorrhages occurred, all in sessions characterized by extensive devascularization without the induction of post-procedure hypotension; which disappeared after a limit to the extent of devascularization per session and post-procedure hypotension were introduced. In the multivariate analysis, hemorrhage predictors were: nidus diameter < 3 cm (OR= 45.02; CI=95%:1.17-203.79; P=0.005); devascularization > 40% (OR=32.4; CI=95%: 3.142- 518.6; P=0.009) per session; intranidal aneurysms (OR=7.5; CI=95%:1.19-341.3; P=0.041) and lack of post-procedure hypotension (OR=16.51; CI=95%:1.81-324.4; P=0.049) and the association of sessions with devascularization exceeding 40% with lack of post-procedure hypotension, showed an increase in the risk of hemorrhage (OR=36.4; CI=95%:3.67-362.4; P=0.002). Extensive devascularization and the absence of post-procedure hypotension increase the risk of hemorrhage. We suggest partial, 25-30%, devascularization per session and the induction of post-procedure hypotension, which produces a 20% decrease of the basal mean arterial pressure (MAP).
MeSH term(s)	Adolescent ; Adult ; Aged ; Arteriovenous Fistula/epidemiology ; Arteriovenous Fistula/therapy ; Causality ; Cerebral Hemorrhage/epidemiology ; Cerebral Hemorrhage/prevention & control ; Child ; Comorbidity ; Cuba/epidemiology ; Embolization, Therapeutic/statistics & numerical data ; Enbucrilate/therapeutic use ; Female ; Hemostatics/therapeutic use ; Humans ; Incidence ; Intracranial Arteriovenous Malformations/epidemiology ; Intracranial Arteriovenous Malformations/therapy ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Young Adult
Chemical Substances	Hemostatics ; Enbucrilate (F8CEP82QNP)
Language	English
Publishing date	2014-02-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	1354913-3
ISSN	1591-0199 ; 1123-9344
ISSN	1591-0199 ; 1123-9344
DOI	10.15274/INR-2014-10011
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Zs.A 6325: Show issues

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Article ; Online: Efficacy and safety of the dual-layer flow-diverting stent (FRED) for the treatment of intracranial aneurysms.

Guimaraens, Leopoldo / Vivas, Elio / Saldaña, Jesus / Llibre, Juan Carlos / Gil, Alberto / Balaguer, Ernest / Rodríguez-Campello, Ana / Cuadrado-Godia, Elisa / Ois, Angel

Journal of neurointerventional surgery

2019 Volume 12, Issue 5, Page(s) 521–525

Abstract: Purpose: To describe the efficacy and complications of treating cerebral aneurysms with the Flow Re-direction Endoluminal Device (FRED) and to identify predictors for aneurysm occlusion.: Methods: A prospective observational registry including all ... ...

Abstract	Purpose: To describe the efficacy and complications of treating cerebral aneurysms with the Flow Re-direction Endoluminal Device (FRED) and to identify predictors for aneurysm occlusion. Methods: A prospective observational registry including all consecutive aneurysms treated with FRED between December 2015 and July 2018 was designed in one therapeutic neuroangiography department. The primary endpoint for treatment efficacy was complete or near-complete occlusion (O'Kelly-Marotta (OKM) C-D), assessed by three-dimensional digital subtraction angiography. Major (all symptomatics) and minor complications were described and those with modified Rankin Scale scores 3-6 were considered clinically relevant. Univariate and multivariate analyses were performed to identify predictors of efficacy. Results: A total of 185 aneurysms were analyzed in 150 patients (mean age 54.3±11.5 years). Mean follow-up was 18.99±11.32 months (range 0-43). Efficacy was evaluated in 156 (84.32%) cases: 132 (84.6%) had OKM C-D occlusion, 31/47 (66%) within the first year and 101/109 (92.7%) later on. Major complications were observed in 12 (6.5%) cases: three strokes (one transient ischemic accident, two minor strokes), six intra-stent thrombosis, and three with bleeding, but only one (0.5%) was clinically relevant. Minor complications (all asymptomatic) were observed in 10 (5.4%) cases: three shortening/repositioning of stent; two arterial dissection, two arterial occlusion, and three intra-stent stenosis. Independent predictors of occlusion were immediate OKM grade B-C-D (OR 4.01, 95% CI 1.51 to 10.62), single aneurysm (OR 3.29, 95% CI 1.05 to 10.32), and small size aneurysm (OR 4.74, 95% CI 1.57 to 14.30). Conclusion: The FRED stent fully complied with efficacy and safety requirements for treatment of intracranial aneurysms. Three predictors of aneurysm occlusion were identified.
MeSH term(s)	Adult ; Aged ; Angiography, Digital Subtraction/methods ; Embolization, Therapeutic/instrumentation ; Embolization, Therapeutic/methods ; Endovascular Procedures/instrumentation ; Endovascular Procedures/methods ; Female ; Follow-Up Studies ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Male ; Middle Aged ; Prospective Studies ; Registries ; Self Expandable Metallic Stents/adverse effects ; Treatment Outcome
Language	English
Publishing date	2019-10-25
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	2514982-9
ISSN	1759-8486 ; 1759-8478
ISSN (online)	1759-8486
ISSN	1759-8478
DOI	10.1136/neurintsurg-2019-015371
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Prevalence of stroke and associated risk factors in older adults in Havana City and Matanzas Provinces, Cuba (10/66 population-based study).

de Jesús Llibre, Juan / Valhuerdi, Adolfo / Fernández, Otman / Llibre, Juan Carlos / Porto, Rudbeskia / López, Ana M / Marcheco, Beatriz / Moreno, Carmen

MEDICC review

2010 Volume 12, Issue 3, Page(s) 20–26

Abstract: Introduction: Cerebrovascular disease (CVD) is the third cause of death and second cause of disability and dementia in adults aged>or=65 years worldwide. The few epidemiological studies of stroke in Latin America generally report lower prevalence and ... ...

Abstract	Introduction: Cerebrovascular disease (CVD) is the third cause of death and second cause of disability and dementia in adults aged>or=65 years worldwide. The few epidemiological studies of stroke in Latin America generally report lower prevalence and different patterns than developed countries. Objective: Estimate the prevalence of stroke and associated risk factors in adults aged>or=65 years in Havana City and Matanzas provinces, Cuba. Methods: Single phase, cross-sectional, door-to-door study of 3015 adults aged>or=65 years in selected municipalities of Havana City and Matanzas provinces. Variables studied were age, sex, educational level, and self-report and description of chronic disease (stroke, heart attack, angina, and diabetes mellitus), substance use (alcohol, tobacco), and dietary habits. Respondents were given a structured physical and neurological exam, and blood pressure was measured. Laboratory tests comprised complete blood count, fasting glucose, total cholesterol and fractions, triglycerides, and apolipoprotein E (APOE) genotype. Diagnosis of stroke was based on the World Health Organization's definition. Stroke prevalence ratios (crude and adjusted), with 95% confidence intervals (CI), were calculated for the variables studied using a Poisson regression model. Risk association was analyzed using multiple logistic regression for dichotomous responses. Results: Assessments were made of 2944 older adults (97.6% response rate). Prevalence of stroke was 7.8% (95% CI 6.9-8.8), and was higher in men. The risk profile for this population group included history of hypertension (OR 2.8; 95% CI 2.0-4.0), low HDL cholesterol (OR 2.6; 95% CI 1.7-3.9), male sex (OR 1.7; 95% CI 1.2-2.5), anemia (OR 1.6; 95% CI 1.1-2.5), history of ischemic heart disease (OR 1.5; 95% CI 1.0-2.3), carrier of one or two apolipoprotein E4 genotype (APOE E4) alleles (OR 1.4; 95% CI 1.0-2.0), and advanced age (OR 1.3; 95% CI 1.1-1.9). Conclusions: Stroke prevalence in this study is similar to that reported for Europe and North America, and higher than that observed in other Latin American countries. The risk profile identified includes classic risk factors plus anemia and APOE E genotype.
MeSH term(s)	Aged ; Cross-Sectional Studies ; Cuba/epidemiology ; Female ; Humans ; Interviews as Topic ; Male ; Population Surveillance ; Risk Factors ; Rural Population ; Stroke/epidemiology ; Urban Population
Language	English
Publishing date	2010-06-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2430374-4
ISSN	1527-3172 ; 1555-7960
ISSN (online)	1527-3172
ISSN	1555-7960
DOI	10.37757/MR2010.V12.N3.6
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Article ; Online: Dementia and other chronic diseases in older adults in Havana and Matanzas: the 10/66 study in Cuba.

Llibre, Juan de Jesús / Valhuerdi, Adolfo / Calvo, Marina / García, Rosa M / Guerra, Milagros / Laucerique, Tania / López, Ana M / Llibre, Juan Carlos / Noriega, Lisseth / Sánchez, Isis Y / Porto, Rudbeskia / Arencibia, Francis / Marcheco, Beatriz / Moreno, Carmen

MEDICC review

2011 Volume 13, Issue 4, Page(s) 30–37

Abstract: Introduction: Chronic non-communicable diseases are the leading cause of death worldwide, except in Sub-Saharan Africa. Nonetheless, one of these conditions, dementia, is the major contributor to disability-adjusted life years in people aged ≥60 years. ... ...

Abstract	Introduction: Chronic non-communicable diseases are the leading cause of death worldwide, except in Sub-Saharan Africa. Nonetheless, one of these conditions, dementia, is the major contributor to disability-adjusted life years in people aged ≥60 years. Few epidemiological studies exist of the prevalence and impact of dementia and selected chronic diseases in older adults in Latin America. Objective: Describe prevalence of dementia, other chronic vascular diseases and cardiovascular risk factors, as well as resulting disabilities and care needs generated in adults aged ≥65 years in Havana City and Matanzas provinces, Cuba. Methods: The 10/66 study is a prospective longitudinal study involving a cohort of 3015 adults aged ≥65 years in municipalities of Havana City and Matanzas provinces, divided into two phases: a cross-sectional door-to-door study conducted in 2003-2006, and a follow-up and assessment phase in 2007-2010. This article reports findings from the first phase. Hypertension diagnosis was based on criteria from the International Society for Hypertension; diabetes mellitus on American Diabetes Association criteria; stroke according to WHO definitions; and dementia according to criteria of the American Psychiatric Society's Diagnostic and Statistical Manual of Mental Disorders DSM-IV and the 10/66 International Dementia Research Group. Ischemic heart disease was defined by self-report of previous physician diagnosis. Study variables included age, sex, educational level, substance use (alcohol, tobacco) and dietary habits. A structured physical and neurological exam, including blood pressure measurement, was performed on all participants. Laboratory tests included complete blood count, fasting blood glucose, total cholesterol and lipoprotein fractions, triglycerides and apolipoprotein E genotype. Prevalence and standardized morbidity ratios (crude and adjusted) were calculated for chronic diseases studied with 95% confidence intervals, using a Poisson regression model and indirect standardization. Results: The study assessed 2944 older adults (response rate 97.6%) and found high prevalence of vascular risk factors and of chronic non-communicable diseases: hypertension 73.0% (95% CI 71.4-74.7), diabetes mellitus 24.8% (95% CI 22.9-26.5), ischemic heart disease 14.1% (95% CI 12.9-15.4), dementia 10.8% (95% CI 9.7-12.0) and stroke 7.8% (95% CI 6.9-8.8). The majority of participants (85%) had more than one cardiovascular risk factor. The main cause of disability and dependency in the study population was dementia. Conclusion: The high prevalence of chronic diseases observed in the elderly--with the consequent morbidity, disability and dependency--highlights the need for prevention, early diagnosis and risk factor control, particularly given the demographic and epidemiologic transition faced by Cuba and other developing countries.
MeSH term(s)	Age Factors ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Cuba/epidemiology ; Dementia/epidemiology ; Diabetes Mellitus/epidemiology ; Female ; Humans ; Hypertension/epidemiology ; Longitudinal Studies ; Male ; Myocardial Ischemia/epidemiology ; Poisson Distribution ; Population Surveillance ; Prevalence ; Prospective Studies ; Risk Factors ; Rural Population ; Stroke/epidemiology ; Urban Population
Language	English
Publishing date	2011-11-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2430374-4
ISSN	1527-3172 ; 1527-3172
ISSN (online)	1527-3172
ISSN	1527-3172
DOI	10.37757/MR2011V13.N4.7
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Article ; Online: Frailty, dependency and mortality predictors in a cohort of Cuban older adults, 2003-2011.

Llibre, Juan de Jesús / López, Ana M / Valhuerdi, Adolfo / Guerra, Milagros / Llibre-Guerra, Jorge J / Sánchez, Y Yvonne / Bosch, Rodolfo / Zayas, Tania / Moreno, Carmen

MEDICC review

2014 Volume 16, Issue 1, Page(s) 24–30

Abstract: Introduction: Population aging translates into more people with chronic non-communicable diseases, disability, frailty and dependency. The study of frailty--a clinical syndrome associated with an increased risk of falls, disability, hospitalization, ... ...

Abstract	Introduction: Population aging translates into more people with chronic non-communicable diseases, disability, frailty and dependency. The study of frailty--a clinical syndrome associated with an increased risk of falls, disability, hospitalization, institutionalization and death--is important to improve clinical practice and population health indicators. Objectives: In a cohort of older adults in Havana and Matanzas provinces, Cuba, estimate prevalence of frailty and its risk factors; determine incidence of dependency; estimate mortality risk and identify mortality predictors. Methods: A prospective longitudinal study was conducted door to door, from June 2003 through July 2011, in a cohort of 2813 adults aged ≥65 years living in selected municipalities of Havana and Matanzas provinces; mean followup time was 4.1 years. Independent variables included demographics, behavioral risk factors and socioeconomic indicators, chronic non-communicable diseases (hypertension, stroke, dementia, depression, diabetes, anemia), number of comorbidities, and APOE ε4 genotype. Dependent variables were frailty, dependency and mortality. Criteria for frailty were slow walking speed, exhaustion, weight loss, low physical activity and cognitive decline. Prevalence and frailty risk were estimated by Poisson regression, while dependency and mortality risks and their predictors were determined using Cox regression. Results: Frailty syndrome prevalence was 21.6% (CI 17.9%-23.8%) at baseline; it was positively associated with advanced age, anemia and presence of comorbidities (stroke, dementia, depression, three or more physically debilitating diseases). Male sex, higher educational level, married or partnered status, and more household amenities were inversely associated with frailty prevalence. In followup, dependency incidence was 33.1 per 1000 person-years (CI 29.1-37.6) and mortality was 55.1 per 1000 person-years. Advanced age, male sex, lower occupational status during productive years, dependency, frailty, dementia, depression, cerebrovascular disease and diabetes were all associated with higher risk of death. Conclusions: Given the challenge for developing countries presented by demographic and epidemiologic transition; the high prevalence in older adults of frailty syndrome, dependency and chronic non-communicable diseases; and the association of all these with higher mortality, attention should be targeted to older adults as a risk group. This should include greater social protection, age-appropriate health services, and modification and control of cardiovascular risk factors.
MeSH term(s)	Aged ; Aged, 80 and over ; Confidence Intervals ; Cuba/epidemiology ; Female ; Forecasting ; Frail Elderly/statistics & numerical data ; Humans ; Independent Living/statistics & numerical data ; Male ; Mortality/trends ; Prospective Studies ; Risk Factors
Language	English
Publishing date	2014-01-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2430374-4
ISSN	1527-3172 ; 1527-3172
ISSN (online)	1527-3172
ISSN	1527-3172
DOI	10.37757/MR2014.V16.N1.6
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Article: Prevalence of Dementia and Alzheimer's Disease in a Havana Municipality: A Community-Based Study among Elderly Residents.

Llibre, Juan de Jesús / Fernández, Yuriem / Marcheco, Beatriz / Contreras, Nereyda / López, Ana M / Otero, Marta / Gil, Isis / Guerra, Milagros / García, Milagros / Bayarre, Héctor

MEDICC review

2010 Volume 11, Issue 2, Page(s) 29–35

Abstract: Introduction Approximately 24.2 million persons throughout the world suffer dementia with 4.6 million new cases reported annually. Only 10% of dementia and Alzheimer's disease studies are conducted in developing countries where 66% of sufferers live. ... ...

Abstract	Introduction Approximately 24.2 million persons throughout the world suffer dementia with 4.6 million new cases reported annually. Only 10% of dementia and Alzheimer's disease studies are conducted in developing countries where 66% of sufferers live. Cuba, a developing country, exhibits health indicators similar to those of developed nations. Its population of 11.6 million is aging rapidly: by the year 2020 it is estimated that persons aged ≥65 years will comprise 25% of the population, making Cuban society the "oldest" in Latin America. Objectives Ascertain and characterize behavior of dementia, its etiologies and risk factors in persons aged ≥65 years in the Havana City municipality of Playa. Methods A two-phase, cross-sectional, door-to-door study was conducted in the municipality targeting all persons aged ≥65 years, achieving a 96.4% response rate (n=18,351). Folstein Mini Mental State Examination (MMSE), Hughes Clinical Dementia Rating (CDR) and a structured interview on risk factors were applied. DSM-IV, NINCDS-ADRDA and NINDS-AIREN criteria were used to determine dementia diagnosis, as well as other criteria for diagnosing Alzheimer's and other specific forms of dementia. Results Dementia prevalence was 8.2% of adults aged ≥65 years, with a slight predominance in males. The most frequent cause of dementia was Alzheimer's disease, followed by mixed dementias. Dementia-associated risk factors were: history of stroke, hypertension, depression, skull-brain trauma, family history of dementia, low educational level and advanced age. Conclusions This study corroborates that dementia and Alzheimer's disease constitute an important and growing health problem for our country due to the accelerated aging of the Cuban population. It also underlines the importance of early diagnosis and proper treatment of hypertension and other vascular risk factors, as well as the need for a national public health program for the prevention and early diagnosis of dementia and Alzheimer's disease, targeting elderly and at-risk populations.
Language	English
Publishing date	2010-04-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2430374-4
ISSN	1527-3172 ; 1555-7960
ISSN (online)	1527-3172
ISSN	1555-7960
DOI	10.37757/MR2009V11.N2.8
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Article ; Online: Dementia in Latin America: Paving the way toward a regional action plan.

Parra, Mario Alfredo / Baez, Sandra / Sedeño, Lucas / Gonzalez Campo, Cecilia / Santamaría-García, Hernando / Aprahamian, Ivan / Bertolucci, Paulo Hf / Bustin, Julian / Camargos Bicalho, Maria Aparecida / Cano-Gutierrez, Carlos / Caramelli, Paulo / Chaves, Marcia L F / Cogram, Patricia / Beber, Bárbara Costa / Court, Felipe A / de Souza, Leonardo Cruz / Custodio, Nilton / Damian, Andres / de la Cruz, Myriam /

Diehl Rodriguez, Roberta / Brucki, Sonia Maria Dozzi / Fajersztajn, Lais / Farías, Gonzalo A / De Felice, Fernanda G / Ferrari, Raffaele / de Oliveira, Fabricio Ferreira / Ferreira, Sergio T / Ferretti, Ceres / Figueredo Balthazar, Marcio Luiz / Ferreira Frota, Norberto Anizio / Fuentes, Patricio / García, Adolfo M / Garcia, Patricia J / de Gobbi Porto, Fábio Henrique / Duque Peñailillo, Lissette / Engler, Henry Willy / Maier, Irene / Mata, Ignacio F / Gonzalez-Billault, Christian / Lopez, Oscar L / Morelli, Laura / Nitrini, Ricardo / Quiroz, Yakeel T / Guerrero Barragan, Alejandra / Huepe, David / Pio, Fabricio Joao / Suemoto, Claudia Kimie / Kochhann, Renata / Kochen, Silvia / Kumfor, Fiona / Lanata, Serggio / Miller, Bruce / Mansur, Leticia Lessa / Hosogi, Mirna Lie / Lillo, Patricia / Llibre Guerra, Jorge / Lira, David / Lopera, Francisco / Comas, Adelina / Avila-Funes, José Alberto / Sosa, Ana Luisa / Ramos, Claudia / Resende, Elisa de Paula França / Snyder, Heather M / Tarnanas, Ioannis / Yokoyama, Jenifer / Llibre, Juan / Cardona, Juan Felipe / Possin, Kate / Kosik, Kenneth S / Montesinos, Rosa / Moguilner, Sebastian / Solis, Patricia Cristina Lourdes / Ferretti-Rebustini, Renata Eloah de Lucena / Ramirez, Jeronimo Martin / Matallana, Diana / Mbakile-Mahlanza, Lingani / Marques Ton, Alyne Mendonça / Tavares, Ronnielly Melo / Miotto, Eliane C / Muniz-Terrera, Graciela / Muñoz-Nevárez, Luis Arnoldo / Orozco, David / Okada de Oliveira, Maira / Piguet, Olivier / Pintado Caipa, Maritza / Piña Escudero, Stefanie Danielle / Schilling, Lucas Porcello / Rodrigues Palmeira, André Luiz / Yassuda, Mônica Sanches / Santacruz-Escudero, Jose Manuel / Serafim, Rodrigo Bernardo / Smid, Jerusa / Slachevsky, Andrea / Serrano, Cecilia / Soto-Añari, Marcio / Takada, Leonel Tadao / Grinberg, Lea Tenenholz / Teixeira, Antonio Lucio / Barbosa, Maira Tonidandel / Trépel, Dominic / Ibanez, Agustin

Alzheimer's & dementia : the journal of the Alzheimer's Association

2020 Volume 17, Issue 2, Page(s) 295–313

Abstract: 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 ...

Abstract	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 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 transformative actions. Then we characterize key sources of complexity (genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions), map them to the above challenges, and provide the basic mosaics of knowledge toward a KtAF. Finally, we describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF.
MeSH term(s)	Biomarkers ; Dementia/epidemiology ; Dementia/therapy ; Evidence-Based Practice ; Humans ; Latin America/epidemiology ; Socioeconomic Factors
Chemical Substances	Biomarkers
Language	English
Publishing date	2020-11-20
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2211627-8
ISSN	1552-5279 ; 1552-5260
ISSN (online)	1552-5279
ISSN	1552-5260
DOI	10.1002/alz.12202
Database	MEDical Literature Analysis and Retrieval System OnLINE

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