ABSTRACT
Background The current pandemic COVID-19 caused by SARS-CoV2 has become a public health challenge, causing difficulty in patient care and follow up of people with cognitive impairment due to Alzheimer's disease. This situation motivated changes and adjustments to the Group of Neurosciences of Antioquia?s (GNA) Social Plan to guarantee effective continuity in patient care, family follow-up, community interventions and adherence to the Alzheimer?s Prevention Initiative (API) Colombia clinical trial. This was an opportunity to innovate, create, reinvent and expand forms of care and intervention during confinement and pandemic to promote access through virtual media and the well-being of beneficiaries. Methods The Social Plan program involves free access to basic care supplies for patients, home-visits, support groups, cognitive stimulation groups and virtual community outreach activities like workshops for caregivers/interested public, Alzheimer's Day Commemoration ?Cuidarme ? Cuidarte? event (with available recorded resources), symposiums for caregivers, and informative meetings with participants of the API Colombia clinical trial. Results In the period of mandatory preventive confinement, 30 families obtained diapers, 23 families received prescription drugs not provided by health maintenance organizations (HMO) and 48 families received groceries. A total of 32 home-visits were made: 7 in rural areas and 25 in urban areas. At the end of the mandatory preventive confinement, outpatient medical consults were resumed, no participants withdrew from the trial during this period. Thirty-six people with MCI or dementia participated in virtual cognitive stimulation activities. Caregiver remote workshops held in the first semester of 2020 had a total attendance of 80 people, and events held in the second semester, such as the Commemoration of Alzheimer's Day and the Symposium for Caregivers, had a total attendance of 1,665 people and 1,000 people respectively. Conclusion GNA?s Social Plan and the amended which includes strategies of social support, knowledge and patient/caregiver empowerment strengthened the interaction between the community and GNA and likely favorably influenced adherence and retention in the API Colombia clinical trial in the face of challenges from the global pandemic.
ABSTRACT
Background Due to the global SARS-CoV2 pandemic it has been hard to conduct research, including research related to prevention of neurodegenerative diseases. The Alzheimer?s Prevention Initiative (API) Autosomal Dominant Alzheimer?s Disease (ADAD) Colombia trial is being conducted in participants with family history of early-onset dementia due to the PSEN1 E280A mutation who are cognitively unimpaired at baseline. Participants are enduring three stressors: 1) fear of developing dementia;2) logistic changes to the study caused by the public health emergency due to the pandemic;and 3) concern about getting infected by SARS-CoV2. Objective: To describe the frequency of new or exacerbated psychological disorders among the participants of the API ADAD Colombia trial assisted by a comprehensive mental health team during the COVID-19 pandemic. Method Participants in the API ADAD Colombia trial have free access to psychology and psychiatry services, either in person or through teleassistance, as well as psychoeducational offerings. These mental health services are provided by the site, outside of the study protocol, and are supported by Health and Social plans which were created to support participants? wellbeing during the trial. Descriptive statistics (mean, standard deviation and percentages) were used to analyze characteristics and frequency of mental health issues in the participants. Result 66 participants (53 women, 80.3%) were treated by the Mental Health Team from March 1st, 2020 through December 31st, 2020. Mean age was 44.09 (SD 6.97) y.o. Before and after the pandemic onset, the most common psychological problems were anxiety (before 36.4%, after 63.6%) and depression (before 34.8 %, after 37.9%). From people who received psychological and psychiatric services, 70% vs. 81.6% felt that those services helped them, respectively. Among participants who received psychological vs. psychiatric assistance, 71.4% vs. 86.9% of patients with depression, 70.3% vs 75% of patients with anxiety and 60% vs 76.2% of patients with other disorders, felt the services helped them with these conditions. Conclusion A comprehensive mental health program immersed in a trial to prevent or treat devastating diseases as dementia, could mitigate the psychological effects of the COVID-19 pandemic in study participants.
ABSTRACT
Introduction: The historical development, frequency, and impact of frontotemporal dementia (FTD) are less clear in Latin America than in high-income countries. Although there is a growing number of dementia studies in Latin America, little is known collectively about FTD prevalence studies by country, clinical heterogeneity, risk factors, and genetics in Latin American countries. Methods: A systematic review was completed, aimed at identifying the frequency, clinical heterogeneity, and genetics studies of FTD in Latin American populations. The search strategies used a combination of standardized terms for FTD and related disorders. In addition, at least one author per Latin American country summarized the available literature. Collaborative or regional studies were reviewed during consensus meetings. Results: The first FTD reports published in Latin America were mostly case reports. The last two decades marked a substantial increase in the number of FTD research in Latin American countries. Brazil (165), Argentina (84), Colombia (26), and Chile (23) are the countries with the larger numbers of FTD published studies. Most of the research has focused on clinical and neuropsychological features (n = 247), including the local adaptation of neuropsychological and behavioral assessment batteries. However, there are little to no large studies on prevalence (n = 4), biomarkers (n = 9), or neuropathology (n = 3) of FTD. Conclusions: Future FTD studies will be required in Latin America, albeit with a greater emphasis on clinical diagnosis, genetics, biomarkers, and neuropathological studies. Regional and country-level efforts should seek better estimations of the prevalence, incidence, and economic impact of FTD syndromes.