The Panama Aging Research Initiative: Dementia‐related biomarker research in a low‐resourced setting

Abstract

AbstractBackgroundThe Panama Aging Research Initiative (PARI) is a two‐cohort study of more than 800 adults aged 60 years and older. PARI has provided the first reports of modifiable and non‐modifiable risk factors of cognitive impairment and dementia, as well as various health conditions common among older adults in Panama, including chronic illnesses, polypharmacy and frailty. Our general objective consists of identifying biomarkers of memory impairment for improving early diagnosis of dementia, and specifically, Alzheimer’s disease (AD). Panama follows the global trend of smartphone use and rapid access to information. Therefore, the implementation of digital phenotyping as clinical tool could be a promising strategy to developing culturally appropriate cost‐ and time‐efficient protocols for early detection of cognitive impairment.MethodsOur ongoing community‐based cohort has undergone clinical interviews, neuropsychological testing, and assessments of frailty at two time points (14‐29 months apart). Fasting blood draws were obtained for measurements of genetic and blood‐based biological markers. Ongoing studies are evaluating genetic variation both in disease genes and in regulatory factors that modulate onset and progression of AD and other neurodegenerative diseases. In collaboration and with the support of the Davos Alzheimer’s Collaborative (DAC) Global Cohort Development program, we are also introducing the collection of longitudinal AD‐related digital phenotypes.ResultsBlood‐based biomarkers have been shown to be highly accurate in detecting AD and MCI, with promising results for early diagnosis of AD‐related cognitive impairment. We will discuss results of studies examining the combination of blood‐based biomarkers with standard neuropsychological tests to generate molecular profiles that could lead to early and timely MCI and AD diagnosis. We will further present how digital phenotyping will open up new opportunities that will help overcome challenges that arise when trying to apply conventional approaches in low‐resourced settings.ConclusionsBlood‐based and digital biomarkers could be used as a first screening tool, followed by additional diagnostic testing for those at risk for cognitive impairment. The DAC initiative to leverage existing infrastructures across cohort studies around the world is of particular relevance to refining our assessment processes and dementia risk profiling, and ultimately, developing novel interventions in low‐resource settings.