ABSTRACT. This review aims to examine the state of the art regarding changes in language abilities in Parkinson’s disease (PD), with a focus on different linguistic domains. To this end, the language alterations are organized into sections (phonetic and phonology, morphology, syntax, semantic and lexicon, and pragmatics) that correspond to each linguistic domain and are complemented by considerations for future research. Linguistic changes can emerge early in the course of PD, even when verbal abilities are not yet significantly compromised. As the disease progresses, individuals with PD commonly exhibit executive dysfunction, visuospatial difficulties, and memory impairment. Communication deficits extend beyond speech and voice, and are directly impacted by linguistic functions. Given the progressive nature of PD, the study of language provides valuable insights into the impact of neurodegeneration on communication, an area often overshadowed by the predominant focus on motor speech disorders, such as dysarthria.

ABSTRACT. The Free and Cued Selective Reminding Test with Immediate Recall (FCSRT-IR), developed by Grober and Buschke, is widely used to assess episodic memory and detect impairments, particularly in Alzheimer’s disease (AD). Recommended by the International Working Group (IWG) for early diagnosis, no prior review has synthesized its findings. This study reviewed articles on norms, clinical validity, and correlations with neuropathological biomarkers. Sixty-four studies were selected out of 728, covering normative data, clinical validation, and biomarker associations. The FCSRT-IR has normative data from seven countries and shows high diagnostic accuracy for mild cognitive impairment (MCI) and dementia, especially AD. In 20 studies, test scores significantly correlated with AD biomarkers. Thus, the FCSRT-IR supports early identification of episodic memory deficits, proving to be a valuable neuropsychological assessment tool.

ABSTRACT. Dementia is a leading global health challenge. Despite its burden, data from American countries remain scarce and fragmented. This lack of robust evidence impedes regional planning and policy-making. Objective: The aim of the study was to evaluate the temporal trends of dementia’s mortality in America with a local and regional approach. Methods: This ecological time-series study analyzed age-adjusted dementia mortality rates across American countries between 2000 and 2019. Data were obtained from Pan American Health Organization and cross-validated with national and international sources. Joinpoint regression was used to estimate annual percent change, identifying significant temporal trends in mortality. Results: Between 2000 and 2019, dementia mortality rates were highest in the Insular Americas and varied widely across countries. The United States, Canada, and several Central and South American nations exhibited elevated rates, while others, such as Paraguay and Venezuela, reported consistently low values. National trends were heterogeneous, with some countries showing steady declines and others persistent or erratic increases. Conclusion: This study highlights significant temporal trends in American dementia mortality, identifying critical areas for public health intervention and offering a foundation for future research on healthcare equity and cancer outcomes.

ABSTRACT. The use of combined interventions for the treatment of Alzheimer’s disease (AD) has become increasingly popular in research, but inconsistencies remain regarding the optimal combinations. Objective: To conduct a systematic review of randomized controlled trials (RCTs) that applied combined or personalized interventions in individuals with mild cognitive impairment (MCI) or AD. Methods: Searches were conducted following predefined selection criteria in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Eighteen studies met the inclusion criteria. The analysis demonstrated that ten of the 18 studies had a low risk of bias. The results showed that, compared to different control or sham groups, there were improvements in scores on various neurocognitive tests, and in biochemical and imaging parameters in some studies. Conclusion: Treatments that combined dietary changes or physical exercise demonstrated greater benefits for individuals with AD or MCI when compared to other combinations.

ABSTRACT Information processing speed (IPS) evaluates the time at which a person reacts to a stimulus. The Wechsler for Adults-III (WAIS-III) includes this domain in the digit symbol test (DS-T). Objective: The aim of this study was to validate a new screening test that could measure the IPS in association with the individual’s age and scholarship. Methods: A new instrument to measure the IPS was constructed, automatic cashier test (AC-T), and for its validation, the DS-T was also carried out. Results: The media of time use in the ACT was 12.3 s; the media of hits in the DS-T was 38.8, with a p<0.0001 and R2: 0.40. Conclusion: P-value showed a linear association between the two tests, but the R2 results showed a low association between these. In the same way, the correlation between both tests is promising, since it shows that both are tests that measure the IPS in a different way with different constructs such as the verbal fluency test that is also used to evaluate IPS. On the other hand, both tests exposed that the scholarship positively influences the IPS.

ABSTRACT. Alzheimer disease (AD) is a neurodegenerative disorder. Evidence suggests that AD shares pathophysiological similarities with type 2 diabetes. Intranasal insulin (INI) has emerged as a potential therapeutic approach for AD by directly targeting the brain and modulating insulin signaling pathways. Objective: To evaluate the efficacy and safety of INI therapy for AD through a systematic review and meta-analysis of randomized controlled trials. Methods: A search of electronic databases, including PubMed, Web of Science, Scopus, and Embase, was conducted to identify relevant studies published up to June 2024. Inclusion criteria encompassed peer-reviewed original research articles focused on humans, investigating the therapeutic effects of INI administration on cognitive impairment associated with AD, and reporting quantitative data on cognitive outcomes, biomarkers, or pathological markers relevant to AD. A meta-analysis was conducted to quantitatively synthesize the effects of INI on cognitive outcomes. Results: A total of 647 articles were identified, and eight studies met the inclusion criteria. The overall odds ratio was 3.75 (95%CI 1.49–9.40). The test for overall effect showed a statistically significant difference (p<0.05). However, the I2 value indicated a high level of heterogeneity (85.5%), suggesting significant variability among the studies. Conclusion: While the current data is not yet conclusive enough to definitively establish INI as a standard treatment for AD, the evidence supporting its safety, efficacy, and reduced risk of systemic side effects suggests potential cognitive benefits for improving global cognition in patients with AD.

ABSTRACT Mind-body interventions have been explored to enhance the psychological well-being of dementia caregivers; however, the specific effects of yoga practice remain underexamined. Objective: The aim of this study was to investigate the benefits of yoga on quality of life (QoL), life satisfaction, psychological well-being, attention, self-compassion, perceived stress, anxiety, depression, and caregiver burden for dementia caregivers. Methods: A comprehensive search was conducted on September 11, 2024, in databases including SciELO, PubMed, BVSalud, Web of Science, Embase, and PsycINFO, focusing on the effects of yoga for informal dementia caregivers compared to passive or active control groups through randomized and non-randomized trials. An initial review reduced 284 to 180 unique records; 172 studies were excluded, leaving 8 that met the inclusion criteria. Two authors independently selected and extracted data using a data extraction sheet based on the Cochrane Consumers and Communication Review Group. The Cochrane Risk of Bias tools (ROB2 and ROBINS-I) were employed to evaluate bias risk. Results: The review included three randomized and five non-randomized studies with a total of 161 participants, predominantly female (wives and daughters), with ages ranging from 39 to 76 years. Four studies utilized hatha yoga, while four employed non-traditional yoga. Significant improvements were observed in QoL, depression, stress, anxiety, and self-compassion, but not in caregiver burden. Furthermore, positive effects were more pronounced in face-to-face or online interventions than in recorded videos. On average, studies exhibited a moderate risk of bias. Conclusion: Yoga practice can serve as an effective intervention for enhancing the psychological aspects of dementia caregivers.

ABSTRACT There is growing evidence suggesting an association between neurodegeneration and inflammation playing a role in the pathogenesis of age-associated diseases, including Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI). Objective: A systematic review and meta-analysis were performed to verify evidence on the diagnostic accuracy parameters of the inflammatory cytokines interleukin-6 (IL-6), interleukin-10 (IL-10) and tumor necrosis factor alpha (TNF-α). Methods: A search of Medical Literature Analysis and Retrieval System Online (Medline), Scientific Electronic Library Online (SciELO), Web of Science and Science Direct databases was performed and nine observational studies associated with peripheral inflammatory biomarkers in MCI were identified. Mean (±standard deviation — SD) concentrations of these biomarkers and values of true positives, true negatives, false positives and false negatives for MCI and healthy controls (HC) were extracted from these studies. Results: Significantly higher levels of IL-10 were observed in subjects in the MCI group and Mini-Mental State Examination (MMSE) scores were lower compared to HC. For the other investigations, no differences were found between the groups. Our meta-analysis for the TNF-α biomarker revealed high heterogeneity between studies in terms of sensitivity and specificity. Conclusion: These findings do not support the involvement of inflammatory biomarkers for detection of MCI, although significant heterogeneity was observed. More studies are needed to evaluate the role of these cytokines in MCI, as well as in other stages of cognitive decline and all-cause dementias.