LEONEL TADAO TAKADA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
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- Classification of Alzheimer's disease and frontotemporal dementia using routine clinical and cognitive measures across multicentric underrepresented samples: A cross sectional observational study(2023) MAITO, Marcelo Adrian; SANTAMARIA-GARCIA, Hernando; MOGUILNER, Sebastian; POSSIN, Katherine L.; GODOY, Maria E.; AVILA-FUNES, Jose Alberto; I, Maria Behrens; BRUSCO, Ignacio L.; BRUNO, Martin A.; CARDONA, Juan F.; CUSTODIO, Nilton; GARCIA, Adolfo M.; JAVANDEL, Shireen; LOPERA, Francisco; MATALLANA, Diana L.; MILLER, Bruce; OLIVEIRA, Maira Okada de; PINA-ESCUDERO, Stefanie D.; SLACHEVSKY, Andrea; ORTIZ, Ana L. Sosa; TAKADA, Leonel T.; TAGLIAZUCHI, Enzo; VALCOUR, Victor; YOKOYAMA, Jennifer S.; IBANEZ, AgustinBackground Global brain health initiatives call for improving methods for the diagnosis of Alzheimer & rsquo;s disease (AD) and frontotemporal dementia (FTD) in underrepresented populations. However, diagnostic procedures in upper -middle-income countries (UMICs) and lower-middle income countries (LMICs), such as Latin American countries (LAC), face multiple challenges. These include the heterogeneity in diagnostic methods, lack of clinical harmonisation, and limited access to biomarkers. Methods This cross-sectional observational study aimed to identify the best combination of predictors to discriminate between AD and FTD using demographic, clinical and cognitive data among 1794 participants [904 diagnosed with AD, 282 diagnosed with FTD, and 606 healthy controls (HCs)] collected in 11 clinical centres across five LAC (ReDLat cohort). Findings A fully automated computational approach included classical statistical methods, support vector machine procedures, and machine learning techniques (random forest and sequential feature selection procedures). Results demonstrated an accurate classification of patients with AD and FTD and HCs. A machine learning model produced the best values to differentiate AD from FTD patients with an accuracy = 0.91. The top features included social cognition, neuropsychiatric symptoms, executive functioning performance, and cognitive screening; with secondary contributions from age, educational attainment, and sex. Interpretation Results demonstrate that data-driven techniques applied in archival clinical datasets could enhance diagnostic procedures in regions with limited resources. These results also suggest specific fine-grained cognitive and behavioural measures may aid in the diagnosis of AD and FTD in LAC. Moreover, our results highlight an opportunity for harmonisation of clinical tools for dementia diagnosis in the region.
- Prevalence of Cognitive Impairment Without Dementia and Dementia in Tremembe, Brazil(2016) CESAR, Karolina G.; BRUCKI, Sonia M. D.; TAKADA, Leonel T.; NASCIMENTO, Luiz F. C.; GOMES, Camila M. S.; ALMEIDA, Milena C. S.; OLIVEIRA, Maira O.; PORTO, Fabio H. G.; SENAHA, Mirna L. H.; BAHIA, Valeria S.; SILVA, Thais B. L.; IANOF, Jessica N.; SPINDOLA, Livia; SCHMIDT, Magali T.; JORGE, Mario S.; VALE, Patricia H. F.; CECCHINI, Mario A.; CASSIMIRO, Luciana; SOARES, Roger T.; GONCALVES, Marcia R.; MARTINS, Ana C. S.; DARE, Patricia; SMID, Jerusa; PORTO, Claudia S.; CARTHERY-GOULART, Maria T.; YASSUDA, Monica S.; MANSUR, Leticia L.; NITRINI, RicardoBackground:The prevalence of cognitive impairment is insufficiently determined in developing countries. The aim of this study was to ascertain the prevalence of cognitive impairment without dementia and dementia in community-dwelling elderly in Brazil.Methods:This was a single-phase cross-sectional survey of the elderly (aged 60 years and above) living in the municipality of Tremembe, Brazil. Twenty percent of the households with elderly persons were randomly selected from urban and rural areas, to obtain a homogenous representation of all socioeconomic and cultural levels.Results:We assessed 630 individuals [mean age, 71.3 y (7.99); mean years of education, 4.9 (+/- 4.54)] and found prevalence rates of 17.5% (95% confidence interval, 14.6-20.6) for dementia and 19.5% (95% confidence interval, 16.6-22.8) for cognitive impairment without dementia. These prevalence rates were influenced by age (P<0.001) and by educational level (P<0.001). There was no significant sex difference among diagnostic groups (P=0.166). The prevalence of dementia was higher in relatively younger individuals (below 70 y) when compared with other studies. Besides, dementia was associated with low socioeconomic status, stroke, previous psychiatric disorder, alcoholism, and epilepsy.Conclusions:The prevalence of dementia in this study was higher than in other studies, particularly among younger elderly.
- Prevalence of depressive symptoms among elderly in the city of Tremembé, Brazil: Preliminary findings of an epidemiological study(2013) CÉSAR, Karolina G.; TAKADA, Leonel T.; BRUCKI, Sonia M.D.; NITRINI, Ricardo; NASCIMENTO, Luiz Fernando C.; OLIVEIRA, Maira O.; GOMES, Camila M.S.; ALMEIDA, Milena C.S.; PORTO, Fábio H.; SENAHA, Mirna L.H.; BAHIA, Valéria S.; YASSUDA, Mônica S.; SILVA, Thaís B.L.; IANOF, Jéssica N.; SPÍNDOLA, Lívia; SCHMIDT, Magali T.; JORGE, Mário S.; VALE, Patrícia H.F.; CECCHINI, Mário A.; CASSIMIRO, Luciana; SOARES, Roger T.; GONÇALVES, Márcia Rúbia; MARTINS, Ana Caroline S.; ROCHA, Elisângela; DARÉ, PatríciaABSTRACT Depression is a heterogeneous mental disease classified as a set of disorders, which manifest with a certain duration, frequency and intensity. The prevalence of depression in the elderly ranges from 0.5 to 16%. Objective To establish, in an epidemiological study, the prevalence of significant depressive symptoms in the population aged 60 years or older. Methods: Results of a cross-sectional epidemiological study, involving home visits, being carried out in the city of Tremembé, Brazil, were reported. The sample was randomly selected by drawing 20% of the population over 60 years from each of the city's census sectors. In this single-phase study, the assessment included clinical history, physical and neurological examination, cognitive evaluation, the Cornell scale and the Patient Health Questionnaire for psychiatric symptoms. Scores greater than or equal to 8 on the Cornell scale were taken to indicate the presence of depressive symptoms. Results: A total of 455 elders were assessed, and of these 169 (37.1%) had clinically significant depressive symptoms (CSDS). Depression prevalence was higher among women (p<0.001) and individuals with lower education (p=0.033). The Chi-square test for trends showed a significant relationship where lower socioeconomic status was associated with greater likelihood of depressive symptoms (p=0.005). Conclusion: The prevalence of depressive symptoms was high in this sample of the population-based study and was associated with female gender, low educational level and socioeconomic status. The assessment of the entire population sample must be completed.
- Performance of the Visual Analogue Scale of Happiness and of the Cornell Scale for Depression in Dementia in the Tremembé Epidemiological Study, Brazil(2014) CÉSAR, Karolina G.; BRUCKI, Sonia M.D.; TAKADA, Leonel T.; NASCIMENTO, Luiz Fernando C.; GOMES, Camila M.S.; ALMEIDA, Milena C.S.; OLIVEIRA, Maira O.; PORTO, Fábio H.G.; SENAHA, Mirna L.H.; BAHIA, Valéria S.; SILVA, Thaís Bento L.; IANOF, Jéssica N.; SPÍNDOLA, Lívia; SCHMIDT, Magali T.; JORGE, Mário S.; VALE, Patrícia H.F.; CECCHINI, Mário A.; CASSIMIRO, Luciana; SOARES, Roger T.; GONÇALVES, Márcia R.; SMID, Jerusa; PORTO, Claudia S.; CARTHERY-GOULART, Maria Teresa; YASSUDA, Mônica S.; MANSUR, Letícia L.; NITRINI, RicardoDepression is a major growing public health problem. Many population studies have found a significant relationship between depression and the presence of cognitive disorders. OBJECTIVE: To establish the correlation between the Visual Analogue Scale of Happiness and the Cornell Scale for Depression in Dementia in the population aged 60 years or over in the city of Tremembé, state of São Paulo, Brazil. METHODS: An epidemiological survey involving home visits was carried out in the city of Tremembé. The sample was randomly selected by drawing 20% of the population aged 60 years or older from each of the city's census sectors. In this single-phase study, the assessment included clinical history, physical and neurological examination, cognitive evaluation, and application of both the Cornell Scale and the Analogue Scale of Happiness for psychiatric symptoms. The presence of depressive symptoms was defined as scores greater than or equal to 8 points on the Cornell Scale. RESULTS: A total of 623 subjects were evaluated and of these 251 (40.3%) had clinically significant depressive symptoms on the Cornell Scale, with a significant association with female gender (p<0.001) and with lower education (p=0.012). One hundred and thirty-six participants (21.8%) chose the unhappiness faces, with a significant association with age (p<0.001), female gender (p=0.020) and low socioeconomic status (p=0.012). Although there was a statistically significant association on the correlation test, the correlation was not high (rho=0.47). CONCLUSION: The prevalence of depressive symptoms was high in this sample and the Visual Analogue Scale of Happiness and Cornell Scale for Depression in Dementia should not be used as similar alternatives for evaluating the presence of depressive symptoms, at least in populations with low educational level.
- Prevalence of cognitive impairment in tremembe, Brazil(2015) CESAR, K. G.; BRUCKI, S. M. D.; TAKADA, L. T.; OLIVEIRA, M. O.; PORTO, F. H. G.; SENAHA, M. L. H.; BAHIA, V. S.; SILVA, T. B. L.; CECCHINI, M. A.; CASSIMIRO, L.; SMID, J.; PORTO, C. S.; CARTHERY-GOULART, M. T.; YASSUDA, M. S.; MANSUR, L. L.; NITRINI, R.
- The Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat): Driving Multicentric Research and Implementation Science(2021) IBANEZ, Agustin; YOKOYAMA, Jennifer S.; POSSIN, Katherine L.; MATALLANA, Diana; LOPERA, Francisco; NITRINI, Ricardo; TAKADA, Leonel T.; CUSTODIO, Nilton; ORTIZ, Ana Luisa Sosa; AVILA-FUNES, Jose Alberto; BEHRENS, Maria Isabel; SLACHEVSKY, Andrea; MYERS, Richard M.; COCHRAN, J. Nicholas; BRUSCO, Luis Ignacio; BRUNO, Martin A.; BRUCKI, Sonia M. D.; PINA-ESCUDERO, Stefanie Danielle; OLIVEIRA, Maira Okada de; KEHOE, Patricio Donnelly; GARCIA, Adolfo M.; CARDONA, Juan Felipe; SANTAMARIA-GARCIA, Hernando; MOGUILNER, Sebastian; DURAN-ANIOTZ, Claudia; TAGLIAZUCCHI, Enzo; MAITO, Marcelo; IBARROLA, Erika Mariana Longoria; PINTADO-CAIPA, Maritza; GODOY, Maria Eugenia; BAKMAN, Vera; JAVANDEL, Shireen; KOSIK, Kenneth S.; VALCOUR, Victor; MILLER, Bruce L.Dementia is becoming increasingly prevalent in Latin America, contrasting with stable or declining rates in North America and Europe. This scenario places unprecedented clinical, social, and economic burden upon patients, families, and health systems. The challenges prove particularly pressing for conditions with highly specific diagnostic and management demands, such as frontotemporal dementia. Here we introduce a research and networking initiative designed to tackle these ensuing hurdles, the Multi-partner consortium to expand dementia research in Latin America (ReDLat). First, we present ReDLat's regional research framework, aimed at identifying the unique genetic, social, and economic factors driving the presentation of frontotemporal dementia and Alzheimer's disease in Latin America relative to the US. We describe ongoing ReDLat studies in various fields and ongoing research extensions. Then, we introduce actions coordinated by ReDLat and the Latin America and Caribbean Consortium on Dementia (LAC-CD) to develop culturally appropriate diagnostic tools, regional visibility and capacity building, diplomatic coordination in local priority areas, and a knowledge-to-action framework toward a regional action plan. Together, these research and networking initiatives will help to establish strong cross-national bonds, support the implementation of regional dementia plans, enhance health systems' infrastructure, and increase translational research collaborations across the continent.
- The impact of SARS-CoV-2 in dementia across Latin America: A call for an urgent regional plan and coordinated response(2020) IBANEZ, Agustin; SANTAMARIA-GARCIA, Hernando; BARRAGAN, Alejandra Guerrero; KORNHUBER, Alexander; TON, Alyne Mendonca Marques; SLACHEVSKY, Andrea; TEIXEIRA, Antonio Lucio; MEZA, Beatriz Marcela Mar; SERRANO, Cecilia M.; CANO, Carlos; GONZALEZ, Carolina Arias; GONZALEZ-BILLAULT, Christian; BUTLER, Christopher; BUSTIN, Julian; DURAN-ANIOTZ, Claudia; ACOSTA, Daisy; MATALLANA, Diana L.; ACOSTA-ALVEAR, Diego; TREPEL, Dominic; RESENDE, Elisa De Paula Franca; OLIVEIRA, Fabricio Ferreira; IBANEZ, Francisco; FELICE, Fernanda G. De; NAVARRETE, Gorka; TARNANAS, Ioannis; MEIER, Irene B.; SMID, Jerusa; LLIBRE-GUERRA, Jorge; LLIBRE-RODRIGUEZ, Juan J.; FAJERSZTAJN, Lais; TAKADA, Leonel Tadao; DUQUE, Lissette; OLIVEIRA, Maira Okada de; BICALHO, Maria Aparecida Camargos; BEHRENS, Maria Isabel; PINTADO-CAIPA, Maritza; PARRA, Mario; WILSON, Maxwell Z.; PUEBLA, Myriam De la Cruz; CUSTODIO, Nilton; SANTIBANEZ, Rodrigo; SERAFIM, Rodrigo Bernardo; TAVARES, Ronnielly Melo; ESCUDERO, Stefanie Danielle Pina; RODRIGUEZ, Tomas Leon; DAWSON, Walter; MILLER, Bruce L.; KOSIK, Kenneth S.The SARS-CoV-2 global pandemic will disproportionately impact countries with weak economies and vulnerable populations including people with dementia. Latin American and Caribbean countries (LACs) are burdened with unstable economic development, fragile health systems, massive economic disparities, and a high prevalence of dementia. Here, we underscore the selective impact of SARS-CoV-2 on dementia among LACs, the specific strain on health systems devoted to dementia, and the subsequent effect of increasing inequalities among those with dementia in the region. Implementation of best practices for mitigation and containment faces particularly steep challenges in LACs. Based upon our consideration of these issues, we urgently call for a coordinated action plan, including the development of inexpensive mass testing and multilevel regional coordination for dementia care and related actions. Brain health diplomacy should lead to a shared and escalated response across the region, coordinating leadership, and triangulation between governments and international multilateral networks.