Dementia and mild cognitive impairment (MCI) are an increasingly prevalent clinical entity in our field, showing an increasing incidence with age.ObjectiveThe purpose of this study was to identify the main types of dementia and MCI treated in a memory disorders unit in Costa Rica.MethodsA consecutive and standardized register of patients diagnosed with dementia and MCI at the memory disorders unit of the National Geriatrics and Gerontology Hospital (NGGH) was analyzed.ResultsDementia was diagnosed in 63.5% of the 3572 cases, whereas 10.6% met criteria for MCI. The most frequent type of dementia was Alzheimer's disease (47.1%), followed by vascular pathology (28.9%), mixed forms (17.2%) and other types (6.8%). In MCI, 69.5% were of amnestic multiple domain type and 14.3% were non-amnestic multiple domain, while 41.3% were of vascular and 35.8% of neurodegenerative etiology. Mean age was 79.6±6.7 years and 64.7% were women in dementia cases whereas mean age was 76.4±6.9 years and 62.1% were women in MCI. Mean years of schooling was 4.95±4.09 years and 6.87±4.71, while mean time between onset of symptoms and clinical diagnosis was 3.2±2.6 years and 2.67±2.69 years, in dementia and MCI, respectively.ConclusionThe determination of the main types of dementia and MCI in Costa Rica and their main features has allowed the registration of comprehensive, hitherto unavailable information that will be useful for the management and strategic planning of public health care.

El artículo tiene como objetivo el análisis de la implicación territorial de los crecientes proyectos de carácter hidroeléctricos, con la ejemplificación de los 13 proyectos privados propuestos en la zona sur de Costa Rica. La información se obtiene por medio de una indagación en cuanto a medios, dominación y conceptos que explican las situaciones de estas comunidades, la cuales se ven envueltas por empresas internacionales en búsqueda de expansionismo, a costa de cualquier precio, y un Estado permisivo. Los resultados que se logran son la exposición del abastecimiento de hidroelectricidad a los proyectos de “desarrollo’’ efectuados a cabo en la región, de manera conflictiva, la custodia y control del agua principalmente en manos privadas y el uso de la institucionalidad del Estado que utiliza como medio de control el discurso “energías limpias’’, y mediante el uso de la violencia para desalojar poblaciones y facilitar la instalación de proyectos. A manera de conclusión se entabla una investigación que busca encontrar las anomalías presentes en el estado actual de estas zonas en Costa Rica, en cuanto al apoderamiento y uso de territorios, de los cuales sus pobladores no han cedido.

The incidence and prevalence of Alzheimer’s disease (AD) dementia are higher among Caribbean Hispanics than among non-Hispanic Whites. The causes of this health disparity remain elusive, partially because of the relative limited capacity for biomedical research in the developing countries that comprise Caribbean Latin America. To begin to address this issue, we were awarded a Development Research Award from the US NIH and Fogarty International Center in order to establish the local capacity to integrate magnetic resonance imaging (MRI) into studies of cognitive aging and dementia in Dominican Republic, establish collaborations with Dominican investigators, and conduct a pilot study on the role of cerebrovascular markers in the clinical expression of AD. Ninety older adult participants with and without AD dementia and with and without a strong family history of AD dementia received MRI scans and clinical evaluation. We quantified markers of cerebrovascular disease (white matter hyperintensities [WMH], presence of infarct, and presence of microbleed) and neurodegeneration (entorhinal cortex volume) and compared them across groups. Patients with AD dementia had smaller entorhinal cortex and greater WMH volumes compared with controls, regardless of family history status. This study provides evidence for the capacity to conduct MRI studies of cognitive aging and dementia in Dominican Republic. The results are consistent with the hypothesis that small vessel cerebrovascular disease represents a core feature of AD dementia, as affected participants had elevated WMH volumes irrespective of family history status.

This work main goal is to describe the case in the community of Longo Mai as an initiative that tries to break with the uncontrolled advance of the ecosocial destructions that have led the planet to collapse; this from the historical context, observations, discussions, and the Joaquín Herrera Flores' relational methodology of human rights. Thus, part of this breakup it is given for the fight of human rights and the quest for autonomy and other alternative ways to capitalism and feedback, in the light of a context in which neighbor villages are involved in dynamics of monoculture that have shown strong social degradations, economic, environmental, and dependency on the decisions of big companies. The spatial and temporal context in which Longo Mai emerges, it allows perceiving the true dimensions of those ecosocial collapses, that is the reason why to take over and to fight for their land by organized peasants and aborigines have been and it will be fundamental to face the terrible inequity and famine in Costa Rica and the world.Keywords: Central American wars; migration; ecosocial collapse; Brunca Region; human rights, ransnational corporations. Luis Diego Arias Campos 1Este trabajo tiene como objetivo describir el caso de la comunidad de Longo Mai como una iniciativa que trata de romper con la dinámica de avance descontrolado de las destrucciones eco sociales que han llevado el planeta al colapso, esto a partir del contexto histórico, observaciones, discusiones, y la metodología relacional de los derechos humanos de Joaquín Herrera Flores. Parte de ese rompimiento se da con la lucha por los derechos humanos, la búsqueda de autonomía, otras formas alternativas al capitalismo y la retroalimentación, ante un contexto en el que pueblos vecinos envueltos en las dinámicas de los monocultivos han mostrado grandes degradaciones sociales, económicas, ambientales, y dependencias de las decisiones de las grandes compañías. El contexto espacial y temporal en el que surge Longo Mai permite percibir las verdaderas dimensiones de dichos colapsos eco sociales, razón por la cual la toma y lucha por la tierra por manos campesinas e indígenas organizadas ha sido y será fundamental para enfrentar las terribles desigualdades y hambrunas en Costa Rica y el mundo.

Antecedentes: la demencia es una entidad clínica cada vez más prevalente en nuestro medio, cuya incidencia aumenta con la edad. El objetivo del presente estudio es identificar los principales tipos de demencia atendidos en una unidad de trastornos de memoria.