The Peruvian Alzheimer Disease Initiative (PeADI): An international effort model to increase diversity in AD research
Maryenela Illanes-Manrique1, Pedro Mena2, Karina Milla-Neyra3, Larry Adams2, Koni Mejia4, Julia Rios-Pinto5, Rosario Isasi2, Angel Medina-Colque6, Gary Beecham2, Ivan Cornejo-Herrera7, Jeffery Vance2, Edward Ochoa-Valle8, Sheila Castro-Suarez9, Michael L. Cuccaro2, Elison Sarapura-Castro3, Diana Cubas-Montecino3, Mario Cornejo Olivas3, Margaret Pericak-Vance2
1Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI), 2John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, 3Neurogenetics Research Center,Instituto Nacional de Ciencias Neurologicas, 4Daniel Alcides Carrion Hospital, 5Universidad Peruana Los Andes, 6Dirección Regional de Salud de Puno, 7Hospital Hipolito de Tacna, 8Hospital Regional de Cusco, 9CBI en Demencias y Enfermedades Desmielinizantes del Sistema Nervioso, Instituto Nacional de Ciencias Neurologica
Objective:
We have developed an international collaborative research initiative to ascertain a Peruvian cohort for AD and other related dementias for genetic studies of Amerindian individuals.
Background:
Peru is one of the five largest countries in Latin America and harboring a high Amerindian ancestry component in this population.The Latin American population, including Peruvians,are underrepresented in research studies of AD.
Design/Methods:
PeADI was developed to recruit and enroll Peruvian adults aged 65 and older to a comprehensive genetic AD study.Individuals will get whole genome sequencing and plasma biomarkers.Participants included cases with AD and ADRD, healthy controls as well as multiplex AD families.Since 2019,we have established a multisource ascertainment approach including recruitment at main hospitals,outreach community activities and more recently due to the COVID19 pandemic remote recruitment and home visits in Lima, the capital city.Our recruitment has expanded to three regions from the Andes highlands (Puno,Huancayo,Cusco) and one region from the southern coast (Tacna).All participants are enrolled using a standard clinical and cognitive protocol administered by neurologists and neuropsychologists.
Results:
As of September 2022,we have enrolled 132 AD and other dementia cases, 292 controls and 6 multiplex AD families. While the majority of participants was recruited in Lima,45% controls and 7% of cases have been recruited in regions outside Lima.We have confirmed a significant association between APOE and AD in Peruvian Population higher than we have observed in non-Hispanics.In addition to ascertainment activities, we are working closely with the respective sites to develop a network and resources for AD research across Peru.To date,we have developed local research capacities within each region,including training opportunities for investigators, coordinators and lab technicians, and basic equipment for all regions.
Conclusions:
PeADI study shows the importance of equitable international north-south cooperation and local network cooperation to increase representation of understudied admixed populations to help us understand Amerindian ancestry in drug target discovery.