ABSTRACT INTRODUCTION Alzheimer disease is the main cause of dementia associated with aging in Cuba and the world. Development of methods for early diagnosis is vital to increasing intervention effectiveness and improving patient quality of life. Recent studies have shown associations between alterations in serum levels of antineuronal antibodies and Alzheimer disease pathology. However, the specific relationship between such antineuronal antibodies and Alzheimer pathogenesis remains unclear because of the great variety of antibodies identified and their heterogeneity among patients and nondemented controls. OBJECTIVE Assess the association between serum levels of antibodies against neuronal antigens (total brain protein, aldolase and amyloid beta protein) and cognitive performance in older Cuban adults. METHODS A cross-sectional pilot study was conducted of adults aged ≥65 years living in Havana’s Playa Municipality and Artemisa Province (southwest of Havana). A sociodemographic and risk factor questionnaire was administered, neuropsychological assessment conducted, and physical and neurological examinations performed. A relative or caregiver was also interviewed. Laboratory tests included: complete blood count, glycemia, lipid panel, and apolipoprotein E genotype. Of 143 individuals studied, 33 were cognitively normal, 52 had mild cognitive impairment, and 58, probable Alzheimer disease. Serum antibody levels were determined by ELISA and compared using covariance analysis with a significance level of 0.05. ELISA specificity, sensitivity and predictive value were assessed by analyzing their respective diagnostic performance curves. RESULTS Patients with probable Alzheimer disease performed least well on the mini mental state examination (cognitively normal 28.8, SD 1.2; mild cognitive impairment 27.4, SD 2.2; probable Alzheimer disease 12.9, SD 6.5; ANOVA p <0.001). The percentage of Apo E4 carriers was seven times greater in the group with probable Alzheimer disease than in the cognitively normal group. Among the antibodies studied, only those against amyloid beta peptide had levels significantly higher in the Alzheimer disease group than in the cognitively normal group (p = 0.007) and the group with mild cognitive impairment (p = 0.002). CONCLUSIONS Results support the presence of an autoimmune component in Alzheimer disease and suggest that serum anti–amyloid-beta could be used for its diagnosis.

OBJECTIVE: This research had two objectives: (1) to determine the prevalence of iron-deficiency anemia and describe iron consumption in the diet of schoolchildren and adolescents enrolled in public and private schools of the urban area of the city of Medellín, Colombia, in the 19992000 school year and (2) to explore the associations that age group, sex, socioeconomic class, and intestinal parasitism show with iron-deficiency anemia and iron deficiency. METHODS: A cross-sectional study was carried out among 960 students from 6 to 18 years old who were selected by simple random sampling after stratified multistage sampling and clustering in public and private schools in districts of Medellín. Body iron content was evaluated by determining ferritin and hemoglobin levels, average corpuscular volume, and amplitude of the erythrocyte distribution; the presence of intestinal parasites was evaluated through stool analysis; nutritional status was evaluated by means of anthropometric measurements; and consumption of iron and vitamin C was evaluated using a semiquantitative questionnaire on food intake. In order to define the cases of iron-deficiency anemia and of iron deficiency we used the standard definitions of the World Health Organization, based on ferritin and hemoglobin values. We used nonparametric tests, with a significance level of 0.05, to examine the associations between age group, sex, socioeconomic class, and the presence of intestinal parasites on the one hand and the presence of anemia on the other hand. RESULTS: The prevalence of iron deficiency was 4.9%, and the prevalence of iron-deficiency anemia was 0.6%. The prevalence of both was higher among adolescent women (P < 0.05) than in the rest of the sample studied. No significant association was found between the presence of intestinal parasites and the presence of anemia. The average daily consumption of iron (± standard deviation) was 5.5 mg (± 2.3 mg) (32% ± 15% of the recommended dietary intake for the studied age group); the average contribution of serum iron in the diet was 0.7 mg (± 0.7 mg). Comparing the children who did and who did not have anemia, there were no significant differences in iron consumption and the type of iron consumed. The anthropometric parameter that showed the greatest association with the presence of anemia was height for age. CONCLUSIONS: The prevalences of iron deficiency and of iron-deficiency anemia found in the population studied were low, according to the parameters for hemoglobin and ferritin as defined by the World Health Organization as being normal for these population groups. The low prevalence of blood-sucking parasites, adequate consumption of vitamin C, and the refined mechanisms with which the body regulates iron homeostasis may have contributed to these results. Adequate iron content in the diet of adolescents should be maintained, and education campaigns should be implemented to help prevent iron deficiency in this population group.

OBJETIVO: Determinar la prevalencia de anemia ferropénica y describir el consumo de hierro en la dieta de escolares y adolescentes matriculados en colegios oficiales y privados de la zona urbana de la ciudad de Medellín, Colombia, en el año escolar 19992000, así como explorar la asociación entre grupo de edad, sexo, clase socioeconómica y parasitismo intestinal por un lado, y anémica ferropénica y deficiencia de hierro por el otro. MÉTODOS: Se realizó un estudio de corte transversal en 960 estudiantes de 6 a 18 años de edad que fueron elegidos por muestreo aleatorio simple tras un muestreo polietápico estratificado y por conglomerados de colegios oficiales y privados en comunas de la zona de Medellín. Se evaluaron el contenido corporal de hierro mediante determinaciones de ferritina, hemoglobina, volumen corpuscular medio y amplitud de la distribución eritrocitaria; la presencia de parásitos intestinales mediante análisis coprológico; el estado nutricional por medio de mediciones antropométricas; y el consumo de hierro y vitamina C mediante un cuestionario semicuantitativo de ingesta alimentaria. Para definir los casos de anemia ferropénica y de deficiencia de hierro se usaron las definiciones estándar de la Organización Mundial de la Salud basadas en los valores de ferritina y hemoglobina. También se examinó la asociación entre grupo de edad, sexo, clase socioeconómica y presencia de parásitos intestinales por un lado y la presencia de anemia por el otro mediante pruebas no paramétricas con un nivel de significación de 0,05. RESULTADOS: La prevalencia de deficiencia de hierro fue de 4,9% y la de anemia ferropénica, de 0,6%. Se encontró una mayor prevalencia de ambas en mujeres adolescentes (P < 0,05) que en el resto de la muestra estudiada. No se demostró ninguna asociación significativa entre la presencia de parásitos intestinales y la de anemia. El consumo promedio de hierro diario fue de 5,5 ±2,3 mg (desviación estándar [DE]) (32% ±15% [DE] de la ingesta dietética recomendada [RDA] para el grupo de edad estudiado); el aporte promedio de hierro hemático en la dieta fue de 0,7 ±0,7 mg [DE]. No se encontraron diferencias significativas en la cantidad y el tipo de hierro consumido entre los niños con y sin anemia. El parámetro antropométrico que mostró la mayor asociación con la presencia de anemia fue la relación entra la estatura y la edad. CONCLUSIONES: Las prevalencias de anemia ferropénica y deficiencia de hierro encontradas en la población estudiada fueron bajas, de acuerdo con los parámetros de hemoglobina y ferritina definidos por la Organización Mundial de la Salud como normales para estos grupos poblacionales. La baja prevalencia de parásitos hematófagos, un consumo adecuado de vitamina C y los finos mecanismos de regulación del metabolismo del hierro pueden haber contribuido a estos resultados. Se debe velar por un contenido adecuado de hierro en la dieta de las adolescentes y poner en marcha campañas educativas que contribuyan a prevenir la deficiencia de hierro en este grupo poblacional.