(1) Background: We proposed to review worldwide estimates of cognitive impairment prevalence and incidence in adults older than 50 years of age living in the community. (2) Methods: Systematic searches were performed in January 2019 using MEDLINE/PubMed. Articles were selected if they referred to cognitive impairment, prevalence, incidence, elders, and population or community-based studies. Analysis, aggregated by different methodologic features, was performed. (3) Results: Prevalence (80 studies) ranged between 5.1% and 41% with a median of 19.0% (25th percentile = 12.0%; 75th percentile = 24.90%). Incidence (11 studies) ranged from 22 to 76.8 per 1000 person-years with a median of 53.97 per 1000 person-years (25th percentile = 39.0; 75th percentile = 68.19). No statistically significant effects were found except for inclusion age. (4) Conclusion: We propose that the homogenization and clarification of the definition of what constitutes cognitive impairment are essential to refine the epidemiological understanding of this entity. The results of this review reinforce the importance of adherence to standardized cut-off scores for cognitive tests to promote study comparability.

Background: The increase in average life expectancy increases the risk of illness and frailty in the elderly, especially in the cognitive arena. This study has the objective to estimate the prevalence and incidence of cognitive impairment, in a representative sample of 65 to 85 years old followed for a mean period of 6-years. Methods: Subjects aged 65–85 years (n = 586) were screened at baseline (1999–2004) to estimate the prevalence of cognitive impairment using the Mini-Mental State Examination. A total of 287 individuals with a normal MMSE at baseline were reassessed after 6.2 mean years (± 4.30 years) to evaluate the incidence of cognitive impairment, defined as scoring below the age and education-adjusted MMSE cut-off points adapted for the Portuguese population. We did not exclude Dementia. Results: The baseline prevalence of cognitive impairment was 15.5% (95% CI: 12.7–18.7). Higher in women (18.9%; 95% CI: 14.9–23.3), that in men (10.4%; 95% CI: 6.7–15.1). Increased with age and was highest for participants without any schooling. The overall incidence rate was 26.97 per 1000 person-years; higher in women (33.8 per 1000 person-years) than in men (18.0 per 1000 person-years). Higher for the oldest participants and those with no schooling. Taking the standard European population, we estimated a prevalence of 16.5% and an incidence of 34.4 per 1000 person-years. Conclusion: The prevalence of cognitive impairment in Portugal is within the estimated interval for the European population, and the incidence is lower than for the majority of the European countries. Women, senior and elders without education have a higher risk of cognitive impairment. In our sample, neither employment nor marital status has a significant effect on cognitive impairment.

(1) Background: In an ageing society, social relationships may benefit cognitive performance with an impact on the health of older people. This study aims to estimate the effect of different social support sources on the risk of cognitive impairment in a sample of older Portuguese people. (2) Methods: From the Portuguese EpiPorto cohort study, we followed a sample of participants with 60 to 85 years (N = 656) between 2009 and 2015 (4.63 mean years of follow-up). The participants’ perception of social support from family, friends and significant others was evaluated. Cox’s regression models were used to investigate the association between this and sociodemographic variables. (3) Results: It was found that social support from friends reduces the risk of cognitive impairment. Men, participants aged 60 to 64 and those not married have a lower risk of cognitive impairment after adjusting for other variables. Participants between 80 and 85 years old (p = 0.021), those with less than four years of education (p < 0.001), and those with cognitive impairment (p = 0.007) have perception of less social support from friends. (4) Conclusions: A social support network from friends reduces the risk of cognitive impairment for older people.

A new era of virus surveillance is emerging based on the real-time monitoring of virus evolution at whole-genome scale (World Health Organization 2021). Although national and international health authorities have strongly recommended this technological transition, especially for influenza and SARS-CoV-2 (World Health Organization 2021, Revez et al. 2017), the implementation of genomic surveillance can be particularly challenging due to the lack of bioinformatics infrastructures and/or expertise to process and interpret next-generation sequencing (NGS) data (Oakeson et al. 2017). We developed and implemented INSaFLU-TELE-Vir platform (https://insaflu.insa.pt/) (Borges et al. 2018), which is an influenza- and SARS-CoV-2-oriented bioinformatics free web-based suite that handles primary NGS data (reads) towards the automatic generation of the main “genetic requests'' for effective and timely laboratory surveillance. By handling NGS data collected from any amplicon-based schema (making it applicable for other pathogens), INSaFLU-TELE-Vir enables any laboratory to perform multi-step and intensive bioinformatics analyses in a user-oriented manner without requiring advanced training. INSaFLU-TELE-Vir handles NGS data collected from distinct sequencing technologies (Illumina, Ion Torrent and Oxford Nanopore Technologies), with the possibility of constructing comparative analyses using different technologies. It gives access to user-restricted sample databases and project management, being a transparent and flexible tool specifically designed to automatically update project outputs as more samples are uploaded. Data integration is thus cumulative and scalable, fitting the need for both routine surveillance and outbreak investigation activities. The bioinformatics pipeline consists of six core steps: read quality analysis and improvement, human betacoronaviruses (including SARS-CoV-2 Pango lineages) and influenza type/subtype classification, mutation detection and consensus generation, coverage analysis, alignment/phylogeny, intra-host minor variant detection (and automatic detection of putative mixed infections). read quality analysis and improvement, human betacoronaviruses (including SARS-CoV-2 Pango lineages) and influenza type/subtype classification, mutation detection and consensus generation, coverage analysis, alignment/phylogeny, intra-host minor variant detection (and automatic detection of putative mixed infections). The multiple outputs are provided in nomenclature-stable and standardized formats that can be visualized and explored in situ or through multiple compatible downstream applications for fine-tuned data analysis. Novel features are being implemented into the INSaFLU-TELE-Vir bioinformatics toolkit as part of the OHEJP TELE-Vir (https://onehealthejp.eu/jrp-tele-vir/) project, including rapid detection of selected genotype-phenotype associations, and enhanced geotemporal data visualization. All the code is available in github (https://github.com/INSaFLU) with the possibility of a local docker installation (https://github.com/INSaFLU/docker). A detailed documentation and tutorial is also available (https://insaflu.readthedocs.io/en/latest/). In summary, INSaFLU supplies public health laboratories and researchers with an open and user-friendly framework, potentiating a strengthened and timely multi-country genome-based virus surveillance.