Introduction. Mental health has historically been overlooked in public policies in Mexico, with up to 80% of people with mental health and substance-related disorders in Mexico lacking adequate care. Objective. To characterize the mental health provider (psychiatrists and psychologists) shortage in the Mexican public sector. Method. Descriptive study. Data from SINERHIAS (Ministry of Health of Mexico) up to the first half of 2023 were analyzed. Results. A total of 1,504 psychiatrists worked in the public sector (1.1 per 100,000 population). The Health Ministry (Secretaría de Salud; Spanish acronym SS) employed 55.9%, IMSS 25.9%, ISSSTE 7.2%, while 1.0% were affiliated to other public institutions. There were 8,668 psychologists in the public sector (6.9 per 100,000 population), of which the SS employed 78.9%, IMSS 6.3%, ISSSTE 2.4%, while 12.3% worked at other public institutions. Thirty-four per cent of psychiatrists were in Mexico City, while 21 states, accounting for 70% of the population, had one psychiatrist or fewer per 100,000 population. Hospital units employed 83.3% of psychiatrists. Discussion. Mexico has an insufficient number of mental health providers at public institutions, with disparities between states and most providers affiliated to hospital units. Conclusion. There is an acute mental health provider shortage in the Mexican public sector, together with limited resources for community mental health care, affecting the treatment of mental health and substance use disorders.

The cognitive characterization of Alzheimer's disease risk states, such as amnestic mild cognitive impairment (aMCI) and subjective cognitive decline (SCD), is fundamental for timely diagnosis and interventions. The Face Name Associative Memory Exam (FNAME) is sensitive to early Alzheimer's disease brain changes, and an extended version captures a fuller range of associative memory abilities. We aimed to assess group effects in the extended FNAME in older adults with SCD, aMCI, and older adult controls (CON). Two concurrently created versions of the extended FNAME were used to test three groups of older adults (CON = 35, SCD = 37, aMCI = 31) at two sites (Mexico = 59, Netherlands = 44). Extended FNAME memory abilities were analyzed in five analyses of variance. Group and site were considered as independent variables. For the recall ability, subtest levels were entered as a within-subject variable. The remaining abilities (Face Recognition, Name Recognition, Spontaneous Name Recall, and Face-Name Matching) were analyzed in independent models. In all models, the main effect for group was significant with large effect sizes, driven by a worse performance of aMCI participants. No significant differences were found between SCD and CON. The main effect for site was only significant in Face Recognition. The worse performance of aMCI in the extended FNAME implies an impairment in associative memory abilities beyond recall. The similar performance of CON and SCD might be explained by the recruitment of SCD participants that did not spontaneously seek help for memory decline. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Face Name Associative Memory Exam (FNAME) is sensitive to associative memory changes early in the Alzheimer’s disease spectrum, but little is known about how healthy aging affects FNAME perform...

Background/Objectives: The Montreal Cognitive Assessment (MoCA) is a widely used cognitive screening tool designed to detect cognitive impairment. However, evidence indicates that the original cut-off score of 26 and the one-point correction for low education may not be appropriate across diverse populations. In Latin America, and particularly in Mexico, existing validation studies are scarce and limited by small sample sizes. The objective of this study was to examine the effects of age and education on MoCA performance in Mexican adults and to develop regression-based normative data for more accurate interpretation. Methods: MoCA performance of 2546 cognitively healthy participants aged 18–99 years from two public health institutions in Mexico City was analyzed. Inclusion criteria required preserved cognition, functionality, independence, and absence of conditions directly affecting brain health. The Spanish version 8.1 of the MoCA was administered. Age-adjusted normative values were obtained. Then, regression analyses were applied to generate age- and education-adjusted norms. Results: MoCA total scores correlated negatively with age and positively with education, while sex showed no significant effect. Regression-based norms revealed that identical raw total scores have different normative interpretations depending on age and education. Conclusions: This study provides the first regression-based MoCA norms for Mexican adults, demonstrating that both age and education exert a substantial influence on test performance. These norms enable a more precise, culturally sensitive interpretation than fixed cut-off scores and reduce the risk of misclassification in clinical and research settings.

Dementia in Latinx communities is increasingly prevalent and its approach is complicated by systemic and cultural barriers to care. In both Latin American countries and Latinx immigrant communities, limited healthcare access, structural barriers, and cultural misconceptions hinder timely diagnosis and treatment. Culturally sensitive care is essential in these contexts to ensure that patients and families are treated with dignity and compassion, addressing their unique challenges and perspectives on dementia. This paper discusses the philosophy of ambiguity and medical uncertainty to explore dementia’s complex realities, particularly in underserved Latinx populations. Clinically, this includes addressing the uncertainty in dementia diagnosis and prognosis in low- and middle-income countries, bridging knowledge gaps by building trust through culturally sensitive communication, and recognizing the impact of ambiguous loss of homeland for Latinx caregivers and patients. Additionally, the ambiguity of familism, with its mixed effects on caregiving roles and expectations, requires nuanced understanding. Embracing these ambiguities fosters a more compassionate, culturally sensitive approach to dementia care that goes beyond the biomedical model and acknowledges the complexities of living with dementia.

A esa edad que me dices, ¿quién