Prevalence, distribution, and impact of mild cognitive impairment in Latin America, China, and India: a 10/66 population-based study.
Date
2012-02Author
Sosa, Ana Luisa
Albanese, Emiliano
Stephan, Blossom C. M
Dewey, Michael
Acosta, Daisy
Ferri, Cleusa P.
Guerra, Mariella
Huang, Yueqin
Jacob, K. S.
Jiménez-Velázquez, Ivonne Z.
Llibre Rodríguez, Juan J.
Salas, Aquiles
Williams, Joseph
Acosta, Isaac
González-Viruet, Maribella
Guerra Hernández, Milagros A
Shuran, Li
Prince, Martin J.
Stewart, Robert
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Show full item recordAbstract
Rapid demographic ageing is a growing public health issue in many low- and middle-income countries
(LAMICs). Mild cognitive impairment (MCI) is a construct frequently used to define groups of people who may be at risk of
developing dementia, crucial for targeting preventative interventions. However, little is known about the prevalence or
impact of MCI in LAMIC settings.
Methods and Findings: Data were analysed from cross-sectional surveys established by the 10/66 Dementia Research
Group and carried out in Cuba, Dominican Republic, Peru, Mexico, Venezuela, Puerto Rico, China, and India on 15,376
individuals aged 65+ without dementia. Standardised assessments of mental and physical health, and cognitive function
were carried out including informant interviews. An algorithm was developed to define Mayo Clinic amnestic MCI (aMCI).
Disability (12-item World Health Organization disability assessment schedule [WHODAS]) and informant-reported
neuropsychiatric symptoms (neuropsychiatric inventory [NPI-Q]) were measured. After adjustment, aMCI was associated
with disability, anxiety, apathy, and irritability (but not depression); between-country heterogeneity in these associations
was only significant for disability. The crude prevalence of aMCI ranged from 0.8% in China to 4.3% in India. Country
differences changed little (range 0.6%–4.6%) after standardization for age, gender, and education level. In pooled estimates,
aMCI was modestly associated with male gender and fewer assets but was not associated with age or education. There was
no significant between-country variation in these demographic associations.
Conclusions: An algorithm-derived diagnosis of aMCI showed few sociodemographic associations but was consistently
associated with higher disability and neuropsychiatric symptoms in addition to showing substantial variation in prevalence
across LAMIC populations. Longitudinal data are needed to confirm findings—in particular, to investigate the predictive
validity of aMCI in these settings and risk/protective factors for progression to dementia; however, the large number
affected has important implications in these rapidly ageing settings.
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