Prevalence of dementia in Latin America, India, and China: a population-based cross-sectional survey.
Date
2008Author
Llibre Rodríguez, Juan J.
Acosta, Daisy
Guerra, Mariella
Huang, Yueqin
Salas, Aquiles
Sosa, Ana Luisa
Acosta, Isaac
Gaona, Ciro
Li, Shuran
Valhuerdi, Adolfo
Prince, Martin J.
Ferri, Cleusa P.
Jacob, K. S.
Krishnamoorthy, E. S.
Dewey, Michael E.
Jotheeswaran, A.T.
Rodríguez, Diana
Rodríguez Pichardo, Guillermina
Senthil Kumar, P.
Ferri, Cleusa P.
Metadata
Show full item recordAbstract
Studies have suggested that the prevalence of dementia is lower in developing than in developed regions. We
investigated the prevalence and severity of dementia in sites in low-income and middle-income countries according to two
definitions of dementia diagnosis. Methods: We undertook one-phase cross-sectional surveys of all residents aged 65 years
and older (n=14 960) in 11 sites in seven low-income and middle-income countries (China, India, Cuba, Dominican
Republic, Venezuela, Mexico, and Peru). Dementia diagnosis was made according to the culturally and educationally
sensitive 10/66 dementia diagnostic algorithm, which had been prevalidated in 25 Latin American, Asian, and African
centres; and by computerised application of the dementia criterion from the Diagnostic and Statistical Manual of Mental
Disorders (DSM IV). We also compared prevalence of DSM-IV dementia in each of the study sites with that from estimates
in European studies. Findings: The prevalence of DSM-IV dementia varied widely, from 0·3% (95% CI 0·1-0·5) in rural India
to 6·3% (5·0-7·7) in Cuba. After standardisation for age and sex, DSM-IV prevalence in urban Latin American sites was
four-fifths of that in Europe (standardised morbidity ratio 80 [95% CI 70-91]), but in China the prevalence was only half (56
[32-91] in rural China), and in India and rural Latin America a quarter or less of the European prevalence (18 [5-34] in rural
India). 10/66 dementia prevalence was higher than that of DSM-IV dementia, and more consistent across sites, varying
between 5·6% (95% CI 4·2-7·0) in rural China and 11·7% (10·3-13·1) in the Dominican Republic. The validity of the 847 of
1345 cases of 10/66 dementia not confirmed by DSM-IV was supported by high levels of associated disability (mean WHO
Disability Assessment Schedule II score 33·7 [SD 28·6]). Interpretation: As compared with the 10/66 dementia algorithm,
the DSM-IV dementia criterion might underestimate dementia prevalence, especially in regions with low awareness of this
emerging public-health problem.
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https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)61002-8/fulltext?code=lancet-siteCollections
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