A review of the epidemiological transition in dementia — cross‐national comparisons of the indices related to Alzheimer's disease and vascular dementia

Abstract

A theoretical model of transition from low incidence-high mortality society to high incidence-high mortality society to low incidence-low mortality society may explain these findings. Rigorous testing in prospective, longitudinal and population-based cross-national studies using culture-fair diagnostic instruments is required.

The importance of the socioeconomic status of countries for mental disorders in old age: development of an epidemiological transition model

“…Ultimately, this will lead to a gradual transition from a high prevalence-high socioeconomic society stage to a low prevalence-high socioeconomic society stage. This epidemiological transition model is similar to a version of the model that has already been proposed for the epidemiological transition of dementia (Suh and Shah, 2001), but the current model could be applied empirically to all age-related disorders and elderly suicide rates.…”

“…The socioeconomic status of societies may influence the incidence and duration of mental illnesses in old age by influencing life expectancy and availability of appropriate healthcare services and treatments (Suh and Shah, 2001). The relationship between a proxy measure of the socioeconomic status (per capita gross national domestic product (GDP)) and (i) the life expectancy, (ii) child mortality rates and (iii) proxy measures of the quality and quantity of available healthcare services (the proportion of GDP spent on health, per capita expenditure on health and child mortality rates) was examined.…”

“…infectious diseases) associated with poor socioeconomic factors are common causes of death early in life due to paucity of appropriate healthcare services and treatments (Suh and Shah, 2001). This is supported by negative correlations between male and female child mortality rates and the proportion of GDP spent on health and per capita expenditure on health.…”

“…https://doi.org/10.1017/S1041610207005479 and the proportion of GDP spent on health and per capita expenditure on health. Hence, the incidence (and therefore the prevalence) of a mental disorder that has an increased risk of development in old age will be low in these societies because fewer people will reach the age of increased risk, and this has been observed for dementia (Chandra et al, 2001;Suh and Shah, 2001). Moreover, in these societies, selective survival of those at reduced risk of developing mental disorders in old age due to genetic or constitutional factors may further compound this trend (Suh and Shah, 2001).…”

“…Hence, the incidence (and therefore the prevalence) of a mental disorder that has an increased risk of development in old age will be low in these societies because fewer people will reach the age of increased risk, and this has been observed for dementia (Chandra et al, 2001;Suh and Shah, 2001). Moreover, in these societies, selective survival of those at reduced risk of developing mental disorders in old age due to genetic or constitutional factors may further compound this trend (Suh and Shah, 2001). In addition, those who do survive into old age may be at reduced risk of developing mental disorders because they may be able to tolerate additional hardship in old age better due to exposure to life-long adversity (Lindesay, 1981;Seiden, 1981) and this may reduce the incidence (and therefore the prevalence).…”