Prevalence of Dementia and Associated Factors among Older Adults in Latin America during the COVID-19 Pandemic

Abstract

<b><i>Background:</i></b> The COVID-19 pandemic has had a great impact on cognitive health in Latin American older adults, increasing the risk of cognitive impairment and dementia. Our objective was to analyze the prevalence of dementia and the associated factors in Latin American older adults during SARS-CoV-2 pandemic. <b><i>Methods:</i></b> A multicentric first phase cross-sectional observational study was conducted during the SARS-CoV-2 pandemic. Five thousand two hundred and forty-five Latin American adults over 60 years of age were studied in 10 countries: Argentina, Bolivia, Chile, Colombia, Ecuador, Guatemala, Mexico, Peru, the Dominican Republic, and Venezuela. We used the telephone version of Montreal Cognitive Assessment, the “Alzheimer Disease 8” scale for functional and cognitive changes, and the abbreviated version of the Yesavage depression scale. We also asked for sociodemographic and lockdown data. All the evaluation was made by telephone. Cross-tabulations and χ<sup>2</sup> tests were used to determine the variability of the prevalence of impairment by sociodemographic characteristics and binary logistic regression to assess the association between dementia and sociodemographic factors. <b><i>Results:</i></b> We observed that the prevalence of dementia in Latin America is 15.6%, varying depending on the country (Argentine = 7.83 and Bolivia = 28.5%). The variables most associated with dementia were race and age. It does not seem to be associated with the pandemic but with social and socio-health factors. <b><i>Conclusion:</i></b> The prevalence of dementia shows a significant increase in Latin America, attributable to a constellation of ethnic, demographic, and socioeconomic factors.

Prevalence of dementia in Latin America and Caribbean countries: Systematic review and meta-analyses exploring age, sex, rurality, and education as possible determinants

“…Regarding rurality, most of the studies included participants in urban areas ( n = 23), while two studies from Brazil ( Brucki and Nitrini, 2014 , Magalhães et al, 2008 ) and one from Bolivia ( Gatz et al, 2022 ) comprised individuals from rural populations, and eight studies had individuals recruited in both, rural and urban areas. In one article ( Soto-Añari et al, 2021 ), the rurality of the samples was unclear for the samples from all nine countries.…”

“…Studies differed on whether they assessed dementia in one phase, with a one-time full assessment or two or more phases, with an initial screening phase and subsequent in-depth assessment of participants with probable dementia. Fourteen out of the 32 included studies conducted a two-phase diagnosis ( Albala et al, 1997 , Bartoloni et al, 2014 , Bottino et al, 2008 , Brucki and Nitrini, 2014 , Correa Ribeiro et al, 2013 , Correia et al, 2011 , Gooding et al, 2006 , Ketzoian et al, 1997a , Llibre et al, 2009 , Lopes et al, 2012 , Neita et al, 2014 , Pedraza et al, 2017 , Ramos-Cerqueira et al, 2005 , Soto-Añari et al, 2021 ) and four studies conducted more than two phases-diagnosis to identify patients with dementia ( Caramelli et al, 2011 , Custodio et al, 2008 , Herrera et al, 2002 , Molero et al, 2007 ). In general, MMSE was used as the main instrument to screen symptoms of dementia; however, the following phases varied widely among studies in terms of instruments used.…”

“…However, some studies used the 10/66 algorithm in addition to the DSM criteria ( Davis et al, 2018 ; Llibre Rodriguez et al, 2008 ). Besides the DSM, one study used the History and Aetiology Schedule Dementia Diagnosis and Subtype ( Scazufca et al, 2008 ), another two applied the National Institute on Aging criteria ( César et al, 2016 ; Gatz et al, 2022 ; Soto-Añari et al, 2021 ), and one of them used the cut-off points of the Cambridge Examination for Mental Disorders ( Magalhães et al, 2008 ).…”

Sociodemographic Differences in COVID-19 Self-Reported Symptoms by Ethnicity and Older Adults in Bolivia

“…There is an increase in the prevalence of cognitive impairment in older persons in Latin America, varying by country, with age, gender, and race is associated with this increased risk due to social and socio-health factors (Soto-Añari et al, 2021 ). In addition, greater marginalization of older persons is observed given the confinement and concentration of health resources in COVID-19, which can make it difficult to access health services for the treatment of pre-existing conditions, making them more vulnerable to COVID-19 (Lustig & Tommasi, 2020 ; United Nations, 2020 ).…”

“…The prevalence of dementia among older adults during COVID-19 shows a significant increase in Latin America (15.6%) and Bolivia (28.5%), attributable to a constellation of ethnic, demographic, and socioeconomic factors (Soto-Añari et al, 2021 ). As well, a high proportion of the Bolivian population is affected by unequal, precarious working conditions, and poverty (Hummel et al, 2021 ) The impact of COVID-19 disease can be seen to be producing income transfers to the upper classes and certain changes in the elite level in the region (Bull & Robles Rivera, 2020 ).…”