The power of knowledge about dementia in Latin America across health professionals working on aging

Abstract

Introduction Expert knowledge is critical to fight dementia in inequitable regions like Latin American and Caribbean countries (LACs). However, the opinions of aging experts on public policies’ accessibility and transmission, stigma, diagnostic manuals, data‐sharing platforms, and use of behavioral insights (BIs) are not well known. Methods We investigated opinions among health professionals working on aging in LACs (N = 3365) with regression models including expertise‐related information (public policies, BI), individual differences (work, age, academic degree), and location. Results Experts specified low public policy knowledge ( X 2 = 41.27, P < .001), high levels of stigma ( X 2 = 2636.37, P < .001), almost absent BI knowledge ( X 2 = 56.58, P < .001), and needs for regional diagnostic manuals ( X 2 = 2893.63, df = 3, P < .001) and data‐sharing platforms (X 2 = 1267.5, df = 3, P < .001). Lack of dementia knowledge was modulated by different factors. An implemented BI‐based treatment for a proposed prevention program improved perception across experts. Discussion Our findings help to prioritize future potential actions of governmental agencies and non‐governmental organizations (NGOs) to improve LACs’ dementia knowledge.

Dementia in Latin America: Paving the way toward a regional action plan

“…Low awareness and stigma have proved a barrier to early characterization of dementia 1,25,26,70–72 . Both factors are pervasive in LACs 73 . Senior Latinos find it difficult to talk about cognitive evaluation because discussing cognitive and mental health is considered a taboo 74 .…”

“…These approaches will help boost critical regional needs, such as the identification of cognitively vulnerable or resilient 98 common and unknown risk factors (such as obesity, smoking, sanitary conditions, depression, gender, genetics, and cardiovascular and cerebrovascular diseases, 20,99 among others) for dementia (Challenges: genetic‐environmental conditions, diagnosis procedures). To identify the influence of lifelong factors on neurocognitive development, LACs would benefit from strategies offered by behavioral insight approaches 100 and systematic assessments of multimodal sources of heterogeneity. A recent survey in >3000 health professionals working in aging suggest a strong interest in behavioral insights and multimodal regional research 73 (Challenges: genetic‐environmental conditions, awareness and stigma, language barriers and racial/ethnic diversity). To incorporate assessment protocols such as those developed by the Neuroscience Group of Antioquia, Colombia through which more genetic variants of dementing illnesses (eg, Ile416Thr, a variant in PSEN1 101 ) will be identified across the region. The implementation of a regional manual for best practices for the dementia diagnosis such those developed by LAC‐CD 102 (particularly from the Multi‐partner Consortium to Expand Dementia Research in Latin America, ReDLat, see Panel 2.C for specific recommendations) can help to harmonize procedures in local contexts (Challenge: diagnosis procedures). Implementation of training/education programs to increase knowledge and practice in topics relevant to mental health and dementia.…”

“…73 Senior Latinos find it difficult to talk about cognitive evaluation because discussing cognitive and mental health is considered a taboo. 74 Messages used to promote awareness are often found to be vague and produce feelings of guilt. Poor awareness is also found among health care providers.…”

The Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat): Driving Multicentric Research and Implementation Science

“…Another example of coordinated actions are related to surveying expert knowledge on dementia across different LACs. We recently assessed multiple dimensions of expert knowledge of health professionals working in aging across LACs ( N = 3,365) and its modulation by different factors including expertise-related information (knowledge of public policies), individual differences (work, age, academic degree), and location across LACs ( 127 ). Results evidenced a tough knowledge gap of dementia at manifold levels ( Figure 6 ) including lack of access and transmission of public health knowledge, stigma among professionals, and almost complete unawareness of innovative behavioral insights or nudges tools in public health domains.…”

“…Significance ( p values): effects significance (** p ≤ 0.05, *** p ≤ 0.01), model significance (° p ≤ 0.1, ° p ≤ 0.05, ° p ≤ 0.01). Academic degree: 1: No reported education, 2: Technicians, 3: Tertiaries, 4; Certificates, 5: Undergrads, 6: Hospital Interns, 7: Post-graduate Specialization, 8: Master's Degree, 9: Ph.D. Reproduced with authorization from ( 127 ).…”