The Prevalence, Correlates and Impact of Dementia in Cuba

Rodriguez, Juan L.; Valhuerdi, Adolfo; Sanchez, I.I.; Reyna, Chantal; Guerra, Mariella; Copeland, J. R. M.; Ferri, Cleusa P.; Prince, Martin

doi:10.1159/000165362

Cited by 37 publications

(23 citation statements)

References 76 publications

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“…However, in a cross-sectional study 33 of elderly Chinese people living in Hong Kong, dementia (odds ratio 157·1), stroke (19·3), Parkinson's disease (14·2), and old fractures (2·5) were the chronic disorders most strongly associated with severe limitation. Finally, previous analyses of the same 10/66 Dementia Research Group dataset have shown that dementia is the largest independent chronic disease contributor to dependency, with a PAPF of 65% in Cuba 34 and 44% in Dominican Republic 35 …”

Section: Discussionmentioning

confidence: 86%

Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: a 10/66 Dementia Research Group population-based survey

Sousa¹,

Ferri²,

Acosta³

et al. 2009

The Lancet

404

299

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SummaryBackgroundDisability in elderly people in countries with low and middle incomes is little studied; according to Global Burden of Disease estimates, visual impairment is the leading contributor to years lived with disability in this population. We aimed to assess the contribution of physical, mental, and cognitive chronic diseases to disability, and the extent to which sociodemographic and health characteristics account for geographical variation in disability.MethodsWe undertook cross-sectional surveys of residents aged older than 65 years (n=15 022) in 11 sites in seven countries with low and middle incomes (China, India, Cuba, Dominican Republic, Venezuela, Mexico, and Peru). Disability was assessed with the 12-item WHO disability assessment schedule 2.0. Dementia, depression, hypertension, and chronic obstructive pulmonary disease were ascertained by clinical assessment; diabetes, stroke, and heart disease by self-reported diagnosis; and sensory, gastrointestinal, skin, limb, and arthritic disorders by self-reported impairment. Independent contributions to disability scores were assessed by zero-inflated negative binomial regression and Poisson regression to generate population-attributable prevalence fractions (PAPF).FindingsIn regions other than rural India and Venezuela, dementia made the largest contribution to disability (median PAPF 25·1% [IQR 19·2–43·6]). Other substantial contributors were stroke (11·4% [1·8–21·4]), limb impairment (10·5% [5·7–33·8]), arthritis (9·9% [3·2–34·8]), depression (8·3% [0·5–23·0]), eyesight problems (6·8% [1·7–17·6]), and gastrointestinal impairments (6·5% [0·3–23·1]). Associations with chronic diseases accounted for around two-thirds of prevalent disability. When zero inflation was taken into account, between-site differences in disability scores were largely attributable to compositional differences in health and sociodemographic characteristics.InterpretationOn the basis of empirical research, dementia, not blindness, is overwhelmingly the most important independent contributor to disability for elderly people in countries with low and middle incomes. Chronic diseases of the brain and mind deserve increased prioritisation. Besides disability, they lead to dependency and present stressful, complex, long-term challenges to carers. Societal costs are enormous.FundingWellcome Trust; WHO; US Alzheimer's Association; Fondo Nacional de Ciencia Y Tecnologia, Consejo de Desarrollo Cientifico Y Humanistico, Universidad Central de Venezuela.

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Section: Discussionmentioning

confidence: 86%

Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: a 10/66 Dementia Research Group population-based survey

Sousa¹,

Ferri²,

Acosta³

et al. 2009

The Lancet

404

299

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“…93 In contrast, other studies found a persistent association even after accounting for health, lifestyle, or familiality. 28, 29,61 Studies that evaluated brain pathology at autopsy found disease pathology to be unrelated to years of education.…”

Section: Discussionmentioning

confidence: 90%

Relationship Between Education and Dementia

Sharp

Gatz

2011

Alzheimer Disease &Amp; Associated Disorders

465

302

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Objective The purpose of this study was to review the relationship between education and dementia. Methods A systematic literature review was conducted of all published studies examining the relationship between education and dementia listed in the PubMed and PsycINFO databases from January 1985 to July 2010. The inclusion criteria were a measure of education and a dementia diagnosis by a standardized diagnostic procedure. Alzheimer’s disease and Total Dementia were the outcomes. Results A total of 88 study populations from 71 articles met inclusion criteria. Overall, 51 (58%) reported significant effects of lower education on risk for dementia whereas 37 (42%) reported no significant relationship. A relationship between education and risk for dementia was more consistent in developed compared to developing regions. Age, gender, race/ethnicity, and geographical region moderated the relationship. Conclusions Lower education was associated with a greater risk for dementia in many but not all studies. The level of education associated with risk for dementia varied by study population and more years of education did not uniformly attenuate the risk for dementia. It appeared that a more consistent relationship with dementia occurred when years of education reflected cognitive capacity, suggesting that the effect of education on risk for dementia may be best evaluated within the context of a lifespan developmental model.

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“…To our knowledge, this is the first study to address both health conditions and unmet needs related to ADL and IADL among PWD in a Latin American country . Previous studies in Latin America and the Caribbean (LAC) have indicated that the care needs of PWD are higher than those of older adults requiring care due to other medical conditions . Nevertheless, to the best of our knowledge, no published study has addressed unmet needs in PWD in LAC .…”

Section: Discussionmentioning

confidence: 92%