Dementia among Older Persons in Jamaica: Prevalence and Policy Implications

Abstract

Objective: To determine the prevalence of dementia and dementia types in Jamaica. Methods: An embedded case-control design was used to investigate dementia within the ageing population. Cases (Mini-Mental State Examination [MMSE] scores of ≤ 20) and controls (MMSE scores of > 20) were evaluated using DSM-IV protocol and magnetic resonance imaging. Prevalences (crude and age-adjusted) were calculated and distribution of dementia by type described. Results: Dementia prevalence was 5.9%. Alzheimer's pattern dementia accounted for 61.8% and vascular dementia 32.4%. However, vascular disease was prominent in 45.5% of the Alzheimer's cases. Female gender and increasing age were associated with higher rates of dementia. Dementia was 38 times more likely in participants with MMSE scores below 20. Conclusion: This first nationally representative study indicated that dementia rates in Jamaica were comparable with regional and global estimates. Regardless of the dementia type, vascular change was pervasive and suggested that synergistic efforts should be made to address underlying contributory factors. Cardiovascular and cerebrovascular risk reduction should be deliberately pursued as integral adjuncts to dementia risk reduction.

A systematic review and meta-analysis of dementia prevalence in seven developing countries: A STRiDE project

“…Even when authors attempted to recruit from a representative sample, there was a lack of explicit evidence that the sample closely represented the national population. Only one study was judged as of low risk in relation to the close representation item (Eldemire-Shearer et al, 2018).…”

“…Many studies were judged to have a high risk of bias regarding how closely representative the sample frame was to the target population (Banerjee et al, 2008;Caramelli et al, 2009;de Jager et al, 2017;Jacob et al, 2007;Llibre Rodriguez et al, 2008;Neita et al, 2014;Seby et al, 2011;Shaji et al, 1996Shaji et al, , 2005Tiwari et al, 2013;Van Der Poel et al, 2011;Vas et al, 2001), with studies failing to clearly report how they chose their sampling frame or selecting a frame out of convenience. Nonresponse bias was also frequently judged to constitute a high risk of bias, due to authors either not stating the study response rate or, when the response rate was low (<75%) whether there was any nonresponse bias (Banerjee et al, 2008(Banerjee et al, , 2017Bottino et al, 2008;Caramelli et al, 2009;Cesar et al, 2016;de Jager et al, 2017;Eldemire-Shearer et al, 2018;Gurukartick et al, 2016;Llibre Rodriguez et al, 2008;Lopes et al, 2012;Neita et al, 2014;Singh et al, 2008;Velazquez-Brizuela et al, 2014).…”

“…Two prevalence studies were identified from Jamaica (Eldemire-Shearer et al, 2018;Neita et al, 2014).…”

Caregivers of Older Persons in Jamaica: Characteristics, Burden, and Associated Factors

“…Approximately 71.9% have a chronic health condition, with 22% reporting arthritis (Planning Institute of Jamaica, 2016). Dementia prevalence is 5.9% (Eldemire-Shearer et al, 2017). These statistics herald an emerging subgroup of the older persons who will likely be in need of care or are currently in receipt of care from caregivers, whether formally or informally.…”

Performance and Receiver Operating Characteristics of the Mini-Mental State Examination Instrument in Detecting Dementia in a Rapidly Aging Developing Country (Jamaica)

“…2 In Jamaica, a middle-income country, with population of approximately 2.7 million, a recent estimate of dementia prevalence among older persons is 5.9%. 3 With the proportion of older persons projected to increase to 16.8% by 2025, 4 the number of cases of dementia is expected to increase.…”