Dementia in Latin America

Abstract

The demographic structure of Latin American countries (LAC) is fast approaching that of developing countries, and the predicted prevalence of dementia in the former already exceeds the latter. Dementia has been declared a global challenge, yet regions around the world show differences in both the nature and magnitude of such a challenge. This article provides evidence and insights on barriers which, if overcome, would enable the harmonization of strategies to tackle the dementia challenge in LAC. First, we analyze the lack of available epidemiologic data, the need for standardizing clinical practice and improving physician training, and the existing barriers regarding resources, culture, and stigmas. We discuss how these are preventing timely care and research. Regarding specific health actions, most LAC have minimal mental health facilities and do not have specific mental health policies or budgets specific to dementia. In addition, local regulations may need to consider the regional context when developing treatment and prevention strategies. The support needed nationally and internationally to enable a smooth and timely transition of LAC to a position that integrates global strategies is highlighted. We focus on shared issues of poverty, cultural barriers, and socioeconomic vulnerability. We identify avenues for collaboration aimed to study unique populations, improve valid assessment methods, and generate opportunities for translational research, thus establishing a regional network. The issues identified here point to future specific actions aimed at tackling the dementia challenge in LAC.

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“… 14 This could be explained by the fact that in low-income countries, health facilities are more often located in big cities, whereas there are few professionals practicing both in the countryside and rural areas. 15 Also, lack of economic and medical resources, poor training, and lack of expertise in mental health are the main factors contributing to poor care for the elderly, especially those with dementia. 14 , 16 Another possible explanation for the absence of studies in low-income countries may be related to the limited access to health services, as well as the limited creation and implementation of public health policies that contribute toward both patient diagnosis and treatment.…”

“… 14 , 16 Another possible explanation for the absence of studies in low-income countries may be related to the limited access to health services, as well as the limited creation and implementation of public health policies that contribute toward both patient diagnosis and treatment. 14 , 15 , 17 …”

“… 18 Because biological age is not always enough to define old age, the World Health Organization has established the age of 60 years old or over for low- and middle-income countries and 65 or over for high-income countries. 15 , 21…”

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“…While dementia is not a normal part of the aging process, advanced age remains a primary risk factor. In the coming decades, expansion of aging populations will occur most rapidly in low-and middle-income countries (LMICs [Parra et al, 2018]). Therefore, the burden of dementia will be disproportionately experienced in these regions (ADI, 2013;GBHI, 2019;UN, 2015).…”

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“…9 Cabe ressaltar que estes dados podem estar subestimados, pois a maioria dos relatórios baseia-se em um número limitado de estudos, que fornecem apenas uma imagem parcial do problema. 12 No Brasil, as taxas de prevalência encontradas nos estudos apresentam um amplo intervalo, variando de 5,1 a 17,5% nos estudos encontrados em idosos acima de 60 anos. [13][14][15][16][17][18] A demência está diretamente associada ao aumento da mortalidade em idosos.…”