Facilitators and Barriers to Dementia Assessment and Diagnosis: Perspectives From Dementia Experts Within a Global Health Context

Sideman, Alissa Bernstein; Al‐Rousan, Tala; Tsoy, Elena; Escudero, Stefanie D Piña; Pintado-Caipa, Maritza; Kanjanapong, Suchanan; Oliveira, Maira Okada de; Cruz-Puebla, Myriam De la; Zygouris, Stelios; Mohamed, Amel abd Elaziem; Ibrahim, H.; Goode, Collette A.; Miller, Bruce L.; Valcour, Victor; Possin, Katherine L.

doi:10.3389/fneur.2022.769360

Cited by 22 publications

(10 citation statements)

References 30 publications

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“…The status of other areas related to dementia awareness, dementia risk reduction, diagnosis, treatment and care, dementia carer support, dementia information systems and research is also similar across these countries highlighting an urgent need for action. Prior reports indicate that there are barriers to dementia assessment and care – stigma about dementia, poor patient engagement, limited trained healthcare professionals who can diagnose and manage dementia, competing healthcare system priorities and insufficient funding [36]. Studies have also identified the importance of establishing research priorities to improve outcomes related to dementia [37].…”

Section: Resultsmentioning

confidence: 99%

Status, determinants and risk factors of all-cause dementia in South Asia: Findings from a preliminary analysis of global health data

Palliyaguru,

Ligo Teixeira

et al. 2024

Preprint

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South Asia is one of the most populous regions of the world. At present, South Asians make up more than 25 percent of the world population but little effort has been dedicated to studying trends and etiological factors driving aging and aging-related conditions in this part of the world. Even less characterization has been done on brain-related conditions, particularly all-cause dementia in South Asia. To address this, we examined data from the US Census Bureau, World Health Organization Global Dementia Observatory and the Global Burden of Disease (GBD) 2019 Study, and conducted a comparative analysis of population statistics, dementia as a priority health area, and dementia incidence rates, death rates and disability-adjusted life years (DALYs) in 8 South Asian countries, Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka. Our analysis reiterated that there are limited resources dedicated to dementia in this region. Sri Lanka and Afghanistan had the highest dementia crude rates and age-standardized rates, respectively. The burden of dementia in some South Asian countries was comparable to estimated global averages, and was largely driven by population aging. Analyses of available data on known biological, behavioral, environmental and disease risk factors, highlighted the role of metabolic risk factors such as high fasting blood glucose. Here, we also underscore the critical need for future follow-up longitudinal studies focusing on brain aging and dementia and describe a roadmap for designing them - taking into account cultural, economic and public health dynamics that may be uniquely applicable to countries in South Asia.

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Section: Resultsmentioning

confidence: 99%

Status, determinants and risk factors of all-cause dementia in South Asia: Findings from a preliminary analysis of global health data

Palliyaguru,

Ligo Teixeira

et al. 2024

Preprint

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“…For example, identifying, examining, and describing what “isms” are relevant to the U.S. (e.g., racism), what “isms” are unique to India (e.g., casteism) [ 43 ], what “isms” are common to the two countries (e.g., genderism/sexism), and what the crossovers or similarities between the two countries are in terms of mechanisms that drive multimorbidity would be worthwhile. For example, are there any gender-related or women-identifying disadvantage(s) due to unequal rights or pay for women in India and/or the U.S.?…”

Section: Discussionmentioning

confidence: 99%

Characterizing Multimorbidity Prevalence and Adverse Outcomes in Ethnically and Culturally Diverse Sub-Populations in India: Gaps, Opportunities, and Future Directions

Zanwar,

Taylor,

Hill-Jarrett

et al. 2024

IJERPH

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India is a large middle-income country and has surpassed China in overall population, comprising 20% of the global population (over 1.43 billion people). India is experiencing a major demographic shift in its aging population. Chronic diseases are common among older adults and can be persistent over the life course, lead to the onset of disability, and be costly. Among older adults in India, the existence of multiple comorbid chronic conditions (i.e., multimorbidity) is rapidly growing and represents a burgeoning public health burden. Prior research identified greater rates of multimorbidity (e.g., overweight/obesity diabetes, hypertension, cardiovascular disease, stroke, and malignancies) in minority populations in the United States (U.S.); however, limited studies have attempted to characterize multimorbidity among older adult sub-populations residing in India. To address this gap, we conducted a narrative review of studies on multimorbidity using the data from the Longitudinal Aging Study of India (LASI), the largest nationally representative longitudinal survey study of adults in India. Our definition of multimorbidity was the presence of more than two conditions in the same person. Our findings, based on 15 reviewed studies, aim to (1) characterize the definition and measurement of multimorbidity and to ascertain its prevalence in ethnically and culturally diverse sub-populations in India; (2) identify adverse outcomes associated with multimorbidity in the Indian adult population; and (3) identify gaps, opportunities, and future directions.

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“…Such beliefs are a key barrier to access to support services among people living with dementia and their carers. Evidence shows that stigma, accompanied by lack of awareness and knowledge, hinders the prevention, care, and treatment of people living with dementia globally (Bernstein Sideman et al, 2022). However, unlike what was found in the overall report, in which over a quarter (25.2%) of the sample thought that nothing can be done to prevent dementia (Alzheimer's Disease International, 2019), we found lower levels of agreement with such a view in each of the four groups in Brazil (less than 20%).…”

Section: Discussionmentioning

confidence: 99%

Dementia-related stigma among health professionals, family carers, people with dementia, and the general public in Brazil.

Godoy,

Oliveira,

da Mata

et al. 2023

Stigma and Health

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People living with dementia often experience stigma and discrimination. There is a dearth of research on this topic in low-and middle-income countries, where the majority of people living with dementia reside. We conducted a secondary analysis of an international database from Alzheimer's Disease International on the knowledge and attitudes toward people living with dementia among four groups: carers, health professionals, people living with dementia, and the general public. We used data from Brazil (n = 2,907), explored the levels and types of stigma and discrimination among the different groups, and used logistic regression to identify participants' sociodemographic characteristics related to the different stigma's domains. Some of the most significant findings are: One in three health professionals believes dementia is a natural part of aging and that it is not important to provide a formal/explicit diagnosis for people living with dementia, more than half of the general public believe that other people do not want to be friends with people living with dementia, nearly 32% of carers believe that individuals living with dementia pose a danger to other people, and more than 30% of carers and health professions consider that there is a dearth of reliable sources of information about dementia. Different forms of stigma were identified in the four groups. Further studies should be carried out to explore other sectors of the population with representation of the different cultural and socioeconomic settings that comprise Brazilian society. Clinical Impact StatementThis is the first study to explore dementia-related stigma in a large sample of different population groups (carers, health professionals, people living with dementia, and the general public) in Brazil. This information can guide the development of antistigma interventions, public policies, and future research aimed at reducing stigma and improving diagnostic rates and long-term care for people living with dementia and their families in different settings.

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Facilitators and Barriers to Dementia Assessment and Diagnosis: Perspectives From Dementia Experts Within a Global Health Context

Cited by 22 publications

References 30 publications

Status, determinants and risk factors of all-cause dementia in South Asia: Findings from a preliminary analysis of global health data

Status, determinants and risk factors of all-cause dementia in South Asia: Findings from a preliminary analysis of global health data

Characterizing Multimorbidity Prevalence and Adverse Outcomes in Ethnically and Culturally Diverse Sub-Populations in India: Gaps, Opportunities, and Future Directions

Dementia-related stigma among health professionals, family carers, people with dementia, and the general public in Brazil.

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