Interethnic Differences in Dementia Epidemiology: Global and Asia-Pacific Perspectives

Venketasubramanian, Narayanaswamy; Sahadevan, Suresh; Kua, Ee Heok; Chen, C.P.L.; Ng, Tze Pin

doi:10.1159/000321675

Cited by 55 publications

(48 citation statements)

References 79 publications

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“…Secondly, once in contact with the point of care, diagnostic evaluation of dementia in immigrant patients can be particularly complicated because of communication problems, often requiring the use of interpreters, and due to a lack of appropriate assessment tools, especially for immigrants with low levels of education [15,16,17]. Thirdly, the epidemiology of the disease might also differ among immigrant groups [18]. A registry-based study from Denmark found that dementia was under-diagnosed among ethnic minorities ≥60 years old but over-diagnosed in those ≤60 years old [19].…”

Section: Introductionmentioning

confidence: 99%

Immigrant Patients with Dementia and Memory Impairment in Primary Health Care in Norway: A National Registry Study

Díaz

Kumar

Engedal

2015

Dement Geriatr Cogn Disord

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Background: Immigrants comprise a growing proportion of the elderly population. However, knowledge about the diagnosis and management of dementia and memory impairment among immigrants is scarce in Norway and elsewhere. Aims: To compare proportions of Norwegians and immigrants aged ≥50 years with a diagnosis of dementia or memory impairment in primary health care and to study the demographic characteristics, utilization of primary health care services and pharmacological treatment of Norwegians and immigrants with either of the two diagnoses in 2008. Method: This is a registry-based study using linked data at the individual level from 4 national Norwegian registers. Results: A significantly lower proportion of immigrants, especially those from other than high-income countries, had a diagnosis of dementia or memory impairment. Among patients with such diagnoses, anti-dementia medication was purchased 20-50% more often by Norwegians than by immigrants, although the differences remained significant only for immigrants from other than high-income countries after adjustment for several variables. Conclusion: The lower proportions of immigrants with a dementia diagnosis and lower proportions of patients receiving treatment might indicate a lower prevalence or milder forms of dementia among immigrants. However, the cultural validity of the assessment tools, linguistic barriers and challenges for general practitioners should be further investigated.

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Section: Introductionmentioning

confidence: 99%

Immigrant Patients with Dementia and Memory Impairment in Primary Health Care in Norway: A National Registry Study

Díaz

Kumar

Engedal

2015

Dement Geriatr Cogn Disord

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“…However, even population-based studies permit limited generalization to the overall population, particularly in developing countries, where sociodemographic and economic characteristics vary widely [5,6,7,8]. As a result, current descriptions of the prevalence of dementia in such contexts are of little help to policymakers in introducing health care measures.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Dementia in Elderly Clients of a Private Health Care Plan: A Study of the FIBRA-RJ, Brazil

Ribeiro¹,

Lopes²,

Lourenço³

2013

Dement Geriatr Cogn Disord

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Aims: To describe the overall prevalence of dementia syndrome and its major subtypes among elderly clients of a private health care plan and to ascertain the association between this syndrome and socioeconomic characteristics. Methods: A survey was organized in two stages: screening for cognitive impairment and diagnostic evaluation. The study population comprised 683 elderly subjects (aged >67 years), an expanded sample of 7,486 individuals, of the database of the FIBRA-RJ, which evaluated clients of a private health care plan residing in northern districts of the municipality of Rio de Janeiro, Brazil. The diagnosis of dementia was obtained according to DSM-IV criteria. Results: A total of 115 individuals were diagnosed with dementia, resulting in a prevalence of 16.9% (95% CI = 14.4–19.8). The association was strongest among older age groups, i.e. 85–89 years old (prevalence ratio = 8.85; 95% CI = 2.11–37.11) and 90 or more years old (prevalence ratio = 8.85; 95% CI = 2.11–37.11), and among illiterate people (prevalence ratio = 2.77; 95% CI = 1.07–7.19). Sex, personal income and marital status displayed no association with dementia. Conclusion: The prevalence of dementia was higher than found by population-based studies. These findings point to a possibility of a high demand for specialized services among older adults served by the private health care sector.

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“…The Brazilian contingent is highly admixed, with roughly 60-75% of its ancestry derived from Iberian whites, 10-30% from West Africans, and 5-20% from Native Americans [18,19]. Studies worldwide have linked AD to ethnic differences between populations [20,21], including recent work suggesting that migrant populations attain rates between those of their homelands and adopted countries [22]. However, few association trials performed with Brazilian AD patients have considered genetic ancestry estimates as main or accessory variables when investigating markers for this complex phenotype.…”

Section: Introductionmentioning

confidence: 99%

Cytokine Gene Polymorphisms and Alzheimer's Disease in Brazil

Moraes

Benedet

Souza

et al. 2013

Neuroimmunomodulation

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Background: Single-nucleotide polymorphisms in genes encoding immunological mediators can affect the biological activity of these molecules by regulating transcription, translation, or secretion, modulating the genetic risk of inflammatory damage in Alzheimer's disease (AD). Nonetheless, the Brazilian contingent is highly admixed, and few association trials performed herein with AD patients have considered genetic ancestry estimates as co-variables when investigating markers for this complex trait. Methods: We analyzed polymorphisms in 10 inflammatory genes and compared the genotype distribution across outpatients with late-onset AD and noncognitively impaired subjects from Midwest Brazil under a strict criterion, and controlling for ancestry heritage and ApoE genotype. Results: Our findings show an almost 40% lower chance of AD (p = 0.004) among homozygotes of the IL10 -1082A allele (rs1800896). Dichotomization to ApoE and mean ancestry levels did not affect protection, except among those with greater European or minor African heritage. Conclusion: The IL10 locus seems to affect the onset of AD in a context sensitive to the genetic ancestry of Brazilian older adults.

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Interethnic Differences in Dementia Epidemiology: Global and Asia-Pacific Perspectives

Cited by 55 publications

References 79 publications

Immigrant Patients with Dementia and Memory Impairment in Primary Health Care in Norway: A National Registry Study

Immigrant Patients with Dementia and Memory Impairment in Primary Health Care in Norway: A National Registry Study

Prevalence of Dementia in Elderly Clients of a Private Health Care Plan: A Study of the FIBRA-RJ, Brazil

Cytokine Gene Polymorphisms and Alzheimer's Disease in Brazil

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