Abstract
Alzheimer's disease is a common cause of dementia and identifying possible spatial patterns of mortality due to this disease may enable preventive actions. The objective of this study was to identify spatial distribution patterns of mortality due to Alzheimer's disease in the state of São Paulo. Ecological and exploratory study conducted in all municipalities in the state of São Paulo. Data on Alzheimer's disease mortality in the state of São Paulo between 2004 and 2009 were obtained from DATASUS (the Department of Informatics in the Brazilian Ministry of Health). Death rates per 100,000 inhabitants were then calculated and spatial analysis was performed by constructing a death rate map, global Moran index and local Moran index, which were used to obtain the Moran map. The kernel technique was also applied. The Terra View 4.0.0 software was used. 13,030 deaths due to Alzheimer were reported in the state of São Paulo (rate of 5.33 deaths/100,000 inhabitants). São José do Rio Preto, Ribeirão Preto, Bauru and Araçatuba had higher rates. The Moran index was I = 0.085 (P < 0.002). The Moran map identified 42 municipalities that merit intervention and the kernel estimator identified a high density of deaths in the northwestern region of the state. Higher densities of deaths due to Alzheimer were concentrated more to the north and northwest of the state of São Paulo. It was possible to identify municipalities that have priority for interventions to reduce the death rates due to this disease.
Highlights
Alzheimer’s disease (AD), a common cause of dementia, is characterized by progressive neurodegenerative disorders with progressive loss of memory and behavioral disorders that diminish individuals’ quality of life
A Brazilian study identified a prevalence of 7.1% for any type of dementia in the elderly population, and 54% of the cases were AD.[4]
A review of the Brazilian literature found a prevalence of dementia ranging from 5.1% to 19% in São Paulo, which may indicate that São Paulo has a prevalence closer to that of developed countries than to the prevalence in other regions of Brazil.[5]
Summary
Alzheimer’s disease (AD), a common cause of dementia, is characterized by progressive neurodegenerative disorders with progressive loss of memory and behavioral disorders that diminish individuals’ quality of life. Extracellular amyloid plaque and intraneuronal neurofibrillary tangles accumulate.[1,2]. The prevalence of dementia in several regions of the world ranges from 1.17% in the population between 65 and 69 years of age to over 50% of the population over 95 years of age.[3] A Brazilian study identified a prevalence of 7.1% for any type of dementia in the elderly population, and 54% of the cases were AD.[4] The female sex has been identified as the one most affected by AD, but it is not yet known whether this is due to a genetic factor or because women are more prevalent in the elderly population.[3,4] A review of the Brazilian literature found a prevalence of dementia ranging from 5.1% to 19% in São Paulo, which may indicate that São Paulo has a prevalence closer to that of developed countries than to the prevalence in other regions of Brazil.[5]
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