Abstract
Background: The global burden of dementia has increasingly shifted to low- and middle-income regions that lack essential data for monitoring epidemiological progression, and policy and planning support. Drawing upon data that have emerged since the last known estimates published in 2015, this study aims to update dementia estimates in the Latin America and Caribbean (LAC) region for the years 2020, 2030, and 2050 through the application of a recently validated Bayesian approach for disease estimates useful when data sources are scarce.Methods: A comprehensive parallel systematic review of PubMed, EMBASE, PsycINFO, Global Health, and LILACS was conducted to identify prospective population-based epidemiological studies on dementia published in English from 2013 to 2018 in LAC. English and non-English data cited by a recent review on dementia estimates in LAC were also examined for additional data. A Bayesian normal-normal hierarchical model (NNHM) was developed to estimate age-specific and age-adjusted dementia prevalence in people aged 60+. Using age-specific population projections from the UN, the total number of people affected by dementia for the years 2020, 2030, and 2050 were estimated.Results: 1,414 studies were identified, of which only 7 met the inclusion criteria. The studies had 7,684 participants and 1,191 dementia cases. The age-standardized prevalence of all forms of dementia in LAC was 8% (95% CI: 5–11.5%) in people aged 60+. The estimated prevalence varied with age, increasing from 2.5% (95% CI: 0.08–4.0%) in the 60-69 age group, to 9.4% (95% CI: 5.4–13.2%) in the 70–79 age group and 28.9% (95% CI: 20.3–37.2%) in the ≥80 age group. The number of people age 60 and older living with dementia in LAC in 2020 was estimated at 6.86 (95% CI: 4.3–9.8) million, 9.94 (95% CI: 6.16–14.15) million in 2030, and 19.33 (95% CI: 12.3–13.6) million in 2050.Conclusion: We project an upward disease trajectory for dementia in LAC countries. The projection is likely an underestimation of the true dementia burden given the underrepresentation of rural and socio-economically deprived populations. More research is urgently needed to improve the accuracy of disease estimates, guide clinicians to improve evaluations for earlier recognition of dementia, and support the development of effective policies for improving dementia prevention, diagnosis and clinical management in LAC's diverse and aging communities.
Highlights
Dementia is an age-related neurocognitive disorder that has become a leading cause of morbidity and mortality in later life
While the cost of dementia might seem low in monetary terms in low- and middleincome countries (LMICs) relative to HICs, the lack of publicly funded formal
To reduce the number of nonEnglish studies we might have missed, we evaluated the studies cited by a recent review of dementia in Latin America and the Caribbean (LAC) by Nitrini et al [7] which included the two systematic reviews of English and non-English studies on the subject
Summary
Dementia is an age-related neurocognitive disorder that has become a leading cause of morbidity and mortality in later life. With the number of dementia cases worldwide projected to double every 20 years, this cost is estimated to rise to US$2 trillion by 2030. In Latin America and the Caribbean (LAC), the average life expectancy has increased by almost 20 years since 1960 [2]. The global burden of dementia has increasingly shifted to low- and middle-income regions that lack essential data for monitoring epidemiological progression, and policy and planning support. Drawing upon data that have emerged since the last known estimates published in 2015, this study aims to update dementia estimates in the Latin America and Caribbean (LAC) region for the years 2020, 2030, and 2050 through the application of a recently validated Bayesian approach for disease estimates useful when data sources are scarce
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