Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-13T05:40:49.893Z Has data issue: false hasContentIssue false
  • English
  • Français

High prevalence of dementia among older adults from poor socioeconomic backgrounds in São Paulo, Brazil

Published online by Cambridge University Press:  11 June 2007

Marcia Scazufca ,
Paulo R. Menezes ,
Homero P. Vallada ,
André L. Crepaldi ,
Maria Pastor-Valero ,
Letícia M. S. Coutinho ,
Vanessa D. Di Rienzo  and
Osvaldo P. Almeida
Marcia Scazufca*
Affiliation:
Department of Psychiatry, University of São Paulo Medical School, and Section of Epidemiology, University Hospital, University of São Paulo, Brazil
Paulo R. Menezes
Affiliation:
Department of Preventive Medicine, University of São Paulo Medical School, and Section of Epidemiology, University Hospital, University of São Paulo, Brazil
Homero P. Vallada
Affiliation:
Department of Psychiatry, University of São Paulo Medical School, Brazil
André L. Crepaldi
Affiliation:
Department of Psychiatry, University of São Paulo Medical School, and Section of Epidemiology, University Hospital, University of São Paulo, Brazil
Maria Pastor-Valero
Affiliation:
London School of Hygiene and Tropical Medicine, Department of Epidemiology and Population Health, Distance Learning Program Unit, London, U.K.
Letícia M. S. Coutinho
Affiliation:
Department of Preventive Medicine, University of São Paulo Medical School, and Section of Epidemiology, University Hospital, University of São Paulo, Brazil
Vanessa D. Di Rienzo
Affiliation:
Department of Psychiatry, University of São Paulo Medical School, and Section of Epidemiology, University Hospital, University of São Paulo, Brazil
Osvaldo P. Almeida
Affiliation:
Western Australian Centre for Health and Ageing, University of Western Australia and Royal Perth Hospital, Perth, Australia
*
Correspondence should be addressed to: Dr. Marcia Scazufca, Nucleo de Epidemiologia, Hospital Universitario, Universidade de São Paulo. Av. Prof. Lineu Prestes, 2565, CEP 05508-900, Brazil. Phone: + 55 11 30399241. Email: scazufca@usp.br.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: The aim of this study was to determine the prevalence of dementia in a socioeconomically disadvantaged population of older adults living in the city of São Paulo, Brazil.

Methods: A cross-sectional one-phase population-based study was carried out among all residents aged ≥ 65 in defined census sectors of an economically disadvantaged area of São Paulo. Identification of cases of dementia followed the protocol developed by the 10/66 Dementia Research Group.

Results: Of 2072 individuals in the study, 105 met the criteria for a diagnosis of dementia, yielding a prevalence of 5.1%. Prevalence increased with age for both men and women after age 75 years, but was stable from 65 to 74 years. Low education and income were associated with increased risk of dementia.

Conclusions: The prevalence of dementia among older adults from low socioeconomic backgrounds is high. This may be partly due to adverse socioeconomic conditions and consequent failure to compress morbidity into the latter stages of life. The increasing survival of poorer older adults with dementia living in developing countries may lead to a rapid increase in the prevalence of dementia worldwide.

Keywords

epidemiologydementiacognitive impairmentprevalenceagingdeveloping countries
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 2 , April 2008 , pp. 394 - 405
Copyright
Copyright © International Psychogeriatric Association 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

10/66 Dementia Research Group 2000a. Methodological issues for population-based research into dementia in developing countries: a position paper from the 10/66 Dementia Research Group. International Journal of Geriatric Psychiatry, 15, 21–30.3.0.CO;2-5>CrossRefGoogle Scholar
10/66 Dementia Research Group 2000b. Dementia in developing countries: a consensus statement from the 10/66 Dementia Research Group. International Journal of Geriatric Psychiatry, 15, 14–20.3.0.CO;2-8>CrossRefGoogle Scholar
10/66 Dementia Research Group 2004. Care arrangements for people with dementia in developing countries. International Journal of Geriatric Psychiatry, 19, 170–177.CrossRefGoogle Scholar
Alzheimer's Australia 2003. The Dementia Epidemic: Economic Impact and Positive Solutions for Australia. http://www.alzheimers.org.au/upload/EpidemicFullReportMarch2003.pdf; accessed 20 March 2007.Google Scholar
Alzheimer's Society 2007. Dementia UK: The Full Report. http://www.alzheimers.org.uk/News_and_Campaigns/Campaigning/PDF/Dementia_UK_Full_Report.pdf; accessed 20 March 2007.Google Scholar
American Psychiatric Association 1994. Diagnostic and Statistic Manual of Mental Disorders: DSM-IV, 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
Breitner, J. C. et al. 1999. APOE-ε4 count predicts age when prevalence of AD increases, then declines: the Cache County Study. Neurology, 53, 321–331.CrossRefGoogle ScholarPubMed
Cohen, J. E. 2003. Human population: the next half century. Science, 302, 1172–1175.CrossRefGoogle ScholarPubMed
Copeland, J. R., Dewey, M. E. and Griffiths-Jones, H. M. 1986. A computerized psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Psychological Medicine, 16, 89–99.CrossRefGoogle ScholarPubMed
de Silva, H. A., Gunatilake, S. B. and Smith, A. D. 2003. Prevalence of dementia in a semi-urban population in Sri Lanka: report from a regional survey. International Journal of Geriatric Psychiatry, 18, 711–715.CrossRefGoogle Scholar
Dewey, M. E. and Copeland, J. R. 2001. Diagnosis of dementia from the history and aetiology schedule. International Journal of Geriatric Psychiatry, 16, 912–917.CrossRefGoogle ScholarPubMed
Dufour, D. L. and Piperata, B. A. 2004. Rural-to-urban migration in Latin America: an update and thoughts on the model. American Journal of Human Biology, 16, 395–404.CrossRefGoogle ScholarPubMed
Ferri, C. P. et al. 2005. Global prevalence of dementia: a Delphi consensus study. Lancet, 366, 2112–2117.CrossRefGoogle ScholarPubMed
Fries, J. F. 1980. Aging, natural death, and the compression of morbidity. New England Journal of Medicine, 303, 130–135.CrossRefGoogle ScholarPubMed
Hall, K. S., Gao, S., Emsley, C. L., Ogunniyi, A. O., Morgan, O. and Hendrie, H. C. 2000. Community screening interview for dementia (CSI ‘D’); performance in five disparate study sites. International Journal of Geriatric Psychiatry, 15, 521–531.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
Hendrie, H. C. et al. 1995. Prevalence of Alzheimer's disease and dementia in two communities: Nigerian Africans and African Americans. American Journal of Psychiatry, 152, 1485–1492.Google ScholarPubMed
Herrera, E. Jr., Caramelli, P., Silveira, A. S. and Nitrini, R. 2002. Epidemiologic survey of dementia in a community-dwelling Brazilian population. Alzheimer Disease and Associated Disorders, 16, 103–108.CrossRefGoogle Scholar
Hofman, A. et al. 1991. The prevalence of dementia in Europe: a collaborative study of 1980–1990 findings. EURODEM Prevalence Research Group. International Journal of Epidemiology, 20, 736–748.CrossRefGoogle ScholarPubMed
Instituto Brasileiro de Geografia e Estatística 2006. Censo 2000: Brazil. http://www.ibge.gov.br/censo/; accessed 20 March 2007Google Scholar
Jorm, A. F., Korten, A. E. and Henderson, A. S. 1987. The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatrica Scandinavica, 76, 465–479.CrossRefGoogle ScholarPubMed
Langa, K. M., Foster, N. L. and Larson, E. B. 2004. Mixed dementia: emerging concepts and therapeutic implications. JAMA, 292, 2901–2908.CrossRefGoogle ScholarPubMed
Lima-Costa, M. F., Barreto, S., Giatti, L. and Uchoa, E. 2003. [Socioeconomic circumstances and health among the Brazilian elderly: a study using data from a National Household Survey]. Cadernos de Saude Publica, 19, 745–757.CrossRefGoogle ScholarPubMed
Lloyd-Sherlock, P. 2000. Population ageing in developed and developing regions: implications for health policy. Social Science and Medicine, 51, 887–895.CrossRefGoogle ScholarPubMed
Lobo, A. et al. 2000. Prevalence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group. Neurology, 54, S4–S9.Google ScholarPubMed
Lotufo, P. A. 2005. Stroke in Brazil: a neglected disease. São Paulo Medical Journal, 123, 3–4.CrossRefGoogle Scholar
Marins, V. M., Almeida, R. M., Pereira, R. A. and Sichieri, R. 2007. The association between socioeconomic indicators and cardiovascular disease risk factors in Rio de Janeiro, Brazil. Journal of Biosocial Science, 39, 221–229.CrossRefGoogle ScholarPubMed
Newman, A. B. et al. 2005. Dementia and Alzheimer's disease incidence in relationship to cardiovascular disease in the Cardiovascular Health Study cohort. Journal of the American Geriatrics Society, 53, 1101–1107.CrossRefGoogle ScholarPubMed
Prince, M., Acosta, D., Chiu, H., Scazufca, M. and Varghese, M. 2003. Dementia diagnosis in developing countries: a cross-cultural validation study. Lancet, 361, 909–917.CrossRefGoogle ScholarPubMed
Prince, M. et al. 2004. Effects of education and culture on the validity of the Geriatric Mental State and its AGECAT algorithm. British Journal of Psychiatry, 185, 429–436.CrossRefGoogle ScholarPubMed
Scazufca, M. et al. 2002. [Epidemiological research on dementia in developing countries]. Revista de Saude Publica, 36, 773–778.CrossRefGoogle ScholarPubMed
Secretaria do Governo da Prefeitura de São Paulo 2004. Sumário de Dados do Município de São Paulo 2004. http://portal.prefeitura.sp.gov.br/secretarias/governo/sumario_dados; accessed 20 March 2007.Google Scholar
Shaji, S., Bose, S. and Verghese, A. 2005. Prevalence of dementia in an urban population in Kerala, India. British Journal of Psychiatry, 186, 136–140.CrossRefGoogle Scholar
StataCorp 2005. Stata Statistical Software, Release 9. College Station, TX: StataCorp.Google Scholar
United Nations Department of Economic and Social Affairs 2002. World Population Ageing 1950–2050. http://www.un.org/esa/population/publications/worldageing19502050/; accessed 20 March 2007.Google Scholar
United Nations Department of Economic and Social Affairs 2005. World Population Prospects: The 2004 Revision Population Dataset. New York: United Nations.Google Scholar
Valenzuela, M. J. and Sachdev, P. 2006. Brain reserve and dementia: a systematic review. Psychological Medicine, 36, 441–454.CrossRefGoogle ScholarPubMed
Vas, C. J. et al. 2001. Prevalence of dementia in an urban Indian population. International Psychogeriatrics, 13, 439–450.CrossRefGoogle Scholar
Welsh, K. A. et al. 1994. The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part V. A normative study of the neuropsychological battery. Neurology, 44, 609–614.CrossRefGoogle Scholar
Zhang, Z. X. et al. 2005. Dementia subtypes in China: prevalence in Beijing, Xian, Shanghai, and Chengdu. Archives of Neurology, 62, 447–453.CrossRefGoogle Scholar