28 July 2008

Dementia In Developing World "Substantially Underestimated"

by Kate Melville

Health experts had previously estimated the prevalence of dementia in the developing world at between a quarter and a fifth of that recorded in developed nations, but these estimates may have substantially underestimated the problem, suggests new research. The new figures are important as dementia and other age-related illnesses are increasing in prevalence and will ultimately place a very heavy burden on carers and existing health infrastructures.

Research group leader Professor Martin Prince, from the Institute of Psychiatry at King's College, London, believes that a number of factors may have led to the underestimation. "It's likely that cultural differences may be partly responsible for researchers missing cases of dementia," says Prince. "Our evidence suggests that relatives in developing world countries are less likely to perceive or report that their elders are experiencing difficulties, even in the presence of clear evidence of disability and memory impairment."

According to Prince's study, the prevalence of dementia in urban settings in Latin America is comparable with rates in Europe and the US, though the prevalence in China and India is lower. He believes that in many developing nations the problem is simply not recognized. "You could question the point of labeling someone as having dementia if their relatives do not acknowledge it as a problem," notes Prince. "Our data suggest that even if it is not recognized as dementia, the illness places a heavy burden on both the elderly patient and their relatives."

The investigators are now analyzing their data to examine the effect of dementia on disability, dependency, strain on the carer, and the economic cost of dementia and other diseases. These data, in conjunction with the prevalence estimates now published, will enable policymakers in low-income and middle-income countries to prioritize more effectively, as they begin to invest more heavily in the prevention and control of chronic non-communicable diseases.

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Source: Wellcome Trust