Prevalence of Dementia in Rural settings of Latin America and The Caribbean: a Systematic Review and Meta-Analysis
Andre Lapeyre Rivera1, Alexandra Chang2, Catherine Jara-Rodas1, Leonardo Arquinigo1, Rubí Angeles Alanya-Yangali1, Hans Baltazar1, Eder Herrera3
1Sociedad Científica de San Fernando, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú, 2Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru, 3Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Perú
Objective:
To estimate the prevalence of dementia in rural settings across Latin America and the Caribbean (LAC).
Background:
Dementia poses a significant global public health challenge, especially in low-resource settings like rural LAC, where there are understudied racial and ethnic minorities. Factors such as less education, appropriate nutrition, and reduced access to adequate healthcare may contribute to higher prevalence rates in these populations.
Design/Methods:
A systematic review was completed using PubMed, SCOPUS, WoS, EMBASE, Scielo, LILACS, and grey literature for all studies published up to October 2024, focusing on dementia prevalence in rural settings from LAC. Only observational studies written in English, Spanish, or Portuguese were included. Quality assessment was performed using the Newcastle-Ottawa Scale for observational studies. A single-arm, random-effects meta-analysis of proportions was performed, with the I² statistic used to measure statistical heterogeneity.
Results:
A total of 1187 studies were screened, resulting in 19 eligible studies comprising 2294 patients from 8 countries. We observed high variability in the diagnostics procedures and the tools for assessing cognitive performance and the functionality. The pooled prevalence of dementia in rural LAC was estimated at 11% (95% CI: 7%-15%). Quality assessment indicated a medium to high risk of bias among the included studies. Substantial heterogeneity was observed [I2=98%], highlighting variability across the regions studied.
Conclusions:
The significant prevalence of dementia in rural LAC highlights the urgent need for targeted interventions to face the environmental factors and risks of cognitive impairment in these areas. Addressing dementia in these settings will require adapted strategies to cultural, linguistic, and ethnic factors for an adequate approach, diagnosis, and management.
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