Dementia in Latin America : assessing the present and envisioning the future

Parra, Mario A. and Baez, Sandra and Allegri, Ricardo and Nitrini, Ricardo and Lopera, Francisco and Slachevsky, Andrea and Custodio, Nilton and Lira, David and Piguet, Olivier and Kumfor, Fiona and Huepe, David and Cogram, Patricia and Bak, Thomas and Manes, Facundo and Ibanez, Agustin (2018) Dementia in Latin America : assessing the present and envisioning the future. Neurology, 90 (5). pp. 222-231. ISSN 1526-632X (https://doi.org/10.1212/WNL.0000000000004897)

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Abstract

The demographic structure of Latin American countries (LAC) is fast approaching that of developing countries, and the predicted prevalence of dementia in the former already exceeds the latter. Dementia has been declared a global challenge, yet regions around the world show differences in both the nature and magnitude of such a challenge. This article provides evidence and insights on barriers which, if overcome, would enable the harmonization of strategies to tackle the dementia challenge in LAC. First, we analyze the lack of available epidemiologic data, the need for standardizing clinical practice and improving physician training, and the existing barriers regarding resources, culture, and stigmas. We discuss how these are preventing timely care and research. Regarding specific health actions, most LAC have minimal mental health facilities and do not have specific mental health policies or budgets specific to dementia. In addition, local regulations may need to consider the regional context when developing treatment and prevention strategies. The support needed nationally and internationally to enable a smooth and timely transition of LAC to a position that integrates global strategies is highlighted. We focus on shared issues of poverty, cultural barriers, and socioeconomic vulnerability. We identify avenues for collaboration aimed to study unique populations, improve valid assessment methods, and generate opportunities for translational research, thus establishing a regional network. The issues identified here point to future specific actions aimed at tackling the dementia challenge in LAC.