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Comparative Study
. 2018 Feb 22;8(2):e018288.
doi: 10.1136/bmjopen-2017-018288.

Dementia prevalence in a population at high vascular risk: the Trinidad national survey of ageing and cognition

Gershwin Davis  1 , Nelleen Baboolal  2 , Amanda Mc Rae  3 , Robert Stewart  4   5
Affiliations
Comparative Study

Dementia prevalence in a population at high vascular risk: the Trinidad national survey of ageing and cognition

Gershwin Davis et al. BMJ Open. .

Abstract

Objective: To investigate the dementia prevalence in a country with high levels of cardiovascular risk factors DESIGN AND METHODS: Older people in Trinidad are recognised to have particularly high levels of cardiovascular risk factors. We carried out a survey in a nationally representative sample of people aged ≥70 years using household enumeration. Dementia status was ascertained using standardised interviews and algorithms from the 10/66 schedule and age-specific prevalence were compared with identically defined output from the 10/66 surveys of 16 536 residents in eight other low-income and middle-income countries.

Results: Of 1832 participants (77.0% response rate), dementia was present in 442 (23.4%). Prevalences were 12.0% in persons aged 70-74 years, 23.5% at 75-79, 25.8% at 80-84, 41.3% at 85-89 and 54.0% in those aged ≥90 years. Prevalence ratios compared with averages from 10/66 surveys in these age groups were 2.2, 2.6, 1.6, 1.7 and 1.6, respectively, and were 2.7, 2.8, 1.7, 1.4 and 0.8, respectively, compared with previously published consensus estimates for the Latin American region. Dementia was significantly associated with reported stroke and diabetes in logistic regression models adjusted for sociodemographic status and other vascular risk factors (OR (95% CI) 4.40 (2.70 to 7.19) and 1.56 (1.20 to 2.03), respectively). Projected national numbers of people with dementia (18 206) were 70%-100% higher than those estimated using most recent regional consensus prevalences.

Conclusion: In a nation with high levels of vascular risk, dementia prevalence is higher than expected, particularly at the lower end of the 70+ age range. International prevalence projections may need to take into account risk status as well as age structures.

Keywords: epidemiology; old age psychiatry; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Dementia prevalence (%) by age and gender (with upper 95% CI).
Figure 2
Figure 2
Prevalences of dementia (%; SE bars) by age group across 10/66 consortium survey sites and the Trinidad survey derived using an identical (‘short 10/66’) case-ascertainment schedule.
See this image and copyright information in PMC

References

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    1. World Alzheimer Report 2015. The Global Impact of Dementia An analysis of prevalence, incidence, cost and trends. https://www.alz.co.uk/research/WorldAlzheimerReport2015.pdf
    1. United Nations, Department of Economic and Social Affairs, Population Division (2015). World Population Ageing, 2015. (ST/ESA/SER.A/390).
    1. Prince M, Knapp M, Guerchet M, et al. Dementia UK: update. London: Alzheimer’s Society, 2014.

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