Prevalence of dementia in Latin America and Caribbean countries: Systematic review and meta-analyses exploring age, sex, rurality, and education as possible determinants

Abstract

Background: Studies have shown that the prevalence of dementia in Latin America and the Caribbean (LAC) may be higher than in high-income countries. Thus, we sought to systematically analyse the prevalence of dementia and explore possible drivers that lead to this disparity in LAC countries.

Method: We searched Pubmed, Web of Knowledge, Scopus, Lilacs, and SciELO for studies on dementia in LAC countries published in English, Spanish, and Portuguese. Random-effects model was applied.

Results: Thirty-one studies from 17 LAC countries were included. Pooled prevalence of all-cause dementia was 10.66%. Further analyses with studies providing raw prevalence by sex, area, and educational level showed a higher prevalence for women (8.97%) than for men (7.26%). Also, dementia prevalence was higher for rural than urban residents (7.71% vs 8.68%, respectively). Participants without formal education presented more than double the prevalence of dementia (21.37%) compared to those with at least one year of formal education (9.88%). Studies with more recent data collection showed higher dementia prevalence.

Conclusion: Our findings suggest a high global dementia prevalence in LAC countries and an unequal burden of dementia for women, lower-educated, and rural residents. Secular increases in dementia prevalence call for greater public health efforts for preventative actions.

Keywords: Dementia; Developing country; Epidemiology; Meta-analysis; Prevalence; Secular trends.

Fig. 1

Flow diagram of the study selection process.

Fig. 2

All-cause dementia prevalence by countries. The diamonds represent the prevalence of all-cause dementia, the horizontal bars the 95% confidence intervals. Note: ES: effect size; CI: confidence intervals.

Fig. 3

All-cause dementia prevalence for studies with representative samples. The diamonds represent the prevalence of all-cause dementia for studies with representative samples, the horizontal bars the 95% confidence intervals. Note: ES: effect size; CI: confidence intervals.

Fig. 4

All-cause dementia prevalence after performing the leave-one-out method. The diamonds represent the prevalence of all-cause dementia for studies with representative samples, the horizontal bars the 95% confidence intervals. Note: ES: effect size; CI: confidence intervals.

Fig. 5

All-cause dementia prevalence by countries in representative samples. The diamonds represent the prevalence of all-cause dementia for studies with representative samples, the horizontal bars the 95% confidence intervals. Note: ES: effect size; CI: confidence intervals.

Fig. 6

All-cause dementia prevalence in men (upper panel) and women (lower panel). The diamonds represent the prevalence of all-cause dementia for studies with representative samples, the horizontal bars the 95% confidence intervals. Note: ES: effect size; CI: confidence intervals; * Additional information retrieved from Mejia-Arango et al. (2021).

Fig. 7

Meta-analysis of female disadvantage in all-type dementia prevalence. Note: RR: Log-transformed Risk Ratios.

Fig. 8

All-cause dementia prevalence by rural area. The diamonds represent the prevalence of all-cause dementia for studies with representative samples, the horizontal bars the 95% confidence intervals. Note: ES: effect size; CI: confidence intervals.

Fig. 9

All-cause dementia prevalence by urban area. The diamonds represent the prevalence of all-cause dementia for studies with representative samples, the horizontal bars the 95% confidence intervals. Note: ES: effect size; CI: confidence intervals; * Additional information retrieved from Mejia-Arango et al. (2021).

Fig. 10

All-cause dementia prevalence for participants with no formal education. The diamonds represent the prevalence of all-cause dementia for studies with representative samples, the horizontal bars the 95% confidence intervals. Note: ES: effect size; CI: confidence intervals; * Additional information retrieved from Mejia-Arango et al. (2021).

Fig. 11

All-cause dementia prevalence for participants with at least one year of formal education. The diamonds represent the prevalence of all-cause dementia for studies with representative samples, the horizontal bars the 95% confidence intervals. Note: ES: effect size; CI: confidence intervals; * Additional information retrieved from Mejia-Arango et al. (2021).

Fig. 12

Dementia prevalence estimates across years of data collection.