The 2022 symposium on dementia and brain aging in low- and middle-income countries: Highlights on research, diagnosis, care, and impact

Raj Kalaria¹, Gladys Maestre², Simin Mahinrad³, Daisy M Acosta⁴, Rufus Olusola Akinyemi⁵, Suvarna Alladi⁶, Ricardo F Allegri^{7

8}, Faheem Arshad⁶, David Oluwasayo Babalola⁹, Olusegun Baiyewu¹⁰, Thomas H Bak¹¹, Tarek Bellaj¹², David K Brodie-Mends¹³, Maria C Carrillo³, Kaputu-Kalala-Malu Celestin¹⁴, Albertino Damasceno¹⁵, Ranil Karunamuni de Silva^{16

17}, Rohan de Silva¹⁸, Mamuka Djibuti¹⁹, Anna Jane Dreyer²⁰, Ratnavalli Ellajosyula^{21

22}, Temitope H Farombi²³, Robert P Friedland²⁴, Noe Garza²⁵, Antoine Gbessemehlan^{26

27}, Eliza Eleni-Zacharoula Georgiou²⁸, Ishtar Govia^{29

30}, Lea T Grinberg^{31

32}, Maëlenn Guerchet²⁶, Seid Ali Gugssa³³, Joy Louise Gumikiriza-Onoria³⁴, Eef Hogervorst^{35

36}, Michael Hornberger³⁷, Agustin Ibanez^{38

39

40

41}, Masafumi Ihara⁴², Thomas Gregor Issac⁴³, Linus Jönsson⁴⁴, Wambui M Karanja^{40

45}, Joseph H Lee⁴⁶, Iracema Leroi⁴⁰, Gill Livingston⁴⁷, Facundo Francisco Manes⁴⁸, Lingani Mbakile-Mahlanza^{39

49}, Bruce L Miller⁵⁰, Christine Wayua Musyimi⁵¹, Victoria N Mutiso^{51

52

53}, Noeline Nakasujja⁵⁴, David M Ndetei^{51

52

53}, Sam Nightingale⁵⁵, Gabriela Novotni⁵⁶, Primrose Nyamayaro^{40

57}, Solomon Nyame⁵⁸, Julius A Ogeng'o⁵⁹, Adesola Ogunniyi⁹, Maira Okada de Oliveira^{39

40

60

61}, Njideka U Okubadejo⁶², Martin Orrell⁶³, Stella-Maria Paddick^{64

65}, Margaret A Pericak-Vance^{66

67}, Zvezdan Pirtosek⁶⁸, Felix Claude Victor Potocnik⁶⁹, Rema Raman⁷⁰, Mie Rizig⁷¹, Mónica Rosselli^{72

73}, Marufjon Salokhiddinov⁷⁴, Claudia L Satizabal^{75

76

77}, Diego Sepulveda-Falla⁷⁸, Sudha Seshadri^{79

80}, Claire E Sexton³, Ingmar Skoog⁸¹, Peter H St George-Hyslop^{82

83

84}, Claudia Kimie Suemoto⁸⁵, Prekshy Thapa⁴⁰, Chinedu Theresa Udeh-Momoh^{39

86

87

88

89}, Victor Valcour⁹⁰, Jeffery M Vance⁶⁶, Mathew Varghese⁹¹, Jaime H Vera⁹², Richard W Walker⁹³, Henrik Zetterberg^{94

95

96

97

98

99}, Yared Z Zewde³³, Ozama Ismail³

Affiliations

¹ Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
² Departments of Neuroscience and Human Genetics, University of Texas Rio Grande Valley, One W. University Blvd, Brownsville, Texas, USA.
³ Division of Medical and Scientific Relations, Alzheimer's Association, Chicago, Illinois, USA.
⁴ Universidad Nacional Pedro Henriquez Urena (UNPHU), Santo Domingo, Dominican Republic.
⁵ Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria.
⁶ Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
⁷ Fleni Neurological Institute, Buenos Aires, Argentina.
⁸ Department of Neurosciences, Universidad de la Costa (CUC), Barranquilla, Colombia.
⁹ College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria.
¹⁰ Department of Psychiatry, University of Ibadan, Ibadan, Oyo, Nigeria.
¹¹ University of Edinburgh, Edinburgh, UK.
¹² Tunis University, Tunis, Tunisia.
¹³ Korle-Bu Teaching Hospital, Accra, Ghana.
¹⁴ Department of Neurology, Centre Neuropsychopathologique (CNPP), Kinshasa University Teaching Hospital, University of Kinshasa, Kinshasa, Republic Democratic of the Congo.
¹⁵ Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
¹⁶ Interdisciplinary Centre for Innovation in Biotechnology and Neuroscience, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
¹⁷ Institute for Combinatorial Advanced Research and Education (KDU-CARE), General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka.
¹⁸ Reta Lila Weston Institute and Department of Clinical, Movement Neuroscience, UCL Queen Square Institute of Neurology, London, UK.
¹⁹ Partnership for Research and Action for Health (PRAH), Tbilisi, Georgia.
²⁰ University of Cambridge, The Old Schools, Cambridge, UK.
²¹ Cognitive Neurology Clinic, Manipal Hospital, and Annasawmy Mudaliar Hospital, Bengaluru, Karnataka, India.
²² Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India.
²³ Tony Anenih Geriatric Center, University College Hospital, Ibadan, Oyo, Nigeria.
²⁴ University of Louisville, Louisville, Kentucky, USA.
²⁵ Department of Neuroscience and Human Genetics, University of Texas Rio Grande Valley, Harlingen, Texas, USA.
²⁶ Inserm U1094, IRD U270, University of Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France.
²⁷ Inserm, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France.
²⁸ Department of Psychiatry, Patras University General Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece.
²⁹ Caribbean Institute for Health Research, The University of the West Indies, Jamaica, West Indies, Jamaica.
³⁰ Institute for Global Health, University College London, London, UK.
³¹ Department of Neurology and Pathology, University of California San Francisco, San Francisco, California, USA.
³² Department of Pathology, University of Sao Paulo, R. da Reitoria, R. Cidade Universitária, São Paulo, Sao Paulo, Brazil.
³³ Department of Neurology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
³⁴ Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
³⁵ Loughborough University, Loughborough, UK.
³⁶ Respati University, Yogyakarta, Indonesia.
³⁷ Norwich Medical School, University of East Anglia, Norwich, UK.
³⁸ Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Peñalolén, Santiago, Chile.
³⁹ Global Brain Health Institute (GBHI), University California San Francisco (UCSF), San Francisco, California, USA.
⁴⁰ Global Brain Health Institute (GBHI), Trinity College Dublin, Lloyd Building Trinity College Dublin, Dublin, Ireland.
⁴¹ Cognitive Neuroscience Center (CNC), Universidad de San Andrés, and National Scientific and Technical Research Council (CONICET), Victoria, Provincia de Buenos Aires, Argentina.
⁴² Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
⁴³ Centre for Brain Research, Indian Institute of Science (IISc), Bengaluru, Karnataka, India.
⁴⁴ Department of Neurobiology, Care Science and Society, section for Neurogeriatrics, Karolinska Institute, Solnavägen, Solna, Sweden.
⁴⁵ Brain and Mind Institute, Aga Khan University, Nairobi, Kenya.
⁴⁶ Sergievsky Center, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Departments of Neurology and Epidemiology, Columbia University, New York, New York, USA.
⁴⁷ University College London, London, UK.
⁴⁸ Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.
⁴⁹ University of Botswana, Gaborone, Botswana.
⁵⁰ Department of Neurology, Memory and Aging Center, University of California San Francisco Weill Institute for Neurosciences, San Francisco, California, USA.
⁵¹ Africa Mental Health Research and Training Foundation, Nairobi, Kenya.
⁵² Department of Psychiatry, University of Nairobi, Nairobi, Kenya.
⁵³ World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya.
⁵⁴ Makerere University College of Health Sciences, Kampala, Uganda.
⁵⁵ Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
⁵⁶ University Clinic of Neurology, Medical Faculty University Ss Cyril and Methodius Institute for Alzheimer's Disease and Neuroscience, Skopje, North Macedonia.
⁵⁷ Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
⁵⁸ Kintampo Health Research Centre, Ghana Health Service, Hospital Road, Near Kintampo-north Municipal Hospital, Kintampo, Ghana.
⁵⁹ University of Nairobi, Nairobi, Kenya.
⁶⁰ Department of Psychiatry at Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
⁶¹ Cognitive Neurology and Behavioral Unit (GNCC), University of Sao Paulo, R. da Reitoria, R. Cidade Universitária, São Paulo, Sao Paulo, Brazil.
⁶² Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Yaba, Lagos, Nigeria.
⁶³ Institute of Mental Health, University of Nottingham, Nottingham, UK.
⁶⁴ Newcastle University, Newcastle upon Tyne, UK.
⁶⁵ Gateshead Health NHS Foundation Trust, Sheriff Hill, Tyne and Wear, UK.
⁶⁶ John P Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Coral Gables, Florida, USA.
⁶⁷ Dr. John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Coral Gables, Florida, USA.
⁶⁸ Faculty of Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia.
⁶⁹ Old Age Psychiatry Unit, Depth Psychiatry, Stellenbosch University, Western Cape, Stellenbosch Central, Stellenbosch, South Africa.
⁷⁰ Alzheimer's Therapeutic Research Institute, University of Southern California, Los Angeles, California, USA.
⁷¹ Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, Queen Square, London, UK.
⁷² Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Boca Raton, Florida, USA.
⁷³ Florida Alzheimer's Disease Research Center, Gainesville, Florida, USA.
⁷⁴ Tashkent Medical Academy, Tashkent, Uzbekistan.
⁷⁵ Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, Texas, USA.
⁷⁶ Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.
⁷⁷ The Framingham Heart Study, Framingham, Massachusetts, USA.
⁷⁸ Molecular Neuropathology of Alzheimer's Disease, Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁷⁹ Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases and South Texas ADRC, UT Health San Antonio, San Antonio, Texas, USA.
⁸⁰ University of Texas Health Sciences Center, San Antonio, Texas, USA.
⁸¹ Institute of Neuroscience and Fysiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁸² Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA.
⁸³ Cambridge Institute for Medical Research and Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Addenbrookes Biomedical Campus, Trumpington, Cambridge, UK.
⁸⁴ Department of Medicine (Neurology), Temerty Faculty of Medicine, University of Toronto, and University Health Network, 27 King's College Cir, Toronto, Ontario, Canada.
⁸⁵ Division of Geriatrics, University of Sao Paulo Medical School, R. da Reitoria, R. Cidade Universitária, São Paulo, Sao Paulo, Brazil.
⁸⁶ FINGERS Brain Health Institute, c/o Stockholms Sjukhem, Stockholm, Sweden.
⁸⁷ Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
⁸⁸ Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institute, Solnavägen, Solna, Sweden.
⁸⁹ Imarisha Centre for Brain health and Aging, Brain and Mind Institute, Aga Khan University, Nairobi, Kenya.
⁹⁰ Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA.
⁹¹ St. John's Medical College, Sarjapur - Marathahalli Rd, beside Bank Of Baroda, John Nagar, Koramangala, Bengaluru, Karnataka, India.
⁹² Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK.
⁹³ Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
⁹⁴ Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
⁹⁵ Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
⁹⁶ Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, Queen Square, London, UK.
⁹⁷ UK Dementia Research Institute at UCL, University College London, London, UK.
⁹⁸ Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China.
⁹⁹ Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.

PMID: 38696263
PMCID: PMC11180946
DOI: 10.1002/alz.13836

Review

The 2022 symposium on dementia and brain aging in low- and middle-income countries: Highlights on research, diagnosis, care, and impact

Raj Kalaria et al. Alzheimers Dement. 2024 Jun.

. 2024 Jun;20(6):4290-4314.

doi: 10.1002/alz.13836. Epub 2024 May 2.

Authors

Affiliations

¹ Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
² Departments of Neuroscience and Human Genetics, University of Texas Rio Grande Valley, One W. University Blvd, Brownsville, Texas, USA.
³ Division of Medical and Scientific Relations, Alzheimer's Association, Chicago, Illinois, USA.
⁴ Universidad Nacional Pedro Henriquez Urena (UNPHU), Santo Domingo, Dominican Republic.
⁵ Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria.
⁶ Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
⁷ Fleni Neurological Institute, Buenos Aires, Argentina.
⁸ Department of Neurosciences, Universidad de la Costa (CUC), Barranquilla, Colombia.
⁹ College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria.
¹⁰ Department of Psychiatry, University of Ibadan, Ibadan, Oyo, Nigeria.
¹¹ University of Edinburgh, Edinburgh, UK.
¹² Tunis University, Tunis, Tunisia.
¹³ Korle-Bu Teaching Hospital, Accra, Ghana.
¹⁴ Department of Neurology, Centre Neuropsychopathologique (CNPP), Kinshasa University Teaching Hospital, University of Kinshasa, Kinshasa, Republic Democratic of the Congo.
¹⁵ Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
¹⁶ Interdisciplinary Centre for Innovation in Biotechnology and Neuroscience, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
¹⁷ Institute for Combinatorial Advanced Research and Education (KDU-CARE), General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka.
¹⁸ Reta Lila Weston Institute and Department of Clinical, Movement Neuroscience, UCL Queen Square Institute of Neurology, London, UK.
¹⁹ Partnership for Research and Action for Health (PRAH), Tbilisi, Georgia.
²⁰ University of Cambridge, The Old Schools, Cambridge, UK.
²¹ Cognitive Neurology Clinic, Manipal Hospital, and Annasawmy Mudaliar Hospital, Bengaluru, Karnataka, India.
²² Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India.
²³ Tony Anenih Geriatric Center, University College Hospital, Ibadan, Oyo, Nigeria.
²⁴ University of Louisville, Louisville, Kentucky, USA.
²⁵ Department of Neuroscience and Human Genetics, University of Texas Rio Grande Valley, Harlingen, Texas, USA.
²⁶ Inserm U1094, IRD U270, University of Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France.
²⁷ Inserm, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France.
²⁸ Department of Psychiatry, Patras University General Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece.
²⁹ Caribbean Institute for Health Research, The University of the West Indies, Jamaica, West Indies, Jamaica.
³⁰ Institute for Global Health, University College London, London, UK.
³¹ Department of Neurology and Pathology, University of California San Francisco, San Francisco, California, USA.
³² Department of Pathology, University of Sao Paulo, R. da Reitoria, R. Cidade Universitária, São Paulo, Sao Paulo, Brazil.
³³ Department of Neurology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
³⁴ Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
³⁵ Loughborough University, Loughborough, UK.
³⁶ Respati University, Yogyakarta, Indonesia.
³⁷ Norwich Medical School, University of East Anglia, Norwich, UK.
³⁸ Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Peñalolén, Santiago, Chile.
³⁹ Global Brain Health Institute (GBHI), University California San Francisco (UCSF), San Francisco, California, USA.
⁴⁰ Global Brain Health Institute (GBHI), Trinity College Dublin, Lloyd Building Trinity College Dublin, Dublin, Ireland.
⁴¹ Cognitive Neuroscience Center (CNC), Universidad de San Andrés, and National Scientific and Technical Research Council (CONICET), Victoria, Provincia de Buenos Aires, Argentina.
⁴² Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
⁴³ Centre for Brain Research, Indian Institute of Science (IISc), Bengaluru, Karnataka, India.
⁴⁴ Department of Neurobiology, Care Science and Society, section for Neurogeriatrics, Karolinska Institute, Solnavägen, Solna, Sweden.
⁴⁵ Brain and Mind Institute, Aga Khan University, Nairobi, Kenya.
⁴⁶ Sergievsky Center, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Departments of Neurology and Epidemiology, Columbia University, New York, New York, USA.
⁴⁷ University College London, London, UK.
⁴⁸ Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.
⁴⁹ University of Botswana, Gaborone, Botswana.
⁵⁰ Department of Neurology, Memory and Aging Center, University of California San Francisco Weill Institute for Neurosciences, San Francisco, California, USA.
⁵¹ Africa Mental Health Research and Training Foundation, Nairobi, Kenya.
⁵² Department of Psychiatry, University of Nairobi, Nairobi, Kenya.
⁵³ World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya.
⁵⁴ Makerere University College of Health Sciences, Kampala, Uganda.
⁵⁵ Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
⁵⁶ University Clinic of Neurology, Medical Faculty University Ss Cyril and Methodius Institute for Alzheimer's Disease and Neuroscience, Skopje, North Macedonia.
⁵⁷ Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
⁵⁸ Kintampo Health Research Centre, Ghana Health Service, Hospital Road, Near Kintampo-north Municipal Hospital, Kintampo, Ghana.
⁵⁹ University of Nairobi, Nairobi, Kenya.
⁶⁰ Department of Psychiatry at Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
⁶¹ Cognitive Neurology and Behavioral Unit (GNCC), University of Sao Paulo, R. da Reitoria, R. Cidade Universitária, São Paulo, Sao Paulo, Brazil.
⁶² Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Yaba, Lagos, Nigeria.
⁶³ Institute of Mental Health, University of Nottingham, Nottingham, UK.
⁶⁴ Newcastle University, Newcastle upon Tyne, UK.
⁶⁵ Gateshead Health NHS Foundation Trust, Sheriff Hill, Tyne and Wear, UK.
⁶⁶ John P Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Coral Gables, Florida, USA.
⁶⁷ Dr. John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Coral Gables, Florida, USA.
⁶⁸ Faculty of Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia.
⁶⁹ Old Age Psychiatry Unit, Depth Psychiatry, Stellenbosch University, Western Cape, Stellenbosch Central, Stellenbosch, South Africa.
⁷⁰ Alzheimer's Therapeutic Research Institute, University of Southern California, Los Angeles, California, USA.
⁷¹ Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, Queen Square, London, UK.
⁷² Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Boca Raton, Florida, USA.
⁷³ Florida Alzheimer's Disease Research Center, Gainesville, Florida, USA.
⁷⁴ Tashkent Medical Academy, Tashkent, Uzbekistan.
⁷⁵ Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, Texas, USA.
⁷⁶ Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.
⁷⁷ The Framingham Heart Study, Framingham, Massachusetts, USA.
⁷⁸ Molecular Neuropathology of Alzheimer's Disease, Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁷⁹ Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases and South Texas ADRC, UT Health San Antonio, San Antonio, Texas, USA.
⁸⁰ University of Texas Health Sciences Center, San Antonio, Texas, USA.
⁸¹ Institute of Neuroscience and Fysiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁸² Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA.
⁸³ Cambridge Institute for Medical Research and Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Addenbrookes Biomedical Campus, Trumpington, Cambridge, UK.
⁸⁴ Department of Medicine (Neurology), Temerty Faculty of Medicine, University of Toronto, and University Health Network, 27 King's College Cir, Toronto, Ontario, Canada.
⁸⁵ Division of Geriatrics, University of Sao Paulo Medical School, R. da Reitoria, R. Cidade Universitária, São Paulo, Sao Paulo, Brazil.
⁸⁶ FINGERS Brain Health Institute, c/o Stockholms Sjukhem, Stockholm, Sweden.
⁸⁷ Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
⁸⁸ Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institute, Solnavägen, Solna, Sweden.
⁸⁹ Imarisha Centre for Brain health and Aging, Brain and Mind Institute, Aga Khan University, Nairobi, Kenya.
⁹⁰ Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA.
⁹¹ St. John's Medical College, Sarjapur - Marathahalli Rd, beside Bank Of Baroda, John Nagar, Koramangala, Bengaluru, Karnataka, India.
⁹² Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK.
⁹³ Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
⁹⁴ Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
⁹⁵ Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
⁹⁶ Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, Queen Square, London, UK.
⁹⁷ UK Dementia Research Institute at UCL, University College London, London, UK.
⁹⁸ Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China.
⁹⁹ Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.

PMID: 38696263
PMCID: PMC11180946
DOI: 10.1002/alz.13836

Abstract

Two of every three persons living with dementia reside in low- and middle-income countries (LMICs). The projected increase in global dementia rates is expected to affect LMICs disproportionately. However, the majority of global dementia care costs occur in high-income countries (HICs), with dementia research predominantly focusing on HICs. This imbalance necessitates LMIC-focused research to ensure that characterization of dementia accurately reflects the involvement and specificities of diverse populations. Development of effective preventive, diagnostic, and therapeutic approaches for dementia in LMICs requires targeted, personalized, and harmonized efforts. Our article represents timely discussions at the 2022 Symposium on Dementia and Brain Aging in LMICs that identified the foremost opportunities to advance dementia research, differential diagnosis, use of neuropsychometric tools, awareness, and treatment options. We highlight key topics discussed at the meeting and provide future recommendations to foster a more equitable landscape for dementia prevention, diagnosis, care, policy, and management in LMICs. HIGHLIGHTS: Two-thirds of persons with dementia live in LMICs, yet research and costs are skewed toward HICs. LMICs expect dementia prevalence to more than double, accompanied by socioeconomic disparities. The 2022 Symposium on Dementia in LMICs addressed advances in research, diagnosis, prevention, and policy. The Nairobi Declaration urges global action to enhance dementia outcomes in LMICs.

Keywords: Alzheimer's disease; dementia; diversity; high‐income countries; low‐ and middle‐income countries; risk factors; vascular dementia.

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Conflict of interest statement

S.M., C.S., M.C., and O.I. are full‐time employees of the Alzheimer's Association. S.M., in the past 36 months, reports receiving payment from Arizona ADRC for grant review. D.M.A., in the past 36 months, reports receiving a travel fellowship from the Alzheimer's Association to attend the 2023 AAIC Satellite Symposium in Mexico City. S.A., in the past 36 months, reports receiving honoraria by International Neuropsychological Society (for being speaker at the 3‐h Continuing Education Workshop Presentation at the 51st Annual Meeting of INS from February 1 to 4, 2023, in San Diego, California), by the Indian Council of Medical research (for serving as subject expert and reviewer for BSD‐PSC‐10 Committee for the ICMR Extramural Research Program 2023 on September 8, 2023), by Ashoka University (for serving as part of selection Committee at Ashoka University on June 27, 2023) and by the Indian Council of Medical Research (for being part of Project Review Committee [PRC] meeting in the area of “Neurological Science” held on December 23, 2022); receiving a travel grant paid by UCL, UK; serving as a vice chair of the Advisory Council Member ISTAART, Alzheimer's Association, USA (2022 to present), member of the Lancet Commission on Dementia Prevention, Intervention and Care 2024, executive committee member of the International Society of Vascular Cognitive and Behavioral Disorders (2019 to present), and President of World Federation of Neurology Specialty Group on Aphasia, Dementia and Cognitive Disorders (2019 to present). R.F.A., in the past 36 months, reports receiving payments or honoraria for lectures at Asofarma, Inc. Lectures, and Novo Nordisk. F.A. reports receiving GBHI support for attending the 2023 AAIC Satellite Symposium in Mexico City. D.O.B. reports receiving support from Alzheimer's Association for attending the 2022 Symposium on Dementia and Brain Aging in Low‐ and Middle‐Income Countries. T.H.B. reports receiving support for attending the meeting for this paper. D.K.B.M. reports receiving support from Alzheimer's Association for attending meetings. K.K.M.C., in the past 36 months, reports receiving travel fees from the organizers of the 2022 dementia symposium. R.K.D.S. reports receiving equipment donated by the National Institutes of Health, Bethesda, MD, USA, through IBRO‐APRC and by the Chinese Neuroscience Society, China. T.H.F., in the past 36 months, reports receiving support from the Alzheimer's Association to attend meeting and/or travel. R.P.F., in the past 36 months, reports receiving loyalties or licenses from Cambridge University Press; receiving a consulting fee from Avanex; receiving payment for expert testimony from various law firms; receiving support for attending meetings and/or travel from the University of Louisville; and having stock or stock options at Axial Biotherapeutics. E.E.Z.G., in the past 36 months, reports receiving a travel award for participation in the Dementia and Brain Aging in Low‐ and Middle‐Income Countries Conference 2022, Nairobi, Kenya, from the Alzheimer's Association. I.G., in the past 36 months, reports receiving consulting fees from F. Hoffmann‐La Roche Ltd. for diversity, equity, and inclusion consultancy; receiving travel, accommodation, and conference registration payments for attending the AAIC 2023, Netherlands from the Alzheimer's Association; and serving on the Data Safety Monitoring Board or Advisory Board of the Scottish Brain Sciences. L.T.G., in the past 36 months, reports receiving consulting fees from Guidepoint Insights; receiving payments from Medscape Education and Celdara Medical for lectures, presentations, speakers bureaus, manuscript writing, or educational events; receiving support from the Alzheimer's Association, Tau Consortium, and BrightFocus Foundation for attending meetings or events; having a leadership or fiduciary role in Global Brain Health Institute; and receiving equipment, materials, drugs, medical writing, gifts, or other services from Pivotal Life Sciences to the institution. M.G., in the past 36 months, reports serving as a member of Alzheimer's Disease International Medical and Scientific Advisory Board (unpaid). S.A.G. reports receiving support from ISTAART to attend the Alzheimer's Association Dementia and Brain Aging in Low‐ and Middle‐Income Countries Conference, Nairobi. E.H., in the past 36 months, reports having a leadership or fiduciary role in the Special Envoy for South East Asia. A. I. reports receiving support from GBHI and the Alzheimer's Association for attending the meeting for this paper and receiving consulting fees from Roche, Lilly, and Cumulus Neuroscience. T.G.I. reports receiving travel fellowship by the Alzheimer's Association to attend the Alzheimer's Association's Dementia and Brain Aging in Low‐ and Middle‐Income Countries Conference, Nairobi. L.J., in the past 36 months, reports license fees from RUD Instrument paid to European Health Economics; a consulting fee paid to European Health Economics from H. Lundbeck A/S; personal fees from Eli Lilly Inc. for lectures, presentations, speakers bureaus, manuscript writing, or educational events; and support from Bioarctic AB for attending meetings and/or travel. J.H.L., in the past 36 months, reports serving on the external advisory board for the Alzheimer's Disease Resource Center for Minority Aging Research, School of Medicine, University of Texas, Rio Grande Valley (UTRGV), and for the Center for Life Sciences, Nazarbayev University, Astana, Kazakhstan. I.L., in the past 36 months, reports receiving payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from the advisory board – Novo Nordisk; support from Roche for attending AAIC (November 2022); and serving as director, Lewy Body Ireland (charity). G.L. reports receiving support to attend the meeting presented in this paper. B.L.M., in the past 36 months, reports receiving payments for royalties or licenses from Cambridge University Press, Elsevier, Inc., Guilford Publications, Inc., Johns Hopkins Press, and Oxford University and Taylor & Francis Group; consulting fees from Massachusetts General Hospital Alzheimer's Disease Research Center (ADRC) Scientific Advisory Board (SAB) (2021, 2022, and 2023), Stanford University ADRC SAB (2021, 2022, and 2023), University of Washington ADRC SAB (2021, 2022, and 2023), and Genworth Medical Advisory Board (March 2023); payments for lectures, presentations, speakers bureaus, manuscript writing, or educational events from the Institute for Lifelong Learning (May 2023), Global Summit on Neurodegenerative Diseases (June 2021), Korean Dementia Society (July 2022), Massachusetts General Hospital, dementia course (2022 and 2023), National MS Society, Don Paty Lectureship (June 2021), Ochsner Neuroscience Institute (November 2021), Providence Saint Joseph Medical Center (September 2021), Taipei Medical University, Dementia Center (March 2022), UC Irvine Institute for Memory Impairments and Neurological Disorders (UCI MIND) (March 2022), University of California, Los Angeles (UCLA) Grand Rounds (April 2022), and University of Texas, Center for Brain Health (January 2021). In addition, B.L.M., in the past 36 months, reports receiving travel and lodging support from the Association for Frontotemporal Degeneration (AFTD) Education Symposium, St. Louis, MO (May 2023), Milken Institute FTD Scientific Retreat, Los Angeles, California (March 2023), California Institute of the Arts, Los Angeles, California (April 2022), and UCLA; serving as external, scientific, or medical advisor for Arizona Alzheimer's Consortium, Association for Frontotemporal Degeneration, Buck Institute for Research on Aging Scientific Advisor Cure ALS, John Douglas French Alzheimer's Foundation, Fundación Centro de Investigación Enfermedades Neurológicas, Madrid, Spain, Genworth, The Larry L. Hillblom Foundation, Massachusetts General Hospital ADRC, National Institute for Health Research Cambridge Biomedical Research Center and its subunit, the Biomedical Research Unit in Dementia, Stanford University ADRC, University of Southern California P01 Urban Air Pollution and Alzheimer's Disease: Risk, Heterogeneity, and Mechanisms, University of Washington ADRC; serving as Director and Internal Advisor for The Bluefield Project to Cure FTD; serving as Founding Director for Global Brain Health Institute; serving as Affiliated Faculty with Institute for Neurodegenerative Diseases; and serving as Co‐Director and Scientific Advisor for the Tau Consortium of the Rainwater Charitable Foundation. N.N., in the past 36 months, reports having a leadership or fiduciary role in the Uganda Society for Health Scientists and serving on a Data Safety Monitoring Board or Advisory Board of Washington University, St. Louis, MO, USA. S. Nightingale, in the past 36 months, reports travel expenses to attend HIV CNS Day 2022 and Naples NeuroHIV conference 2023. G.N. reports receiving travel and accommodation support from the organizing committee of the Dementia and Brain Aging in Low‐ and Middle‐Income Countries Conference in 2022. M.O.O., in the past 36 months, reports receiving payment for attending the Alzheimer's Association's Dementia and Brain Aging in Low‐ and Middle‐Income Countries Conference, Nairobi, Kenya; the Alzheimer's Association international conference satellite symposium in Mexico City; and the ReD‐Lat‐Mexico Conference. N.U.O., in the past 36 months, reports receiving payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from the International Parkinson and Movement Disorders Society; support for attending the International Parkinson and Movement Disorders Society and the Global Parkinson's Genetics Program (GP2); and serving on the International Parkinson and Movement Disorders Society International Executive Committee and Africa Section Executive Committee and steering committee of GP2. S.M.P. reports receiving support from the Alzheimer's Association to attend the 2022 Alzheimer's Association's Dementia and Brain Aging in Low‐ and Middle‐Income Countries Conference, Nairobi; and serving as executive member of Royal College of Psychiatrists Volunteering and International Psychiatry Special Interest Group (unpaid, conference organizer). R.R., in the past 36 months, reports receiving support from the Alzheimer's Association to attend meetings and/or travel and serving as the Alzheimer's Association San Diego/Imperial Chapter Board Chair (Unpaid). S.S., in the past 36 months, reports receiving consultation fees from Biogen and Easai. P.H.S.G.H., in the past 36 months, reports receiving consultation fees from TransitionBio; airfare to attend the 2022 Alzheimer's Association's Dementia and Brain Aging in Low‐ and Middle‐Income Countries Conference, Nairobi; and serving on the Council of Governors, Cambridge University Hospitals. C.K.S., in the past 36 months, reports receiving support from the Alzheimer's Association to attend the meeting presented in this paper; serving as advisory council for ISTAART (unpaid) and having a leadership or fiduciary role in the Brazilian Society of Geriatrics and Gerontology (unpaid). P.T., in the past 36 months, reports receiving support for attending the 2022 Alzheimer's Association's Dementia and Brain Aging in Low‐ and Middle‐Income Countries Conference, Nairobi. C.T.U.M., in the past 36 months, reports receiving consulting fees from the Brain and Mind Institute, Aga Khan University, Kenya; receiving a fellowship from the Alzheimer's’ Association and FINGERS Brain Health Institute to cover travel and accommodation to the 2022 Alzheimer's Association International Conference and the Dementia and Brain Aging in Low‐ and Middle‐Income Countries Conference; and serving as (unpaid) committee member—NIH‐sponsored National Academies of Science project to determine research priorities for Alzheimer's disease and related dementias, co‐lead, global CEOi/Davos Alzheimer's Collaborative Workgroup on Implementation of Blood‐Based Biomarkers in Clinical Practice, committee member, Neurodegeneration Proteomics Initiative (with Janssen R&D, Gates Ventures, ADDI), committee member, CHARIOT:PRO Steering Group (with Janssen R&D, Gates Ventures, Merck, Takeda), elected trustee at British Society for Neuroendocrinology (roles: EDI Chair and Grants Committee member), and executive committee member at Biofluids Based Biomarker PIA – Alzheimer's Association. V.V., in the past 36 months, reports receiving payment or honoraria from IAS‐USA for providing CME talks and from NIH for grant review. J.M.V., in the past 36 months, reported royalties or licenses from Athena through Duke University; having Leadership or fiduciary role (no payment) for EC4C, ADSP, NIH, and board, functional consortium, NIA, NIH. J.H.V., in the past 36 months, reports receiving payment from Gilead, ViiV Healthcare for lectures, presentations, speakers bureaus, manuscript writing, or educational events. R.W.W., in the past 36 months, reports receiving consultation fee from BIAL, advisory board online meeting July 14, 2022, and ABBVIE review panel December 22, 2022; receiving payment from BIAL for a talk at BRITMODIS meeting on June 10, 202; and receiving support from BIAL to attend the Movement Disorders International Congress in Madrid September 15 to 18, 2022 (personal payment). H.Z. has served on scientific advisory boards and/or as a consultant for Abbvie, Acumen, Alector, Alzinova, ALZPath, Annexon, Apellis, Artery Therapeutics, AZTherapies, Cognito Therapeutics, CogRx, Denali, Eisai, Nervgen, Novo Nordisk, Optoceutics, Passage Bio, Pinteon Therapeutics, Prothena, Red Abbey Labs, reMYND, Roche, Samumed, Siemens Healthineers, Triplet Therapeutics, and Wave, has given lectures at symposia sponsored by Alzecure, Biogen, Cellectricon, Fujirebio, Lilly, and Roche, is a co‐founder of Brain Biomarker Solutions in Gothenburg AB (BBS), which is a part of the GU Ventures Incubator Program (outside submitted work), and is chair of the Alzheimer's Association Global Biomarker Standardization Consortium (no payment made). The remaining authors have nothing to declare. Author disclosures are available in the supporting information.

Figures

**FIGURE 1**
Projected prevalence of dementia cases in LMICs compared to HICs. Graph labels: x‐axis shows year; y‐axis represents numbers in millions. Data modified from Wimo et al. (2018).

**FIGURE 2**
Differential numbers of pharmacological clinical trials in AD between LMICs and HICs. Compiled by R Allegri, Argentina, 2022 using data from clinicaltrials.gov.

See this image and copyright information in PMC

References

1. Nichols E, Steinmetz JD, Vollset SE, et al. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health. 2022;7:e105‐e125. doi:10.1016/S2468-2667(21)00249-8 - DOI - PMC - PubMed
1. Prince MJ, Acosta D, Castro‐Costa E, Jackson J, Shaji KS. Packages of care for dementia in low‐ and middle‐income countries. PLoS Med. 2009;6:e1000176. doi:10.1371/journal.pmed.1000176 - DOI - PMC - PubMed
1. Risk factors related to population diversity and disparity determine healthy aging. Nat Med. 2023;29:2183‐2184. doi:10.1038/s41591-023-02531-0 - DOI - PubMed
1. Ibáñez A, Legaz A, Ruiz‐Adame M. Addressing the gaps between socioeconomic disparities and biological models of dementia. Brain. 2023;146:3561‐3564. doi:10.1093/brain/awad236 - DOI
1. Wimo A, Gauthier S, Prince M. World Alzheimer Report 2018: The state of the art of dementia research: New frontiers. Alzheimer's Disease International; 2018.

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The 2022 symposium on dementia and brain aging in low- and middle-income countries: Highlights on research, diagnosis, care, and impact

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The 2022 symposium on dementia and brain aging in low- and middle-income countries: Highlights on research, diagnosis, care, and impact

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