DESK REVIEWS | 06.02.10. Is there evidence of associations between dementia and poverty?

DESK REVIEW | 06.02.10. Is there evidence of associations between dementia and poverty?

Yes. Results from São Paulo Ageing and Health Study, published in 2008, showed that non-skilled occupation and unfavourable personal income increased the risk of dementia. Illiteracy and a cumulative effect of socioeconomic adversities across the life-course were also associated with higher prevalence of dementia in São Paulo (Scazufca et al., 2010).

References:

Scazufca, M., Almeida, O. P., & Menezes, P. R. (2010). The role of literacy, occupation and income in dementia prevention: The São Paulo Ageing & Health Study (SPAH). International Psychogeriatrics, 22(8), 1209–1215. https://doi.org/10.1017/S1041610210001213

Some of the common conditions that have been found to accelerate the ageing process and affect longevity in developing countries are early exposure to adverse conditions such as poverty, malnutrition, prenatal stress, and infectious diseases (Kalaria et al., 2008). Poverty, low literacy and lower socioeconomic status have been found to be closely linked and further associated with poor access to health care and thus an increased risk of cognitive impairment (Sengupta et al., 2014).

References:

Kalaria, R. N., Maestre, G. E., Arizaga, R., Friedland, R. P., Galasko, D., Hall, K., … & Prince, M. (2008). Alzheimer’s disease and vascular dementia in developing countries: prevalence, management, and risk factors. The Lancet Neurology, 7(9), 812-826. https://doi.org/10.1016/S1474-4422(08)70169-8

Sengupta, P., Benjamin, A. I., Singh, Y., & Grover, A. (2014). Prevalence and correlates of cognitive impairment in a north Indian elderly population. WHO South-East Asia journal of public health3(2), 135-143. https://doi.org/10.4103/2224-3151.206729

There is no evidence of association between dementia and poverty in Indoensia.

Badan Pusat Statistik (Statistics Indonesia) uses a basic needs approach to define poverty. Living in poverty is defined as monthly per capita expense (food and non-food commodities) lower than the established poverty line. As of March 2019 the poverty line in Indonesia was Rp 425.250,-/capita/month. Approximately 25.14 million people (9.41% of the national population) were defined as living in poverty. This number in 2019 represents a historically all-time low (Badan Pusat Statistik, 2019a). Although there has been no evidence regarding association between dementia and poverty in Indonesia, Yogyakarta is one of the provinces with high rates of poverty (11.7%) (Badan Pusat Statistik, 2019a). However, this is not the case for Bali. Therefore, it is not possible to draw a conclusion based on these data.

References:

Badan Pusat Statistik. (2019a). Berita Resmi Statistik.

One study associated dementia and poverty through qualitative interviews. Due to the huge financial cost of pharmacological treatment of dementia and reduction in a person’s productivity, families often have to sell off their assets to cater for diagnosis and care for the person with dementia. This can drain family resources and lead to poverty (Njoki, 2018).

References:

Njoki, M. (2018). Dementia in Africa: an exploration of Kenyan carers’ experiences supporting someone with dementia. https://dementia.stir.ac.uk/blogs/dementia-centred/2018-05-17/dementia-africa-exploration-kenyan-carers-experiences-supporting

There are no sufficient studies to prove this. However, as it was previously mentioned, Acosta-Castillo et al. (2017), demonstrate great variability in the prevalence of dementia by state and suggest that numerous people affected by dementia experience high levels of deprivation.

References:

Acosta-Castillo, G. I., Sosa-Ortiz, A. L., Manrique Espinoza, B. S., Salinas Rodriguez, A., & Juárez, M. de los Á. L. (2017). Prevalence of Dementia By State and Level of Marginalization in Mexico. Alzheimer’s & Dementia, 13(7), P512. https://doi.org/10.1016/j.jalz.2017.06.583