DESK REVIEWS | 06.02. Epidemiology of dementia

DESK REVIEW | 06.02. Epidemiology of dementia

According to the Global Burden of Disease Study 2016, the estimated prevalence of dementia in Brazil was approximately 16.9% in 2016 (GBD 2016, 2019). A systematic review conducted between 1990 and 2010 with older people aged 60 years and over found that, among high quality studies, all conducted in urban areas of São Paulo state, the prevalence of dementia ranged from 5.1% to 19.0% (Fagundes et al., 2011). Another study projected the prevalence of dementia among people 65 years and older in Brazil based on Census data (2010). The authors estimated that prevalence in the national territory would be 7.9% in 2020 (Burlá et al., 2013). There are several articles reporting prevalence measures in the literature; all of these were conducted in the south or southeast of Brazil. Therefore, there is lack of updated studies representative of the Brazilian population. The incidence rate of dementia was 13.8 per 1,000 person-years according to a study carried out in the city of Catanduva, São Paulo, with individuals aged 65 years and over (Nitrini et al., 2004). A study conducted in the city of Porto Alegre found the incidence rate of Alzheimer’s disease as 14.8 per 1,000 person-years (Chaves et al., 2009).

References:

Burlá, C., Camarano, A. A., Kanso, S., Fernandes, D., & Nunes, R. (2013). Panorama prospectivo das demências no Brasil: Um enfoque demográfico. Ciência & Saúde Coletiva, 18(10), 2949–2956. https://doi.org/10.1590/S1413-81232013001000019

Chaves, M. L., Camozzato, A. L., Godinho, C., Piazenski, I., & Kaye, J. (2009). Incidence of Mild Cognitive Impairment and Alzheimer Disease in Southern Brazil. Journal of Geriatric Psychiatry and Neurology, 22(3), 181–187. https://doi.org/10.1177/0891988709332942

Fagundes, S. D., Silva, M. T., Thees, M. F. R. S., & Pereira, M. G. (2011). Prevalence of dementia among elderly Brazilians: A systematic review. Sao Paulo Medical Journal, 129(1), 46–50. https://doi.org/10.1590/S1516-31802011000100009

GBD 2016. (2019). Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology, 18, 88–106. http://dx.doi.org/10.1016/S1474-4422(18)30403-4

Nitrini, R., Caramelli, P., Herrera, E., Bahia, V. S., Caixeta, L. F., Radanovic, M., Anghinah, R., Charchat-Fichman, H., Porto, C. S., Carthery, M. T., Hartmann, A. P. J., Huang, N., Smid, J., Lima, E. P., Takada, L. T., & Takahashi, D. Y. (2004). Incidence of dementia in a community-dwelling Brazilian population. Alzheimer Disease and Associated Disorders, 18(4), 241–246.

Prevalence of dementia has been reported based on several population based epidemiological studies conducted across India over the last two decades. According to the Dementia India Report 2010 (Alzheimer’s and Related Disorders of India [ARDSI], 2010) projections, an estimated 5.29 million Indian people aged over 60 have dementia. The more recent Global Burden of Disease study estimated that 3.69 million people had Alzheimer’s disease or other dementias in India in 2019 (India State-Level Disease Burden Initiative Neurological Disorders Collaborators, 2021). There is variability in reported prevalence rates ranging from 0.3% (Rodriguez et al., 2008) to 14.9% (Seby et al., 2011) among older adults, depending on the sample size, age of the cohort, geographical area considered (rural vs. urban population) and the year of the study (Table 6.1). Meta-analysis of individual studies have reported pooled prevalence estimates for dementia to range from 3.4% (95% CI = 2.0 to 5.0) to 4.4% (2.2-7.2) in India (Dhiman et al., 2021; Farina et al, 2020).

Differences in estimates may be related to the adoption of different methods and defining criteria, but differences in environmental and genetic risk factors may also contribute. Recognising the need to study dementia prevalence using a uniform method, the Government of India’s scientific research funding agency, specifically the Department of Biotechnology, has initiated a multi-centric study across rural, urban, and tribal areas to observe dementia prevalence (Bhatt, 2020).

Table 6.1 shows dementia prevalence across the country

S.No Publication Location Age of population surveyed Number

screened

Screening tool Confirmation tool Prevalence of dementia
1 Razdan et al., (1994)

Neuroepidemiology

Rural Kashmir All 63,645   Neurological examination No dementia was found
2 Shaji et al., (1996)

The British Journal of Psychiatry

Rural Kerala ≥60 years 2067 Vernacular adaptation of the Mini Mental State Examination.

 

Score of 23 and below -a detailed neuropsychological evaluation by CAMDEX-Section B.

DSM-III-R criteria for dementia

 

Subcategorisation of dementia was done based on ICD-10 diagnostic criteria

 33.9 per 1000

 

 

3 Rajkumar, Kumar and Thara (1997)

International Journal of Geriatric Psychiatry

Rural

Tamil Nadu

≥60 years 750 Geriatric Mental State schedule (GMS).   3.5%
4 Chandra et al., (1998)

Neurology

Rural

Haryana

≥55 years 5126 Hindi cognitive and functional screening instruments, developed for and validated in this population. DSM- IV

diagnostic criteria,

Clinical Dementia Rating Scale (CDR),

National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) criteria.

≥55 years: 0.84%

≥65 years: 1.36%

5 Vas et al., (2001)

International Psychogeriatrics

Urban

Maharashtra

≥40 years 24,488 Self-report or interviewer-rated protocols based on the Sandoz Clinical Assessment Geriatric Scale.

 

“A score +2 SD above the mean were screened for cognitive functioning using a modified and translated version of the Mini Mental State Examination”

Detailed neurological, psychiatric, and neuropsychological evaluation as well as  laboratory investigations and other tests etc.

 

DSM-IV diagnostic criteria.

≥40 years: 0.43%

 

≥65 years: 2.44%

6 Shaji, Bose and Verghese (2005)

The British Journal of Psychiatry

 

Urban

Kerala

≥65 years 1934 Vernacular adaptation of the Mini-Mental State Examination Diagnoses according to DSM-IV criteria. Identified cases were categorised by ICD-10 criteria. 33.6 per 1000
7 Das et al., (2006)

The Indian Journal of Medical Research

Urban

West Bengal

≥50 years 52,377 National Institute of Mental Health and Neurosciences (NIMHANS) used questionnaire.

 

A modified version of

“Cognitive Battery”

used by Ganguli et al.

DSM-IV

criteria

87.82 per 100,000 population
8 Rodriguez et al.,

(2008)

Lancet

Urban/Rural

Tamil Nadu

≥65 years Urban: 1005

 

Rural: 999

10/66 dementia diagnostic algorithm and by computerised application of dementia criterion from the DSM-IV.   10/66 standardized prevalence:

 

Urban: 8.2%

 

Rural: 8.7%

 

DSM-IV dementia standardized prevalence:

 

Urban: 0.9%

 

Rural: 0.3%

9 Das et al., (2008)

The Journal of the Association of Physicians of India

Urban

West Bengal

≥60 years 5430 National Institute of Mental Health and Neurosciences (NIMHANS) developed questionnaire.

 

A modified version of

“Cognitive Battery”

developed by Ganguli et al.

DSM-IV

criteria and for “individual subtypes the standard

Definitions of NINDS-ADRDA” were used.

 

≥60 years: 7.89 per 1000 elderly

 

 

10 Banerjee et al., (2008)

Neuroepidemiology

Urban

West Bengal

≥50 years 6129 Screening questionnaire

 

Kolkata Cognitive Test Battery

DSM-IV criteria ≥50 years: 0.62%

≥60 years: 1.25%

11 Raina et al., (2008)

Annals of Indian Academy of Neurology

Migrant community cluster of Jammu city Kashmir

 

≥60 years 200 Kashmiri version of the Mini-Mental State Examination

 

A functional ability questionnaire- Everyday Abilities Scale for India (EASI)

Clinical evaluation was carried out by a neurologist.

 

Patients diagnosed with dementia  further underwent detailed laboratory investigations and MRI scan.

6.5%
12 Mathuranath et al., (2010)

International Journal of Geriatric Psychiatry

Urban

Kerala

≥55 2466 Addenbrooke’s cognition examination (ACE) (Mathuranath et al., 2000), a cognition screening battery like the CERAD screening battery.

 

An instrumental activities of daily living scale for the elderly (IADL-E)

A semi-structured family interview with family members.

 

The evaluations included:

 

a) Cognition and behavioural symptoms (over past month).

 

b) Clinical evaluation.

 

c) Neuropsychological evaluation.

 

d) Further evaluation – screening blood investigations and/or neuroimaging tests.

 

DSM-IV criteria used to diagnose dementia.

 

≥65 years: 4.86%

 

13 Saldanha et al., (2010)

Indian Journal of Psychiatry

Urban

Maharastra

≥65 2119 Mini Mental State Examination (MMSE

 

‘Cognitive test component’ of the 10/66 research groups instrument – community screening instrument for Dementia (CSI-D),

ICD-10 Diagnostic Research Criteria. ≥65 years: 4.1%
14 Seby, et al., (2011)

Indian Journal of Psychiatry

Urban Pune – Maharashtra >65 202 Hindi version Mini-Mental State Examination (MMSE)   14.9%
15 Poddar et al., (2011)

Annals of Indian Academy of Neurology

Urban and Rural

Uttar Pradesh

≥50 years 2890 Hindi version of the Mini Mental State Examination (MMSE)   5.1%
16 Raina et al., (2014)

North American Journal of Medical Sciences

Urban, Rural, Tribal Himalaya ≥60 years 2000 Hindi Mental State Examination (HMSE) Detailed clinical history.

 

Subjects examined for

cognitive or intellectual, functional, and  psychiatric or behavioural symptoms.

1.6%

 

17 Raina, Chander and Bhardwaj (2016)

Journal of Neurosciences in rural practice

Tribal Himachal Pradesh ≥60 years 481 Bharmouri Mental State Examination [BMSE] The clinical evaluation was carried out by a neurologist. No dementia
18 Banerjee et al., (2017)

International Journal of Geriatric Psychiatry

Urban Bengal ≥60 years 100,802 Two dementia pertinent questions to family members

 

Detailed clinical history

 

Kolkata Cognitive Screening Battery

DSM-IV criteria for dementia

 

 

1.53%

Table Source: (Razdan et al., 1994;  Shaji et al., 1996; Rajkumar, Kumar and Thara, 1997; Chandra et al., 1998; Vas et al., 2001; Shaji, Bose and Verghese, 2005; Rodriguez et al., 2008; Das et al., 2006; Das et al., 2007; Das et al., 2008; Raina et al., 2008; Mathuranath et al., 2010 ; Saldanha et al., 2010; Seby, Chaudhary and Chakraborty, 2011, Poddar et al., 2011; Raina et al., 2014; Raina, Chander and Bhardwaj, 2016; Banerjee et al., 2017).

Moreover, there are few studies reporting incidence of dementia in India and results are varied (Table 6.2).

Table 6.2 shows studies reporting incidence rates for dementia in India

S.No. Publication Method Screening tool Confirmation tool Incidence
1. Chandra et al., 2001, Neurology 28 villages in Haryana (North India)

2 years.

Hindi cognitive screening battery based on the Consortium

to Establish a Registry for AD (CERAD) neuropsychological

panel.

DSM-IV criteria and

the Clinical Dementia Rating scale CDR

Incidence rates per 1000 persons-years for AD: 3.24 (95% CI: 1.48-6.14) for those aged ≥ 65 years.

1.74 (95% CI: 0.84-3.20) for those aged ≥55 years.

Standardised against the age distribution of the 1990 US Census, the overall incidence rate in those aged 65 years was 4.7 per 1000 person-years.

2. Mathuranath et al., 2012, Neurology India 4 urban and semi-urban regions of Trivandrum city in Kerala. Malayalam Addenbrooke’s cognitive examination (mACE). Clinical evaluation by neurologist based on the DSM-IV criteria. Incidence rates per 1000 person-years for AD:

11.67 (95% CI: 10.9-12.4) for those aged ≥55 years.

15.54 (95% CI: 14.6-16.5) for those aged ≥65 years.

Standardised against the year 2000 U.S. Census, the age-adjusted incidence rate was 9.19 (95% CI: 9.03-9.35) per 1000 person-years.

3. Banerjee et al., 2017, Int Journal of GerPsychiatry Kolkata, West Bengal Two dementia pertinent questions to family members.

 

Detailed clinical history

 

Kolkata Cognitive Screening Battery

DSM-IV criteria Average annual incidence rate of dementia was 72.57 per 100,000 ≥ 55 years age.

 

Source: (Chandra et al., 2001; Mathuranath et al., 2012; Banerjee et al., 2017)

References:

Alzheimer’s and Related Disorders Society of India. (2010). THE DEMENTIA INDIA REPORT 2010: Prevalence, impact, cost and services for dementia. New Delhi. Available from:  https://ardsi.org/pdf/annual%20report.pdf

Banerjee, T. K., Dutta, S., Das, S., Ghosal, M., Ray, B. K., Biswas, A.,… & Das, S. K. (2017). Epidemiology of dementia and its burden in the city of Kolkata, India. International Journal of Geriatric Psychiatry, 32(6), 605–614. https://doi.org/10.1002/gps.4499

Banerjee, T. K., Mukherjee, C. S., Dutt, A., Shekhar, A., & Hazra, A. (2008). Cognitive dysfunction in an urban Indian population: some observations. Neuroepidemiology, 31(2), 109–114. https://doi.org/10.1159/000146252

Bhatt, B. (2020). DBT’s multi-centric Dementia Science Programme. Vigyan Samachar. Available from: https://vigyanprasar.gov.in/wp-content/uploads/DBT%E2%80%99s-multi-centric-Dementia-Science-Programme-10apr20.pdf

Chandra, V., Ganguli, M., Pandav, R., Johnston, J., Belle, S., & DeKosky, S. T. (1998). Prevalence of Alzheimer’s disease and other dementias in rural India: the Indo-US study. Neurology, 51(4),1000–1008. https://doi.org/10.1212/wnl.51.4.1000

Chandra, V., Pandav, R., Dodge, H. H., Johnston, J. M., Belle, S. H., DeKosky, S. T., & Ganguli, M. (2001). Incidence of Alzheimer’s disease in a rural community in India: the Indo-US study. Neurology, 57(6), 985–989. https://doi.org/10.1212/wnl.57.6.985

Das, S. K., Biswas, A., Roy, J., Bose, P., Roy, T., Banerjee, T. K., … & Hazra, A. (2008). Prevalence of major neurological disorders among geriatric population in the metropolitan city of Kolkata. The Journal of the Association of Physicians of India, 56, 175–181. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/18697633

Das, S. K., Biswas, A., Roy, T., Banerjee, T. K., Mukherjee, C. S., Raut, D. K., & Chaudhuri, A. (2006). A random sample survey for prevalence of major neurological disorders in Kolkata. Indian Journal of Medical Research, 124(2), 163.

Das, S. K., Bose, P., Biswas, A., Dutt, A., Banerjee, T. K., Hazra, A. M., …& Roy, T. (2007). An epidemiologic study of mild cognitive impairment in Kolkata, India. Neurology, 68(23), 2019–2026. https://doi.org/10.1212/01.wnl.0000264424.76759.e6

Dhiman, V., Menon, G. R., Kaur, S., Mishra, A., John, D., Rao Vishnu, M. V., Tiwari, R. R., & Dhaliwal, R. S. (2021). A Systematic Review and Meta-analysis of Prevalence of Epilepsy, Dementia, Headache, and Parkinson Disease in India. Neurology India, 69(2), 294–301. https://doi.org/10.4103/0028-3886.314588

Farina, N., Ibnidris, A., Alladi, S., Comas-Herrera, A., Albanese, E., Docrat, S., Ferri, C. P., Freeman, E., Govia, I., Jacobs, R., Astudillo-Garcia, C. I., Musyimi, C., Sani, T. P., Schneider, M., Theresia, I., Turana, Y., Knapp, M., & and, S. B. (2020). A systematic review and meta-analysis of dementia prevalence in seven developing countries: A STRiDE project. Global Public Health, 1–16. https://doi.org/10.1080/17441692.2020.1792527

India State-Level Disease Burden Initiative Neurological Disorders Collaborators (2021). The burden of neurological disorders across the states of India: The Global Burden of Disease Study 1990-2019. The Lancet. Global health, 9(8), e1129–e1144.

Mathuranath, P. S., Cherian, P. J., Mathew, R., Kumar, S., George, A., Alexander, A.,  Sarma, P. S. (2010). Dementia in Kerala, South India: prevalence and influence of age, education and gender.International Journal of Geriatric Psychiatry, 25(3), 290–297. https://doi.org/10.1002/gps.2338

Mathuranath, P., Menon, R., Ranjith, N., Sarma, Ps., Verghese, J., George, A., …& Kumar, Ms. (2012). Incidence of Alzheimer′s disease in India: A 10 years follow-up study. Neurology India, 60(6), 625. https://doi.org/10.4103/0028-3886.105198

Poddar, K., Kant, S., Singh, A., & Singh, T. B. (2011). An epidemiological study of dementia among the habitants of eastern Uttar Pradesh, India. Annals of Indian Academy of Neurology, 14(3), 164–168. https://doi.org/10.4103/0972-2327.85874

Raina, S. K., Chander, V., & Bhardwaj, A. (2016). Dementia in a tribal landlocked elderly population at high altitude: What explains the lower prevalence?. Journal of neurosciences in rural practice, 7(3), 419–422. https://doi.org/10.4103/0976-3147.182775

Raina, S. K., Raina, S., Chander, V., Grover, A., Singh, S., & Bhardwaj, A. (2014). Is dementia differentially distributed? A study on the prevalence of dementia in migrant, urban, rural, and tribal elderly population of himalayan region in northern India. North American Journal of Medical Sciences, 6(4), 172–177. https://doi.org/10.4103/1947-2714.131243

Raina, S., Raina, S., Razdan, S., & Pandita, K. (2008). Prevalence of dementia among Kashmiri migrants. Annals of Indian Academy of Neurology, 11(2), 106. https://doi.org/10.4103/0972-2327.41878

Rajkumar, S., Kumar, S., & Thara, R. (1997). PREVALENCE OF DEMENTIA IN A RURAL SETTING: A REPORT FROM INDIA. International Journal of Geriatric Psychiatry, 12(7), 702–707. https://doi.org/10.1002/(SICI)1099-1166(199707)12:7<702::AID-GPS489>3.0.CO;2-H

Razdan, S., Kaul, R. L., Motta, A., Kaul, S., & Bhatt, R. K. (1994). Prevalence and Pattern of Major Neurological Disorders in Rural Kashmir (India) in 1986. Neuroepidemiology, 13(3), 113–119. https://doi.org/10.1159/000110368

Rodriguez, J. J. L., Ferri, C. P., Acosta, D., Guerra, M., Huang, Y., Jacob, K., … &10/66 Dementia  Research Group. (2008). Prevalence of dementia in Latin America, India, and China: A population-based cross-sectional survey. The Lancet, 372(9637), 464–474. https://doi.org/10.1016/S0140-6736(08)61002-8

Saldanha, D., Mani, M. R., Srivastava, K., Goyal, S., & Bhattacharya, D. (2010). An epidemiological study of dementia under the aegis of mental health program, Maharashtra, Pune chapter. Indian Journal of Psychiatry, 52(2), 131–139. https://doi.org/10.4103/0019-5545.64588

Seby, K., Chaudhury, S., & Chakraborty, R. (2011). Prevalence of psychiatric and physical morbidity in an urban geriatric population. Indian journal of psychiatry, 53(2), 121. https://doi.org/10.4103/0019-5545.82535

Shaji, S., Bose, S., & Verghese, A. (2005). Prevalence of dementia in an urban population in Kerala, India. British Journal of Psychiatry, 186(2), 136–140. https://doi.org/10.1192/bjp.186.2.136

Shaji, S., Promodu, K., Abraham, T., Roy, K. J., & Verghese, A. (1996). An Epidemiological Study of Dementia in a Rural Community in Kerala, India. British Journal of Psychiatry, 168(6), 745–749. https://doi.org/10.1192/bjp.168.6.745.

Vas, C. J., Pinto, C., Panikker, D., Noronha, S., Deshpande, N., Kulkarni, L., …& Sachdeva, S. (2001). Prevalence of Dementia in an Urban Indian Population. International Psychogeriatrics,13(4), 439–450. https://doi.org/10.1017/S1041610201007852

The earliest report estimated that the dementia prevalence in Indonesia comes from a joint report of ADI Asia-Pacific members in 2005. The report stated a prevalence of 606,100. The same source reported an incidence of 191,400, which was predicted to increase to 314,100 by 2020 and to 932,000 by 2050 (Access Economics, 2006).

 The most recent estimates based on regional prediction published in the revised World Alzheimer Report 2015 stated that in 2015, approximately 1.2 million people in Indonesia were living with dementia and this number was expected to increase up to almost 4 million by 2050 (Prince et al., 2015).

Other studies identified reported regional dementia prevalence rates.

Yesufu (2009, p.12) reported a dementia prevalence of 4.1% among those aged 60 and older. The research further found that the prevalence of people living with Alzheimer’s Disease was 3.1% in the same age group, while that of all other dementias (‘including Vascular Dementia, possible secondary dementia, and other non-assessed sub-types) was estimated to be 5.4% (age range 52-98 years)’. This research had been conducted in Sumedang (West Java) and Borobodu (Central Java) as well as urban sites in Central and South Jakarta (Northwest Java).

Hogervorst (2011, p.8), studying similar areas to Yesufu (the study was conducted in West and Central Java as well as at an urban site in Jakarta) and who aimed to validate two short dementia screening tests in Indonesia reported a ‘suspected dementia prevalence’ of 8% among those aged 60 and 65 years. The author reports that they found a very high rate (16-21%) possible dementia cases in Borobudur, Central Java, which raised the overall estimated prevalence rate.

Surveymeter, an independent research institution, investigated the prevalence of dementia in the province of Yogyakarta (Suriastini et al., 2016) and Bali (Suriastini et al., 2018). Yogyakarta is located in Java, which is the most densely-populated island in Indonesia (The Editors of Encyclopaedia Britannica, 2017), and currently is the province with the highest percentage of older people among all provinces in Indonesia  (Pusat Data dan Informasi Kementerian Kesehatan RI, 2017). Surveymeter’s data from Yogyakarta showed a dementia prevalence of 20.1% (Suriastini et al., 2016). No data regarding incidence in Yogyakarta were found.

A similar study conducted in 2018 in the province of Bali showed a higher prevalence of dementia at 32.16% (Suriastini et al., 2018). This high prevalence might be related to the proportion of older population in this province. Among provinces outside of Java Island, Bali has the highest number of older people outside of Java (Pusat Data dan Informasi Kementerian Kesehatan RI, 2017). There were no data found regarding incidence in this province either. Surveymeter’s data is based on household surveys in the province of Yogyakarta (Suriastini et al., 2016) and Bali (Suriastini et al., 2018). Both studies were conducted using structured questionnaire and instruments of cognitive screening and functional status assessment such as MMSE, ADL and IADL for both the patients and caregivers in villages or sub-districts.

References:

Access Economics. (2006). Demensia Di Kawasan Asia Pasifik: Sudah Ada Wabah. https://www.alz.co.uk/research/files/apreportindonesian.pdf

Hogervorst, E. (2011). Validation of two short dementia screening tests in Indonesia. IN: Jacobsen, S.R. (ed.) Vascular Dementia: Risk Factors, Diagnosis and Treatment, New York: Nova Science, pp. 235-256.

Prince, M., Wimo, A., Guerchet, M., Ali, G.-C., Wu, Y.-T., Prina, M., & Alzheimer’s Disease International. (2015). 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

Pusat Data dan Informasi Kementerian Kesehatan RI. (2017). Analisis Lansia di Indonesia.

Suriastini, Turana, Y., Sukadana, W., Sikoki, B., Witoelar, F., Lesmana, C. B. J., Mulyanto, E. D., Hermoko, R., & Anandari, G. A. A. A. (2018). Menggugah Lahirnya Kebijakan Kelanjutusiaan Menggugah Lahirnya Kebijakan Kelanjutusiaan.

Suriastini, Turana, Y., Witoelar, F., Supraptilah, B., Wicaksono, T., & Dwi, E. (2016). Policy Brief Angka Prevalensi Demensia: Perlu Perhatian Kita Semua. SurveyMETER, Maret, 1–4.

The Editors of Encyclopaedia Britannica. (2017). Java. Encyclopædia Britannica. https://www.britannica.com/place/Java-island-Indonesia

Yesufu, A. O. (2009). Demographic and modifiable risk factors for age related cognitive impairment and possible dementia. Loughborough: Loughborough University

In 2016, the number of prevalent cases for dementia in Kenya was 61,120 and revealed a minor reduction of –2.1% (95% uncertainty Interval [UI] –2.8 to –1.5) from 1990 to 2016 (Nichols et al., 2019).

References:

Nichols, E., Szoeke, C. E. I., Vollset, S. E., Abbasi, N., Abd-Allah, F., Abdela, J., … Murray, C. J. L. (2019). Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology, 18(1), 88–106. http://doi.org/10.1016/S1474-4422(18)30403-4

Since 2003, two national health surveys and two dementia specific surveys have documented the prevalence of dementia and cognitive impairment in Mexico.

1. Mexican Health and Aging Study, MHAS (Encuesta Nacional de Salud y Envejecimiento en México, ENASEM, mhasweb.org).

The initiative is funded by the National Institute of Health and the National Institute of Aging of the United States. This is the first large scale longitudinal study in Mexico with data collected in 2001 (baseline study) with follow-up interviews in 2003, 2012, 2015 and 2018 (Wong et al., 2015). The objective of this longitudinal study is to prospectively evaluate the impact of diseases, functioning and mortality of adults 50 years of age and older (or adults born in 1951 or earlier at the time of the baseline survey), in more and less urban areas of Mexico. In MHAS, the identification of cases of dementia was made using an algorithm based on a cognitive evaluation (performed with a battery of instruments) and another on functional ability. The prevalence of dementia estimated in a report of 2011 was 5.2%, adjusted for age and schooling (Mejía-Arango et al., 2011).

2. National Health and Nutrition Survey ENSANUT 2012 (Encuesta Nacional de Salud y Nutrición, https://ensanut.insp.mx/).

The National Survey of Health and Nutrition (ENSANUT) is a probabilistic, multi-phase survey designed to estimate the prevalence of health conditions, nutrition, and its determinants, in nationally representative samples of children 0 to 11 years of age, adolescents 12 to 19 years old, adults 20 to 59, and older adults (60+ years). It has a representative sample design at the national, state, urban and rural stratum (Romero-Martinez et al., 2013). The module for the evaluation of older adults was first added in 2012 and included a sample of 8,874 adults aged 60 or older. Two instruments were used for dementia diagnosis: a battery to assess cognitive functioning (semantic verbal fluency the Mini-cog) and the evaluation of functional ability. These were used to construct a diagnostic algorithm. People who presented alteration in both cognitive ability and functional ability were considered to have dementia. This resulted in an estimated dementia prevalence of 7.9% for the total of older adults’ sample (Manrique Espinoza et al., 2013). In relation to distribution of dementia across the country, Acosta-Castillo et al., (2017) report the prevalence of dementia by state and level of deprivation, and report adjusted prevalence of dementia (by sex, age and education) of 8.0% at national level, ranging from 3.3% in Querétaro to 12.5% in Jalisco, and from 3.9% in people between 60-69 years and 20.6% in the group aged 80 years or more. The prevalence is similar in some levels of deprivation (around 8.0%), except in those areas with high and very high deprivation (11.1%). They report that of the almost 900,000 people living with dementia in Mexico, more than half have experienced food insecurity and about 200 thousand live in localities with high and very high levels of deprivation. This demonstrates great variability in the prevalence of dementia by state and suggests that many people affected by dementia experience high levels of vulnerability.

3. Dementia Research Group 10/66 study (https://www.alz.co.uk/1066/).

The 10/66 Dementia Research Group research programme was developed to address the dementia prevalence, incidence, and impact across Latin American countries, China and India, using a validated and common methodology in a multi-centric population of adults aged 65 years and over (Prina et al., 2017). Data have been obtained on the prevalence and impact of dementia, and on incidence (phase 2007-2010), which evaluated the incidence of dementia and some associated risk factors, as well as mortality, with a median follow-up of 3 years (Prince et al., 2012). The case identification of dementia is carried out using two algorithms, one that operationalizes the criteria for dementia of the DSM-IV, and another that is developed by the 10/66 group (Prince et al., 2003). A case is considered positive for dementia if either of the two criteria is positive. The prevalence of dementia is of 8.6% in the urban area, compared to 7.4 in the rural area. However, the standardised prevalence (95% CI) using the 10/66 algorithm is 7.4% (5.9-8.9) in Mexico in urban areas, and 7.3% (5.7-8.9) in rural areas. The standardised prevalence according to DSM-IV criteria is 3.2% (2.2-4.2) in Mexico urban, and 2.4% (1.2-3.6) (Llibre et al., 2008).

4. Survey of the Metropolitan Area of Guadalajara.

In 2014, a cross-sectional study was conducted on a population aged 60 years or above, living in the state of Jalisco (in the Western region of the country). A total of 1,142 people participated. Participants were selected through multiple probability random sampling and door-to-door interviewing. All participants were evaluated for their cognitive function, emotional state, and physical performance. Cognitive function, depression and functional disability were assessed using the Mini-Mental State Examination (Folstein et al., 1975), the geriatric depression scale and the Katz index, respectively. The diagnosis of dementia was made according to the DSM-IV criteria. The prevalence of dementia was 9.5% (63.35% of women and 36.7% of men) (Velázquez-Brizuela et al., 2014).

Table 11 shows prevalence data of dementia. Variations may be due to the use of different classifications, forms and extensions of cognitive assessments and assessment of limitations in functionality. For example, while ENSANUT and MHAS/ENASEM only assess dementia with cognition and loss of function (assessed through altered activities of daily living); in 1066 DSM-IV criteria are operationalised and the algorithm is tested against these criteria, not only against the sum of cognitive impairment and loss of functionality. 

Table 11. Population studies, prevalence data of dementia.

Study Evaluation criteria Sample size Adjusted prevalence, total or subgroups
MHAS/ENASEM

(Mejía- Arango et al., 2011)

Cognitive evaluation and functional limitations (CCCE, difficulty in performing daily activities 7,166 community-dwelling adults, 60 years and older 6.1
Dementia Research Group 10/66

(Llibre et al., 2008)

10/66 Algorithm and DSM IV Criteria 1,003 urban and 1,000 rural community-dwelling adults, 65 years and older Urban 8.6

Rural 8.5

Survey of the Metropolitan Area of Guadalajara (Encuesta del Área Metropolitana de Guadalajara)

(Velázquez-Brizuela et al., 2014)

DSM-IV 1,142 older adults, 60 years and older 9.5
National Health and Nutrition Survey ENSANUT 2012

(Manrique Espinoza et al., 2013)

Cognitive evaluation and functional limitations 8,874 older adults, 60 years and older 7.9
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

Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198. https://doi.org/10.1016/0022-3956(75)90026-6

Llibre, J., Ferri, C. P., Acosta, D., Guerra, M., Huang, Y., Jacob, K. S., Krishnamoorthy, E. S., Salas, A., Sosa, A. L., Acosta, I., Dewey, M. E., Gaona, C., Jotheeswaran, A. T., Li, S., Rodriguez, D., Rodriguez, G., Kumar, P. S., Valhuerdi, A., & Prince, M. (2008). Prevalence of dementia in Latin America, India, and China: a population-based cross-sectional survey. The Lancet, 372(9637), 464–474. https://doi.org/10.1016/S0140-6736(08)61002-8

Manrique Espinoza, B., Salinas Rodríguez, A., Moreno Tamayo, K. M., Acosta Castillo, I., Sosa Ortiz, A. L., Gutiérrez Robledo, L. M., & Téllez Rojo, M. M. (2013). Health conditions and functional status of older adults in Mexico. Condiciones de salud y estado funcional de los adultos mayores en México. Salud Pública de México, 55(1), 323–331. https://doi.org/10.21149/spm.v55s2.5131

Mejía-Arango, S., Gutierrez, L. M., Minthon, L., Londos, E., Jo, L., Bostro, F., Larraya, F. P., Grasso, L., & Marí, G. (2011). Prevalence and Incidence Rates of Dementia and Cognitive Impairment No Dementia in the Mexican Population. International Journal of Geriatric Psychiatry, 23(7), 713–719. https://doi.org/10.1177/0898264311421199

Prina, A. M., Acosta, D., Acosta, I., Guerra, M., Huang, Y., Jotheeswaran, A. T., Jimenez-Velazquez, I. Z., Liu, Z., Llibre Rodriguez, J. J., Salas, A., Sosa, A. L., Williams, J. D., & Prince, M. (2017). Cohort Profile: The 10/66 study. International Journal of Epidemiology, 46(2), 406–406i. https://doi.org/10.1093/ije/dyw056

Prince, M., Acosta, D., Chiu, H., Scazufca, M., & Varghese, M. (2003). Dementia diagnosis in developing countries: a cross-cultural validation study. Lancet (London, England), 361(9361), 909–917. https://doi.org/10.1016/S0140-6736(03)12772-9

Prince, M., Acosta, D., Ferri, C. P., Guerra, M., Huang, Y., Rodriguez, J. J. L., Salas, A., Sosa, A. L., Williams, J. D., Dewey, M. E., Acosta, I., Jotheeswaran, A. T., & Liu, Z. (2012). Dementia incidence and mortality in middle-income countries, and associations with indicators of cognitive reserve: A 10/66 Dementia Research Group population-based cohort study. The Lancet, 380(9836), 50–58. https://doi.org/10.1016/S0140-6736(12)60399-7

Romero-Martínez, M., Shamah-Levy, T., Franco-Núñez, A., Villalpando, S., Cuevas-Nasu, L., Pablo Gutiérrez, J., & Rivera-Dommarco, J. (2013). Encuesta nacional de salud y nutrición 2012: diseño y cobertura. [National Health and Nutrition Survey 2012: design and coverage]. Salud Publica Mex, 55(2), S332-S340 (in Spanish). https://doi.org/10.21149/spm.v55s2.5132

Velázquez-Brizuela, I., Ortiz, G., Ventura-Castro, L., Árias-Merino, E., Pachecho-Moisés, F., & MA, M.-Islas. (2014). Prevalence of Dementia, Emotional State and Physical Performance among Older Adults in the Metropolitan Area of Guadalajara, Jalisco, Mexico. Current Gerontology and Geriatrics Research, 2014, 1–8. https://doi.org/10.1155/2014/387528

Wong, R., Michaels-Obregón, A., Palloni, A., Miguel Gutiérrez-Robledo, L., González-González, C., López-Ortega, M., María Téllez-Rojo, M., Mendoza-Alvarado, L. R., & Ts, L. (2015). Progression of aging in Mexico: the Mexican Health and Aging Study (MHAS) 2012 HHS Public Access. In Salud Publica Mex. https://researchexperts.utmb.edu/en/publications/progression-of-aging-in-mexico-the-mexican-health-and-aging-study

According to a study published in 2019 that systematically analysed data from the Global Burden of Disease Study 2016, there were 80,600 deaths (69,174 to 94,940; 95% confidence interval) due to dementia in Brazil in 2016 (GBD 2016, 2019). We could not find specific data for YLL. However, a subnational analysis of the Global Burden of Disease carried out for Brazil (from 1990 to 2016) described a small and non-significant increase in the age-standardised YLL rate of 2.7% (-1.3% to 7.0%) for Alzheimer’s disease over the observed period (GBD 2016, 2018).

References:

GBD 2016. (2018). Burden of disease in Brazil, 1990-2016: A systematic subnational analysis for the Global Burden of Disease Study 2016. The Lancet Neurology, 392. http://dx.doi.org/10.1016/S0140-6736(18)31221-2

GBD 2016. (2019). Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology, 18, 88–106. http://dx.doi.org/10.1016/S1474-4422(18)30403-4

As per the Global Burden of Disease (GBD) study (India State-Level Disease Burden Initiative Neurological Disorders Collaborators, 2021), an estimated 129,000 deaths were attributed to Alzheimer’s disease and other dementias in 2019. GBD estimates (2019) indicate there were 117.14 Years of Life Lost (YLL’s) per 100,000 due to dementia (IHME, 2019).

References:

India State-Level Disease Burden Initiative Neurological Disorders Collaborators (2021). The burden of neurological disorders across the states of India: The Global Burden of Disease Study 1990-2019. The Lancet. Global health, 9(8), e1129–e1144.

Institute for Health Metrics and Evaluation (IHME) (2019).  GBD Compare. Seattle, WA: IHME, University of Washington, Available from http://vizhub.healthdata.org/gbd-compare.

According to the Global Health Data Exchange, the YLL of Alzheimer’s disease and other dementias in Indonesia in 2017 is 522,067.55 (Global Health Data Exchange, 2019).

References:

Global Health Data Exchange. (2019). GBD Results Tool. http://ghdx.healthdata.org/gbd-results-tool

A total of 3205 deaths were attributed to dementia in 2016 showing an increase of 15.3% (95% UI 2.0 to 43.5) in age-standardised rates from 1990 to 2016 (Nichols et al., 2019). However, there is no information on YLL due to dementia specifically for Kenya.

References:

Nichols, E., Szoeke, C. E. I., Vollset, S. E., Abbasi, N., Abd-Allah, F., Abdela, J., … Murray, C. J. L. (2019). Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology, 18(1), 88–106. http://doi.org/10.1016/S1474-4422(18)30403-4

This information is not available.

We could not find specific data for YLD due to dementia. However, a subnational analysis of the Global Burden of Disease project carried out for Brazil between 1990 and 2016 (GBD 2016, 2018) described an increase in the age-standardised YLD rate of 4.9% (2.3% to 7.7%) for Alzheimer’s disease over the years analysed.

References:

GBD 2016. (2018). Burden of disease in Brazil, 1990-2016: A systematic subnational analysis for the Global Burden of Disease Study 2016. The Lancet Neurology, 392. http://dx.doi.org/10.1016/S0140-6736(18)31221-2

The GBD estimates (2019) that the YLD’s due to dementia were 35.7 per 100,000 (IHME, 2019).

References:

Institute for Health Metrics and Evaluation (IHME). (2019).  GBD Compare. Seattle, WA: IHME, University of Washington, Available from http://vizhub.healthdata.org/gbd-compare.

According to the Global Health Data Exchange, the YLD of Alzheimer’s disease and other dementias in Indonesia in 2017 is 139,446.64 (Global Health Data Exchange, 2019).

References:

Global Health Data Exchange. (2019). GBD Results Tool. http://ghdx.healthdata.org/gbd-results-tool

Disability adjusted life years (DALYs) attributed to dementia was 42,739 in 2016, showing an increase of 9.6% (95% UI –0·4 to 26.2) in age-standardised rates from 1990 to 2016 (Nichols et al., 2019).

References:

Nichols, E., Szoeke, C. E. I., Vollset, S. E., Abbasi, N., Abd-Allah, F., Abdela, J., … Murray, C. J. L. (2019). Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology, 18(1), 88–106. http://doi.org/10.1016/S1474-4422(18)30403-4

 

Of the 10 leading causes of DALYs in Mexico’s older population, seven conditions are age-related, namely diabetes mellitus, ischemic heart disease, chronic kidney disease, and other organ diseases, Alzheimer’s disease and other dementias, cerebrovascular diseases, and chronic obstructive pulmonary disease. Alzheimer’s and other dementias represent the fifth main cause of DALYS (disability-adjusted life-years) in Mexican older persons (Parra-Rodríguez et al., 2019). However, no accurate data is available on the total deaths due to dementia.

References:

Parra-Rodríguez, L., González-Meljem, J. M., Gómez-Dantés, H., Gutiérrez-Robledo, L. M., López-Ortega, M., García-Peña, C., & Medina-Campos, R. H. (2019). The Burden of Disease in Mexican Older Adults: Premature Mortality Challenging a  Limited-Resource Health System. Journal of Aging and Health, 898264319836514. https://doi.org/10.1177/0898264319836514

All studies on prevalence were conducted in the South and South-Eastern regions of Brazil, so we do not have data from other regions to compare. Even within the same region there is, however, an important variation on prevalence, but this is more likely due to differences in the methodology used in the different studies.

As per the Global Burden of Disease (GBD) study (India State-Level Disease Burden Initiative Neurological Disorders Collaborators, 2021), 3.69 million people were living with Alzheimer’s disease and other dementias in 2019 in India. The GBD study (India State-Level Disease Burden Initiative Neurological Disorders Collaborators, 2021) also provides state-wise prevalence and crude DALY rate for Alzheimer’s disease and other dementias per 100,000 in 2019 (Table 6.3).

Table 6.3 depicts state wise prevalence and crude DALY rate (2019) – per 100,000

Sl No STATE PREVALENCE CRUDE DALY RATE
1 Andhra Pradesh 368 224
2 Arunachal Pradesh 149 95
3 Assam 192 112
4 Bihar 203 114
5 Chhattisgarh 227 133
6 Delhi 201 110
7 Goa 414 231
8 Gujarat 252 149
9 Haryana 286 174
10 Himachal Pradesh 359 214
11 Jammu & Kashmir and Ladakh 247 142
12 Jharkhand 244 141
13 Karnataka 318 185
14 Kerala 564 312
15 Madhya Pradesh 227 129
16 Maharashtra 323 193
17 Manipur 217 133
18 Meghalaya 164 111
19 Mizoram 213 129
20 Nagaland 198 125
21 Odisha 292 189
22 Other UT’s 255 145
23 Punjab 356 208
24 Rajasthan 231 134
25 Sikkim 247 142
26 Tamil Nadu 366 182
27 Telangana 272 157
28 Tripura 265 151
29 Uttar Pradesh 195 113
30 Uttarakhand 256 150
  India 266 153

Source: (India State-Level Disease Burden Initiative Neurological Disorders Collaborators, 2021 (Data From Figure 2 and Supplementary Document)).

The numbers of persons with dementia are further estimated to increase by 197% between 2019-2050 in India, with 11.4 million people projected to live with dementia in India in 2050 (GBD 2019 Dementia Forecasting Collaborators, 2022).

References:

GBD 2019 Dementia Forecasting Collaborators. (2022). Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. The Lancet Public Health.

India State-Level Disease Burden Initiative Neurological Disorders Collaborators (2021). The burden of neurological disorders across the states of India: The Global Burden of Disease Study 1990-2019. The Lancet. Global health, 9(8), e1129–e1144.

There has been not enough evidence to conclude a dementia prevalence nationally. However, Surveymeter’s studies showed higher prevalence in rural areas both in Yogyakarta (23.0%) and Bali (36.1%) (Suriastini et al., 2016, 2018).

References:

Suriastini, Turana, Y., Sukadana, W., Sikoki, B., Witoelar, F., Lesmana, C. B. J., Mulyanto, E. D., Hermoko, R., & Anandari, G. A. A. A. (2018). Menggugah Lahirnya Kebijakan Kelanjutusiaan Menggugah Lahirnya Kebijakan Kelanjutusiaan.

Suriastini, Turana, Y., Witoelar, F., Supraptilah, B., Wicaksono, T., & Dwi, E. (2016). Policy Brief Angka Prevalensi Demensia: Perlu Perhatian Kita Semua. SurveyMETER, Maret, 1–4.

It is not evident through literature whether the prevalence of dementia is pronounced in some specific geographical areas. However, a report by the Africa Mental Health Research and Training Foundation revealed a high rate of people with mild to moderate cognitive impairment in Makueni County in Kenya. Among all people with mental health problems, the rate of cognitive impairment using Mini-Mental State Exam (MMSE) was estimated to be 16%. This led to dementia (manifested as cognitive impairment) being ranked third, after depression and drug and substance abuse (Mutiso et al., 2016). This is the only study in Kenya that has been conducted to estimate prevalent rates on dementia.

References:

Mutiso, V., Pike, K. M., Ndetei, D., Musau, A., Nandoya’, E., Musyimi’, C., … Wambua, R. (2016). Multi-sectoral Stakeholder TEAM Approach to Scale-Up Community Mental Health in Kenya: Building on Locally Generated Evidence and Lessons Learnt (TEAM). Nairobi, Kenya. https://www.mhinnovation.net/sites/default/files/downloads/innovation/reports/TEAM%20Project%20Report%20to%20County_Final_31_01_17.pdf

Even though there is no official data reported at the state level, an analysis with the data derived from ENSANUT (Acosta-Castillo et al., 2017) demonstrates great variability in the prevalence of dementia by state and suggests that numeorous people affected by dementia experience high levels of vulnerability.

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

 

No information was found on this.

The age of onset of dementia has been studied in dementia cohorts and evaluated in hospital-based studies. In India, the proportion of patients with early-onset dementia is higher (49.9%) in comparison to developed countries (7-30%) (Das, Ghosal and Pal, 2012; Alladi et al., 2011). A study examining subtypes of dementia from a memory clinic in South India reported the mean age of onset of dementia as 66.3 years (Alladi et al., 2011). This is likely to be reflective of the demographic and epidemiologic profile of India. For example, lower levels of education and socioeconomic status, contribute to a higher number of individuals with vascular dementia (who are typically younger than persons with AD patient) (Alladi et al, 2011). Furthermore, lower referral rates of older elderly to hospitals as a result of lack of awareness and ‘sociocultural’ protection of elderly with memory loss in developing countries may also be contributing towards the lower age of onset reported by clinic studies (Alladi et al., 2011).

References:

Alladi, S., Mekala, S., Chadalawada, S. K., Jala, S., Mridula, R., & Kaul, S. (2011). Subtypes of \Dementia: A Study from a Memory Clinic in India. Dementia and Geriatric Cognitive Disorders, 32(1), 32–38. https://doi.org/10.1159/000329862

Das, S., Ghosal, M., & Pal, S. (2012). Dementia: Indian scenario. Neurology India, 60(6), 618. https://doi.org/10.4103/0028-3886.105197

We could not identify data on the average age of dementia onset in Indonesia.

It is difficult to indicate when dementia begins because the onset is gradual. However, Young Onset Dementia (YOD) typically occurs before the age of 65 (Alzheimer’s Disease International (ADI) and World Health Organization (WHO), 2012). There is no information on the average age onset in Kenya.

References:

Alzheimer’s Disease International (ADI) and World Health Organization (WHO). (2012). Dementia: A public health priority. United Kingdom. https://www.alzint.org/u/2020/08/Dementia-A-Public-Health-Priority.pdf

No information was found on this.

There is no information available on the average life expectancy with dementia in India.

We could not identify data on the average life expectancy of people living with dementia.

There is no information on the average life expectancy with dementia.

Yes. According to a systematic review conducted in 2011 (Fagundes et al., 2011), the prevalence of dementia was higher among women in all studies selected. The authors of this systematic review acknowledge that the age distribution of the sample populations was not uniform, which may explain the variation in the prevalence of dementia that was detected, as women tend to live eight years longer than men on average in Brazil, and, therefore, would contribute more to the prevalence rates of dementia. The review also showed that the prevalence of dementia increased with age and was inversely related to the socioeconomic status and number of years of education.

References:

Fagundes, S. D., Silva, M. T., Thees, M. F. R. S., & Pereira, M. G. (2011). Prevalence of dementia among elderly Brazilians: A systematic review. Sao Paulo Medical Journal, 129(1), 46–50. https://doi.org/10.1590/S1516-31802011000100009

Prevalence by age/gender

The GBD (India State-Level Disease Burden Initiative Neurological Disorders Collaborators, 2021) study provides a breakdown of dementia prevalence as per age and gender, demonstrating higher prevalence of dementia among women than men in India. This is available on Page 125 of the Supplementary document: https://www.thelancet.com/cms/10.1016/S2214-109X(21)00164-9/attachment/26ff536c-3eec-45f7-897a-183dc4e7777e/mmc1.pdf

Prevalence by ethnic groups

The prevalence of dementia across ethnic groups has not been widely studied in India. One study conducted in the state of Jammu and Kashmir examined the prevalence of dementia among the ethnic Dogra population compared to the migrant Kashmiri Pandit population (Raina, Razdan and Pandita, 2010; Raina et al., 2008). The study reported overall prevalence of dementia in those aged 60 and over as 1.83% in the ethnic Dogra population, which was lower than the prevalence rate among the migrant Kashmiri Pandits (6.5%) reported in an earlier study (Raina, Razdan and Pandita, 2010, Raina et al., 2008).

References:

India State-Level Disease Burden Initiative Neurological Disorders Collaborators (2021). The burden of neurological disorders across the states of India: The Global Burden of Disease Study 1990-2019. The Lancet. Global health, 9(8), e1129–e1144.

Raina, S. K., Razdan, S., & Pandita, K. K. (2010). Prevalence of dementia in ethnic Dogra population of Jammu district, North India: a comparison survey. Neurology Asia15(1).

Raina, S., Raina, S., Razdan, S., & Pandita, K. (2008). Prevalence of dementia among Kashmiri migrants. Annals of Indian Academy of Neurology, 11(2), 106. https://doi.org/10.4103/0972-2327.41878

Data from the studies in both Yogyakarta and Bali showed a higher prevalence of dementia in women (22.0% and 38%, respectively) than men (17.9% and 25.7%, respectively) (Suriastini et al., 2016, 2018). This is consistent with other, international data on dementia, which suggests that this condition affect more women than men (Erol et al., 2015).

We found no data on differences between ethnic groups.

References:

Erol, R., Brooker, D., & Peel, E. (2015). Women and Dementia A global research review. 52.

Suriastini, Turana, Y., Sukadana, W., Sikoki, B., Witoelar, F., Lesmana, C. B. J., Mulyanto, E. D., Hermoko, R., & Anandari, G. A. A. A. (2018). Menggugah Lahirnya Kebijakan Kelanjutusiaan Menggugah Lahirnya Kebijakan Kelanjutusiaan.

Suriastini, Turana, Y., Witoelar, F., Supraptilah, B., Wicaksono, T., & Dwi, E. (2016). Policy Brief Angka Prevalensi Demensia: Perlu Perhatian Kita Semua. SurveyMETER, Maret, 1–4.

 

There is currently no study in Kenya to our knowledge that has provided estimates of dementia incidence or prevalence by gender or ethnic groups. According to the Global Burden of Disease reported by Alzheimer’s Disease International (ADI) and WHO in 2012, the estimates of dementia prevalence in East Sub-Saharan Africa was  highest among those aged 85 years and above (16.3%), followed by those aged between 80 to 84 years (8.2%), then 75 to 79 years (4.3%), 70 to 74 years (2.3%), 65 to 69 years (1.2%) and the least percentage (0.6%) seen among those aged 60 to 64 years (Alzheimer’s Disease International (ADI) and World Health Organization (WHO), 2012).

References:

Alzheimer’s Disease International (ADI) and World Health Organization (WHO). (2012). Dementia: A public health priority. United Kingdom. https://www.alzint.org/u/2020/08/Dementia-A-Public-Health-Priority.pdf

According to ENSANUT dementia is more prevalent in women (9.1%) compared to men (6.9%). In MHAS, rate of dementia in women was higher compared to men (3.1 vs 2.1), adjusted by age.

Disaggregated data by ethnic groups is not yet available.

No information was found specifically regarding dementia in this question. However, a longitudinal study conducted in São Paulo on Life Expectancy with Cognitive Impairment (LEWCI) showed that at the age of 60 years LEWCI was 1.9 years among men but varied between 3.4 years for men with no schooling and 0.6 years for men with 8 years of schooling. For women, the LEWCI was 3.1 years, varying from 4.5 years among women with no schooling to 1.0 years among those with 8 years of schooling (Andrade et al., 2019).

References:

Andrade, F. C. D., Corona, L. P., & de Oliveira Duarte, Y. A. (2019). Educational Differences in Cognitive Life Expectancy Among Older Adults in Brazil. Journal of the American Geriatrics Society, 67(6), 1218–1225. https://doi.org/10.1111/jgs.15811

We found no data on the average number of years lived by people living with dementia.

In Kenya, the average life expectancy is 66.7 years  (64.4 years for males and 68.9 years for females) (World Health Rankings, 2018). The average life expectancy for persons with dementia in Kenya is not yet available.  However, it varies depending on the type and of dementia, its severity at the time of diagnosis, age, sex, and general health (Brodaty et al., 2012). For instance, the life expectancy for a person with Alzheimer’s disease can vary between 3 to 10 years. Since the main predictor is age, caregiver and providers should plan on a median life span of between 7 to 10 years for persons whose diagnosis was made while in their early 60’s or 70’s and three years or less for those diagnosed at the age of around 90 years (Zanetti et al., 2009).

References:

Brodaty, H., Seeher, K., & Gibson, L. (2012). Dementia time to death: A systematic literature review on survival time and years of life lost in people with dementia. International Psychogeriatrics, 24(7), 1034-1045. http://doi.org/10.1017/S1041610211002924

World Health Rankings. (2018). Health Profile: Kenya. https://www.worldlifeexpectancy.com/country-health-profile/kenya

Zanetti, O., Solerte, S. B., & Cantoni, F. (2009). Life expectancy in Alzheimer’s disease (AD). Archives of Gerontology and Geriatrics, 49, 237–243. https://doi.org/10.1016/j.archger.2009.09.035

No data is yet available.

No information was found on this topic.

The  prevalence of AIDS associated dementia is relatively low (1-2% of persons infected with HIV) in the Indian context (Ranga et al., 2004; Satischandra et al., 2000; Wadia et al., 2001).

References:

Ranga, U., Shankarappa, R., Siddappa, N. B., Ramakrishna, L., Nagendran, R., Mahalingam, M., Mahadevan, A., Jayasuryan, N., Satishchandra, P., Shankar, S. K., & Prasad, V. R. (2004). Tat protein of human immunodeficiency virus type 1 subtype C strains is a defective chemokine. Journal of virology78(5), 2586–2590. https://doi.org/10.1128/jvi.78.5.2586-2590.2004

Satishchandra, P., Nalini, A., Gourie-Devi, M., Khanna, N., Santosh, V., Ravi, V., … & Shankar, S. K. (2000). Profile of neurologic disorders associated with HIV/AIDS from Bangalore, south India (1989-96). Indian Journal of Medical Research, 111, 14-23.

Wadia, R. S., Pujari, S. N., Kothari, S., Udhar, M., Kulkarni, S., Bhagat, S., & Nanivadekar, A. (2001). Neurological manifestations of HIV disease. The Journal of the Association of Physicians of India, 49, 343-348.

We found non data on the national prevalence or incidence of specific type of dementias.

There are no national statistics on HIV-related dementia in Kenya.

No data is yet available.

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

There has been no specific campaign for dementia risk reduction in Brazil. However, there are strong efforts by primary and secondary care services, as well as federal state and municipal programs to prevent and reduce the burden of established risk factors for other chronic conditions, which are risk factors for dementia too. These include smoking, high blood pressure, and diabetes. Campaigns are communicated through television programmes, paper adverts, and education groups in the community (school, parks, etc.). Prevention program such as HIPERDIA (for diabetes and hypertension) are conducted in the PCU (Primary Care Units).

Currently, there is no programme that specifically targets dementia in India at a national level. However, the Government of India has launched the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS) (Ministry of Health and Family Welfare [MoHFW], 2017), which aims at targeting risk factors for non-communicable diseases that are also risk factors for dementia.

References:

Ministry of Health and Family Welfare. (2017). National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases, and Stroke (NPCDCS).

In 2014, Alzheimer’s Indonesia (ALZI) in collaboration with On Track Media Indonesia and Juara Agency started the #JanganMaklumDenganPikun campaign to raise awareness and reduce risk of dementia. “Jangan maklum dengan pikun” means “Do not underestimate memory loss”. This campaign was supported by Grand Challenges Canada and resulted in various communication materials, including the 10 Tanda Demensia Alzheimer (10 Warning Signs of Alzheimer’s) video and leaflet (Virgianti, 2014). The leaflet lists the 10 common signs of Alzheimer’s disease, while the video has an additional explanation on how to reduce risks of dementia, for example, through routine physical activities of at least 150 minutes per week, consuming a healthy and balanced diet as well as mental stimulation, positive thinking, and engaging in productive, creative activities (OnTrackMedia, 2014).

In 2015, the Minister of Health issued a regulation on the management of non-communicable diseases. Based on this, the Ministry of Health launched the campaign ‘CERDIK’ to reduce risk of non-communicable diseases. CERDIK is an acronym of Cek kesehatan rutin (routine health check-up), Enyahkan asap rokok (eliminate smoking), Rajin aktivitas fisik (routine physical activity), Diet sehat dan gizi seimbang (healthy diet and balanced nutrition), Istirahat cukup (Enough rest/sleep), and Kelola stres (Managing stress) (Ministry of Health Republic of Indonesia, 2015a). Aligning with this campaign, the most current version of ALZI’s 10 Tanda Demensia leaflet includes CERDIK as the advice regarding risk reduction for dementia (Alzheimer’s Indonesia, 2019a).

In 2016, the national dementia strategy was launched. The national strategy has seven action steps, in which the first is ‘Campaign of public awareness and promotion of healthy lifestyle’ (Ministry of Health Republic of Indonesia, 2015a, p.25). This step has four activities, which are:

  • [To] ‘Strengthen the existing programs and creating new programs to promote healthy and productive older persons, [to address] risk factors, and protective factors, including healthy lifestyle
  • [To] Intensify healthy and productive older persons campaign
  • [To] Strengthen education program on older people in schools, community, occupational health programmes
  • [To] Promote cognitive health using [a] coordinated training model at the national level’.
References:

Alzheimer’s Indonesia. (2019a). 10 Gejala Awal Demensia Alzheimer. https://alzi.or.id/10-gejala-awal-demensia-alzheimer/

Ministry of Health Republic of Indonesia. (2015a). Ministry of Health Regulation No. 67/2015 on Geriatric Services in Public Health Center (Permenkes No. 67/2015 Tentang Penyelenggaraan Pelayanan Kesehatan Lanjut Usia Di Pusat Kesehatan Masyarakat). Kementrian Kesehatan Indonesia, 1–140.

OnTrackMedia. (2014). 10 Tanda Demensia Alzheimer. https://youtu.be/DymN8tviXEQ

Virgianti K. (2014). Alzi sebarkan info Alzheimer gandeng pemerintah. Satu Harapan. Available at: https://www.satuharapan.com/read-detail/read/alzi-sebarkan-info-alzheimer-gandeng-pemerintah

There is no campaign in Kenya to specifically reduce the risk of dementia. However, the campaigns conducted by ADOK to create awareness on dementia care partly cover risk reduction.

There are currently no campaigns, however, Mexico is part of the FINGER study which aims at piloting an intervention to reduce risks of dementia and the results may be available in the near future.

Longitudinal studies on dementia identified the following as risk factors: advanced age (Nitrini et al., 2004) and years of education (Chaves et al., 2009).

References:

Chaves, M. L., Camozzato, A. L., Godinho, C., Piazenski, I., & Kaye, J. (2009). Incidence of Mild Cognitive Impairment and Alzheimer Disease in Southern Brazil. Journal of Geriatric Psychiatry and Neurology, 22(3), 181–187. https://doi.org/10.1177/0891988709332942

Nitrini, R., Caramelli, P., Herrera, E., Bahia, V. S., Caixeta, L. F., Radanovic, M., Anghinah, R., Charchat-Fichman, H., Porto, C. S., Carthery, M. T., Hartmann, A. P. J., Huang, N., Smid, J., Lima, E. P., Takada, L. T., & Takahashi, D. Y. (2004). Incidence of dementia in a community-dwelling Brazilian population. Alzheimer Disease and Associated Disorders, 18(4), 241–246.

Few studies have examined the associations of various factors with mild cognitive impairment/dementia across different regions in India. This has been summarised in Table 6.4.

Table 6.4.

Associations with MCI/ dementia City/State Study was conducted Description
Gender All states, India The GBD 2019 study provides a state wise prevalence of dementia across India, demonstrating that the prevalence of dementia is consistently higher in females than males (India State-Level Disease Burden Initiative Neurological Disorders Collaborators, 2021)
Hypertension and diabetes Kolkata, West Bengal Community-based study identified risk factors for mild cognitive impairment (MCI) to be hypertension and diabetes mellitus (Das et al., 2007).
Ernakulam, Kerala A univariate analysis done as part of another comparative study showed that hypertension had a significant association with dementia (Lalu et al., 2018).
Obesity New Delhi, Delhi Most participants (68%) with vascular dementia were obese in a study conducted in memory clinic of a tertiary care hospital. The study concluded that obesity is common in persons with vascular dementia and needs to be addressed as it can independently contribute to vascular dementia (Chandra and Anand, 2015).
New Delhi, Delhi A case control study identified higher BMI to be associated with greater risk for dementia (Tripathi et al., 2012).
Hearing Loss Ernakulam, Kerala A univariate analysis as part of a comparative study of risk factors in dementia patients and control group found hearing loss to be a risk factor for dementia (Lalu et al., 2018).
Education (association with dementia shows mixed results) Ernakulam, Kerala A univariate analysis as part of a comparative study of risk factors for dementia patients and a control population found a significant association between dementia and education (Lalu et al., 2018).
Hyderabad, Telangana Examination of cases records of 648 dementia patients showed relationship between dementia and education is context-dependent, influenced by LSES, CVD and bilingualism (Iyer et al., 2014).
Hassan district, Karnataka A higher prevalence of

dementia was found among illiterates (7.4%) (Sumana et al., 2016).

Depression Ludhiana, Punjab Cognitively impaired older adults were found to be 3 times at risk of developing depression and furthermore depression was associated with

cognitive impairment (Sengupta and Benjamin, 2015).

Low socioeconomic status Ludhiana, Punjab Poverty and illiteracy were reported to be associated with cognitive impairment (Sengupta et al., 2014).
Smoking Kolkata, West Bengal

 

Inhaling and chewing of tobacco— was a risk factor among dementia patients when compared to the control population in an epidemiological study of mild cognitive impairment (Das et al., 2007).
Kerala Smoking was identified to be associated with vascular dementia in an epidemiological study of dementia prevalence in rural Kerala (Shaji et al., 1996).
Physical inactivity Ernakulam, Kerala Univariate analysis has demonstrated poor levels of physical activity have been identified as an independent risk factor for dementia (Lalu et al., 2018).

Source: (Das et al., 2007; India State-Level Disease Burden Initiative Neurological Disorders Collaborators, 2021; Iyer et al., 2014; Lalu et al., 2018; Sengupta et al., 2014; Sengupta and Benjamin, 2015; Shaji et al., 1996; Sumana et al., 2016)

In addition, a cross-sectional study of potentially modifiable risk factors for dementia reported less education, hearing impairment, depression, and physical inactivity, in particular, to be associated with increased odds of dementia in India (Belessiotis-Richards et al., 2021).

The risk factors in Table 6.4 are similar to previously identified potentially modifiable risk factors (low education in early life, mid-life hearing loss, mid-life hypertension, mid-life obesity, later-life smoking, later-life depression, later-life physical inactivity, later-life social isolation and later-life diabetes) for dementia, which, if addressed, may delay up to 41% of dementia in India (Mukadam et al., 2019).

References:

Chandra, M., & Anand, K. S. (2015). Obesity in Indian subjects with vascular dementia. International Journal of Advances in Medicine2(2), 147.

Belessiotis-Richards, C., Livingston, G., Marston, L., & Mukadam, N. (2021). A cross-sectional study of potentially modifiable risk factors for dementia and cognitive function in India: A secondary analysis of 10/66, LASI, and SAGE data. International journal of geriatric psychiatry37(2), 10.1002/gps.5661. Advance online publication. https://doi.org/10.1002/gps.5661

Das, S. K., Bose, P., Biswas, A., Dutt, A., Banerjee, T. K., Hazra, A. M., …& Roy, T. (2007). An epidemiologic study of mild cognitive impairment in Kolkata, India. Neurology, 68(23), 2019–2026. https://doi.org/10.1212/01.wnl.0000264424.76759.e6

India State-Level Disease Burden Initiative Neurological Disorders Collaborators (2021). The burden of neurological disorders across the states of India: The Global Burden of Disease Study 1990-2019. The Lancet. Global health, 9(8), e1129–e1144.

Iyer, G. K., Alladi, S., Bak, T. H., Shailaja, M., Mamidipudi, A., Rajan, A., … & Kaul, S. (2014). Dementia in developing countries: Does education play the same role in India as in the West? Dementia & Neuropsychologia, 8(2), 132–140. https://doi.org/10.1590/S1980-57642014DN82000008

Lalu, J. S., Vijayakumar, P., George, S., Nair, A. V., & B., A. (2018). Risk factors of dementia: a comparative study among the geriatric age group in Ernakulam, Southern India. International Journal Of Community Medicine And Public Health, 5(2), 544. https://doi.org/10.18203/2394-6040.ijcmph20180117

Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., … & Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413-446.

Mukadam, N., Sommerlad, A., Huntley, J., & Livingston, G. (2019). Population attributable fractions for risk factors for dementia in low-income and middle-income countries: an analysis using cross-sectional survey data. The Lancet Global Health7(5), e596-e603.

Sengupta, P., & Benjamin, A. I. (2015). Prevalence of depression and associated risk factors among the elderly in urban and rural field practice areas of a tertiary care institution in Ludhiana. Indian journal of public health59(1), 3. https://doi.org/10.4103/0019-557X.152845

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

Shaji, S., Promodu, K., Abraham, T., Roy, K. J., & Verghese, A. (1996). An Epidemiological Study of Dementia in a Rural Community in Kerala, India. British Journal of Psychiatry, 168(6), 745–749. https://doi.org/10.1192/bjp.168.6.745.

Sumana, M., Sreelatha, C.Y., Sreeranga, A., Arpitha,B., Akshatha, S., & Anand, H. (2016). Prevalence of dementia and other psychiatric morbidities among geriatric population of Salagame primary health centre in Hassan district, Karnataka, India. International Journal of Community Medicine and Public Health, 3(5), 1315–1317. https://doi.org/10.18203/2394-6040.ijcmph20161404

Tripathi, M., Vibha, D., Gupta, P., Bhatia, R., Srivastava, M.V.P., Vivekanandhan, S., Bhushan Singh, M., Prasad, K., Dergalust, S., Mendez, M.F. (2012). Risk factors of dementia in North India: a case–control study. Aging Ment. Health 16, 228–235. https://doi.org/10.1080/13607863.2011.583632

The national dementia strategy document mentioned several risk factors which can affect brain health negatively over the life course. These including congenital anomaly, genetics, smoking, alcohol, malnutrition, non-communicable and communicable diseases, metabolic diseases, vascular, and neurological disorders (Ministry of Health Republic of Indonesia, 2015b).

Surveymeter’s study in Bali shows that 47.6% of respondents diagnosed with dementia reported a comorbidity with stroke, followed by 40% with cancer, 38.8% heart disease, and 34.6% hypertension. However, the study did not investigate the association between these possible risk factors with dementia (Suriastini et al., 2018). Other studies in different populations have also reported the association with hypertension (Fitri & Rambe, 2018), diabetes (Kayo et al., 2012), and dyslipidemia (Maryam & Sahar, 2019). Moreover, according to Turana et al., 2019, the highest estimated population-attributable risks are low education, smoking, and physical inactivity (Turana et al., 2019).

References:

Fitri, F. I., & Rambe, A. S. (2018). Correlation between hypertension and cognitive function in elderly. IOP Conference Series: Earth and Environmental Science, 125(1). https://doi.org/10.1088/1755-1315/125/1/012177

Kayo, A. R., Wimala, A. R., Angela, N., & Rashid, I. binti A. (2012). Random blood glucose level as predictor of cognitive impairment in elderly. Universa Medicina, 31(2), 131–138. https://doi.org/10.1805/UnivMed.2012.v31.131-138

Maryam, R. S., & Sahar, J. (2019). Determining factors of dementia in elderly individuals residing in the special capital region of Jakarta. Enfermería Clínica.

Ministry of Health Republic of Indonesia. (2015b). National Strategy: Management of Alzheimer and Other Dementia Diseases: Towards Healthy and Productive Older Persons. Ministry of Health Republic of Indonesia.

Suriastini, Turana, Y., Sukadana, W., Sikoki, B., Witoelar, F., Lesmana, C. B. J., Mulyanto, E. D., Hermoko, R., & Anandari, G. A. A. A. (2018). Menggugah Lahirnya Kebijakan Kelanjutusiaan Menggugah Lahirnya Kebijakan Kelanjutusiaan.

Turana, Y., Tengkawan, J., Suswanti, I., Suharya, D., Riyadina, W., & Pradono, J. (2019). Primary Prevention of Alzheimer’s Disease in Indonesia. International Journal of Aging Research, 1–8. https://doi.org/10.28933/ijoar-2019-06-2506

Increasing age, illiteracy, vascular disease, low-fiber diet, depression, and genetic factors (presence of APOE-𝜀4 allele) have been identified as risk factors for dementia in two reviews on epidemiology of dementia in Sub-Saharan Africa and developing countries (three studies included findings from Kenya) (Kalaria et al., 2008; Olayinka & Mbuyi, 2014). A study conducted in Kenya revealed that there was no evidence between education or vascular factors and dementia status (Chen et al., 2010). According to a systematic analysis for the global burden of disease study involving 195 countries (including Kenya) in 2016, the four main risk identified to have a causal link to Alzheimer’s disease and other dementias are high Body Mass Index (BMI), high fasting plasma glucose, smoking, and high intake of sugar-sweetened beverages (Nichols et al., 2019). More studies are required to confirm inconsistencies in earlier findings.

References:

Chen, C.-H., Mizuno, T., Elston, R., Kariuki, M. M., Hall, K., Unverzagt, F., … Patel, N. B. (2010). A comparative study to screen dementia and APOE genotypes in an ageing East African population. Neurobiology of Aging, 31(5), 732–740. https://doi.org/10.1016/j.neurobiolaging.2008.06.014

Kalaria, R. N., Maestre, G. E., Arizaga, R., Friedland, R. P., Galasko, D., Hall, K., … Potocnik, F. (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

Nichols, E., Szoeke, C. E. I., Vollset, S. E., Abbasi, N., Abd-Allah, F., Abdela, J., … Murray, C. J. L. (2019). Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology, 18(1), 88–106. http://doi.org/10.1016/S1474-4422(18)30403-4

Olayinka, O. O., & Mbuyi, N. N. (2014). Epidemiology of dementia among the elderly in Sub-Saharan Africa. International Journal of Alzheimer’s Disease, 2014. https://doi.org/10.1155/2014/195750

Studies in Mexico have reported diabetes and hypertension as risk factors for dementia (Academia Nacional de Medicina de México, 2017).

References:

Academia Nacional de Medicina de México. (2017). La Enfermedad de Alzheimer y otras demencias como problema nacional de salud. Documento de postura (L. Robledo, Maria. Peña, Paloma. Rojas, & A. Martinez, Eds.; 1a edición). Intersistemas. https://www.anmm.org.mx/publicaciones/ultimas_publicaciones/ANM-ALZHEIMER.pdf

Educational status has been reported as the main preventable risk factor in studies in México (Academia Nacional de Medicina de México, 2017).

References:

Academia Nacional de Medicina de México. (2017). La Enfermedad de Alzheimer y otras demencias como problema nacional de salud. Documento de postura (L. Robledo, Maria. Peña, Paloma. Rojas, & A. Martinez, Eds.; 1a edición). Intersistemas. https://www.anmm.org.mx/publicaciones/ultimas_publicaciones/ANM-ALZHEIMER.pdf

The data is available in Brazil for people aged 25 years and over through the PNAD 2017 (National Household Sample Survey) and shows that 59% of the population have completed primary education in Brazil. However, if we consider the proportion of people that have the primary education as their most advanced level of education, this proportion drops to 8.5% among people aged 25 years and older. There are 12.4% of women and 13.6% of men who completed primary education as their most advanced level of education (PNAD, 2017).  As mentioned previously, a systematic review conducted in 2011 showed that the prevalence of dementia increased with age and was inversely related to the socioeconomic status and number of years of education (Fagundes et al., 2011).

References:

Fagundes, S. D., Silva, M. T., Thees, M. F. R. S., & Pereira, M. G. (2011). Prevalence of dementia among elderly Brazilians: A systematic review. Sao Paulo Medical Journal, 129(1), 46–50. https://doi.org/10.1590/S1516-31802011000100009

PNAD. (2017). PNAD Contínua: Edição 2017. https://agenciadenoticias.ibge.gov.br/media/com_mediaibge/arquivos/05dc6273be644304b520efd585434917.pdf

According to the National Socioeconomic Survey/Survey Sosioekonomi Nasional (Susenas) conducted in March 2018, among the population aged 15 years and older, 32.48% have completed primary school education. In urban areas, the proportion of males in this age group whose highest educational attainment is completion of primary is 19.34%, while it is 20.85% for females. In the rural areas, the proportion of males in this age group with primary school as their highest educational qualification is 33.06%. while it is 31.91% for females (Badan Pusat Statistik, 2019a).

References:

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

In 2015, the gross enrolment ratio (GER) (total enrolment regardless of age which is expressed as a percentage of the population within the official primary school education age) in primary education for Kenya was 109%. GER can exceed 100% because of the inclusion of over-aged and under-aged students related to repeating grade(s) and early or late school entry. In 2012, the net enrolment rate (NER) (ratio of the enrolled official primary school age children to total population of the official primary school age children) was 84.9% (Knoema, 2019c).

References:

Knoema. (2019c). World Data Atlas: World and regional statistics, national data, maps, rankings. https://knoema.com/atlas/Kenya

In 2015, last educational level obtained by individuals 15 years and older show that 15% report completed primary level (INEGI, 2015b).

References:

INEGI. (2015b). Encuesta Intercensal 2015 Estados Unidos Mexicanos. Instituto Nacional de Estadística y Geografía, 1, 85–90. http://internet.contenidos.inegi.org.mx/contenidos/Productos/prod_serv/contenidos/espanol/bvinegi/productos/nueva_estruc/702825078966.pdf

These data are also available in Brazil for people aged 25 years and over through the PNAD 2017 (National Household Sample Survey). Data show that 46.1% of the population completed secondary education in Brazil. However, considering secondary education as one’s most advanced level of education, this amounts to 26.8%. Yet considering these data, there are 30.6% of women in Brazil who have secondary education, while this proportion is 30.2% for men (PNAD, 2017).

References:

PNAD. (2017). PNAD Contínua: Edição 2017. https://agenciadenoticias.ibge.gov.br/media/com_mediaibge/arquivos/05dc6273be644304b520efd585434917.pdf

According to the 2011 Census, the overall literacy rate was reported as 74.04% (65.46% for women and over 80% for men) among the Indian population (Census, of India, 2011).

References:

Census of India. (2011). Literacy in India. Available from: https://www.census2011.co.in/literacy.php

Data from Susenas (March 2018) also states that among those 15 years and older, 21.60%, declare their highest education attainment to be secondary (junior high) school, 13.82% completed senior high school and 5.63% vocational high school. A total of 4.49% have a university degree (including: diploma for 1-3 years education, bachelor’s degree, and postgraduate degrees).

In urban areas, among males in this age group, 20.97% declared junior high school to be their highest educational attainment for males, 27.97% reported senior high school, 8.80% vocational high school, and 12.06% a university degree. For females, these percentages are 20.92%, 24.65%, 5.92%, and 12.35%, respectively. In rural areas, 22.22% of males reported junior high school to be their highest educational attainment. 15.42% completed senior high school, 4,36% vocational high school and 4.16% a university degree. For females, these percentages were 20.98%, 12.22%, 2.61%, and 4.82%, respectively (Badan Pusat Statistik, 2019a).

References:

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

In 2012, the GER in secondary school for Kenya was 67.6% (Knoema, 2019c). Data on NER in secondary school is currently unavailable.

References:

Knoema. (2019c). World Data Atlas: World and regional statistics, national data, maps, rankings. https://knoema.com/atlas/Kenya

 

In 2015, 24% completed secondary school, 22% completed high school[1] (3 years between secondary and undergraduate education), 19% completed graduate/undergraduate education (university, technical colleges, etc.), 6% reported no formal education, and the remaining (14%) reported uncompleted primary or secondary school (some years attended but not graduated/finished) (INEGI, 2015b). On average, population 15 years and older in Mexico have 9.2 years of schooling, which would be equivalent to completing secondary education school and 93.6% of this same age group knows how to read and write (literacy).

[1] Starting in 2018, public compulsory education in Mexico comprises preschool (3 years, starting at age 3), primary education (6 years) and secondary education (3 years). For those 15 years and older at the time of the Inter-Census, compulsory education was comprised of primary (6 years) and secondary (3 years) education.

References:

INEGI. (2015b). Encuesta Intercensal 2015 Estados Unidos Mexicanos. Instituto Nacional de Estadística y Geografía, 1, 85–90. http://internet.contenidos.inegi.org.mx/contenidos/Productos/prod_serv/contenidos/espanol/bvinegi/productos/nueva_estruc/702825078966.pdf

According to the most recent version of the National Health Survey (PNS 2013, in Portuguese), 21.4% of the Brazilian population above 18 years were diagnosed with hypertension. A larger proportion of women (24.2%) self-reported the diagnosis compared with men (18.3%). The proportion of people living with hypertension increased with age reaching a peak of 55.0% among people aged 75 and over, followed by the proportion of 52.7% among those between 65 and 74 years old. Among those 60 and 64 years old 44.4% had a diagnosis of hypertension and among those aged 30 and 59 years it was 20.6%. Hypertension was mostly diagnosed among black people (24.2%) followed by white (22.1%) and mixed race people (20.0%) (Brazilian Ministry of Health, 2013b).

References:

Brazilian Ministry of Health. (2013b). Pesquisa Nacional de Saúde 2013: Percepção do estado de saúde, estilos de vida e doenças crônicas. https://biblioteca.ibge.gov.br/visualizacao/livros/liv91110.pdf

A cross-sectional study examining data (811,917 participants) from the National Family Health Survey 2015-2016 reported that the age adjusted prevalence rate of hypertension was 11.3% in India in persons aged between 15-49 (Ghosh and Kumar, 2019). The study also reported variations in hypertension age-adjusted prevalence across states, ranging from 8.2% in Kerala to 20.3% in Sikkim (Ghosh and Kumar, 2019).

Another study based on a national level survey carried out in 2015 examining blood pressure across 24 states and UTs (180,335 participants had their blood pressure recorded) in India, reported overall prevalence of hypertension as 30.7% (95% CI: 30.5, 30.9) (Ramakrishnan et al., 2019).

References:

Ghosh, S., & Kumar, M. (2019). Prevalence and associated risk factors of hypertension among persons aged 15–49 in India: a cross-sectional study. BMJ open, 9(12), e029714.

Ramakrishnan, S., Zachariah, G., Gupta, K., Rao, J. S., Mohanan, P. P., Venugopal, K., … & Banerjee, S. C. A. (2019). Prevalence of hypertension among Indian adults: results from the great India blood pressure survey. Indian heart journal, 71(4), 309-313.

There are two different estimates of the proportion of the population living with hypertension in Indonesia. One estimate suggests that prevalence of hypertension among people older than 18 years is 8.8% (Riset Kesehatan Dasar (Basic Health Survey). This estimate is based on clinical diagnosis or current use of hypertension medication. The second estimate is based on blood pressure measures taken as part of the survey and suggests a significantly higher proportion (34.1%) (Ministry of Health Republic of Indonesia, 2018). It is important to consider the probability of white-coat hypertension (people exhibiting higher blood pressure than normal when examined in medical settings) in interpreting this data.

References:

Ministry of Health Republic of Indonesia. (2018). Riset Kesehatan Dasar 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan. Available at: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf

According to the Kenya STEPwise Survey for Non-Communicable Diseases Risk Factors 2015 Report, those who had raised blood pressure (defined as having Systolic Blood Pressure (SBP) of >=140 mm Hg and/or diastolic blood pressure (DBP) >=90 mm Hg) was 23.8%. Those with severe hypertension (SBP of >=160 mm Hg and/or DBP >=100 mm Hg) was 8% (MoH-Kenya et al., 2015). Moreover, Kenyans with high blood pressure or on medication revealed a significantly higher prevalence among rural residents (25.3%). Highest prevalence was also seen among the middle-class (about 30%) compared to approximately 20% for individuals in the lowest quintile in terms of socio-economic status.

References:

MoH-Kenya, KNBS, & WHO. (2015). Kenya STEPwise Survey for Non Communicable Diseases Risk Factors 2015 Report. MoH-Kenya. https://www.health.go.ke/wp-content/uploads/2016/04/Executive-summary-6-2.pdf

 

Please refer to Table 12 under part 06.02.13.11.

According to data from Vigitel 2018 (Surveillance System of Risk and Protection Factors for Chronic Diseases by Telephone Survey), 19.8% of adults were obese (with the body mass index greater than or equals to 30Kg/m2). This rate is slightly higher among women (20.7%) than men (18.7%). The proportion of obesity among adults increased with age up to 44 years for men (25.8%) and up to 64 years for women (27.7%). In both sexes, the frequency of obesity decreased with increased education, notably for women (Brazilian Ministry of Health, 2018h).

References:

Brazilian Ministry of Health. (2018h). Vigitel Brasil 2018: Vigilância dos fatores de risco e proteção para doenças crônicas por inquérito telefônico. http://portalarquivos2.saude.gov.br/images/pdf/2019/julho/25/vigitel-brasil-2018.pdf

The  ICMR-INDIAB 2015 study examining prevalence of obesity across 3 states (Tamil Nadu, Maharashtra, Jharkhand) and one UT (Chandigarh) reported obesity and abdominal obesity prevalence in India to vary between 11.8% to 31.3% and 16.9% to 36.3% respectively (Pradeepa et al., 2015). A more recent study (Venkatrao et al., 2021) examining data of around 1 lakh participants from phase 1 of a nationwide randomised cluster survey (Niyantrita Madhumeha Bharata), revealed the overall prevalence of obesity to be 40.3% in India, with wide variations across different regions of the country.

References:

Pradeepa, R., Anjana, R. M., Joshi, S. R., Bhansali, A., Deepa, M., Joshi, P. P., & Group, the I.-I. C. S. (2015). Prevalence of generalized &amp; abdominal obesity in urban &amp; rural India- the ICMR – INDIAB Study (Phase-I) [ICMR – INDIAB-3]. The Indian Journal of Medical Research, 142(2), 139. https://doi.org/10.4103/0971-5916.164234

Venkatrao, M., Nagarathna, R., Majumdar, V., Patil, S. S., Rathi, S., & Nagendra, H. (2021). Prevalence of Obesity in India and Its Neurological Implications: A Multifactor Analysis of a Nationwide Cross-Sectional Study. Annals of Neurosciences, 27(3-4), 153-161. https://doi.org/10.1177/0972753120987465

 

Approximately 21.8% of the Indonesian population is considered to be obese. Obesity was defined as a Body Mass Index of 27.0 or higher (Ministry of Health Republic of Indonesia, 2018).

References:

Ministry of Health Republic of Indonesia. (2018). Riset Kesehatan Dasar 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan. Available at: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf

According to the 2014 Kenya Demographic and Health Survey (2014 KDHS), 33% of women are either overweight or obese with 10% of them being obese (Obudho et al., 2015). The focus is mostly on women and children under five with no focus on the older person or men. More recent (2016) reveal an adult prevalence rate of obesity at 7.1% (Index Mundi, 2019c).

References:

Index Mundi. (2019c). Kenya Obesity – adult prevalence rate. https://www.indexmundi.com/kenya/demographics_profile.html

Obudho, M., Munguti, J. N., Bore, J. K., & Kakinyi, M. (2015). Kenya Demographic and Health Survey 2014. Nairobi, Kenya. https://dhsprogram.com/pubs/pdf/fr308/fr308.pdf

Please refer to Table 12 under part 06.02.13.11.

Data from the PNS 2013 revealed that 1.1% of the population in Brazil experienced hearing loss. Regarding sex, this proportion was 1.0% among women and 1.2% among men. In the urban population, hearing loss was 1.1% while it was 1.4% among the rural population. The proportion among white people was 1.4%, while among black and mixed-race people it was 0.9%, for both groups. Hearing loss was more frequent among people aged 60 years and over (5.2%), compared with other age groups: 0-9 years (0.1%), 10-17 years (0.3%), 18-29 years (0.3%), 30-39 years (0.4%), 40-59 years (1.0%) (Brazilian Institute of Geography and Statistics, 2015a).

References:

Brazilian Institute of Geography and Statistics (Ed.). (2015a). Pesquisa nacional de saúde, 2013: Ciclos de vida: Brasil e grandes regiões. Instituto Brasileiro de Geografia e Estatística – IBGE.

As per the WHO estimates, it is estimated that around 63 million (6.3%) people have significant auditory impairment in India (Garg et al., 2009).

References:

Garg, S., Chadha, S., Malhotra, S., & Agarwal, A. K. (2009). Deafness: Burden, prevention and control in India. Natl Med J India22(2), 79-81.

According to a WHO report from 2000, the estimated prevalence of ‘adult onset hearing loss for adults aged 15 years and’ older was 7.1 for adults aged 41 and older, 1.4 for people aged 61 and older and 0.1 for people aged 81 and older (Mathers et al., 2000, p.8).

References:

Mathers, C., Smith, A. & Concha, M. (2000). Global burden of hearing loss in the year 2000, Geneva: World Health Organization. https://www.who.int/healthinfo/statistics/bod_hearingloss.pdf

Hearing impairment was the third most frequently mentioned disability (10.4%) for those aged below 21 years (Republic of Kenya, 2014b). According to the 2009 census, 28% of individuals with disability were deaf and by 2016 this number had doubled (Chacha, 2016).

References:

Chacha, G. (2016). Reaching out to heal Kenya’s deaf, 9 November. Standard Media. Nairobi, Kenya. https://www.standardmedia.co.ke/wednesday-life/article/2000222734/reaching-out-to-heal-kenyas-deaf

Republic of Kenya. (2014b). Kenya National Special Needs Education Survey Report. Nairobi, Kenya. https://www.vsointernational.org/sites/default/files/SNE%20Report_Full%20-2.pdf

Disability data from the 2010 Census (INEGI, 2010b) estimates that a total of 4,527,784 individuals (4% of the total population) live with some physical or mental limitation[1]. Of this total, 498,640 report difficulty to hear even when using a hearing aid or are deaf. Regarding older adults, data from the National Health and Nutrition Survey 2012 (Gutiérrez-Robledo et al., 2012) show that 11.3% of individuals 60 years and older report hearing limitations even when using a hearing aid or are deaf. Among those, 4.9% are aged 60-69, 11.8% are 70-79 years old and 31.4% are 80 years of age and older.

[1] Since 2000 INEGi is part of the Washington Group on Disability and includes in its Census and many national surveys the Groups’ questions on disability. The term used in the Census is “limitacion con/para…” “Limitation with or to do…”

References:

Gutiérrez-Robledo, L. M., Téllez-Rojo, M. M., Espinoza-Manrique, B., Castillo-Acosta, I., López-Ortega, M., Rodríguez-Salinas, A., & Ortiz-Sosa, A. L. (2012). Evidencia para la política pública en salud. Discapacidad y dependencia en adultos mayores mexicanos : un curso sano para una vejez plena. https://ensanut.insp.mx/encuestas/ensanut2012/doctos/analiticos/DiscapacidAdultMayor.pdf

INEGI. (2010b). Principales resultados del Censo de Población y Vivienda 2010. In Principales resultados del Censo de Población y Vivienda 2010. (Vol. 1).

According to the most recent version of the National Health Survey (PNS 2013, in Portuguese), 14.7% of the population smoked in 2013, with 12.7% smoking daily. The prevalence among men was 16.2% and among women was 9.7%. The proportion of those who consumed tobacco (smoked or not) was 15%. A larger proportion of men than women consumed tobacco (19.2% versus 11.2%). People within the age group 40-59 represented higher proportion of tobacco users (19.4%), followed by those aged 60 years and over (13.3%) (Brazilian Ministry of Health, 2013b).

References:

Brazilian Ministry of Health. (2013b). Pesquisa Nacional de Saúde 2013: Percepção do estado de saúde, estilos de vida e doenças crônicas. https://biblioteca.ibge.gov.br/visualizacao/livros/liv91110.pdf

As per the Global Adult Tobacco Survey 2016-2017 in India, 28.6% of all adults (15 and above) are tobacco users (National Health Mission, n.d.).

References:

National Health Mission (n.d.). Global Adult Tobacco Survey 2 Highlights India 2016-2017. Government of India. Available from: https://nhm.gov.in/NTCP/Surveys-Reports-Publications/GATS-2-Highlights-(National-level).pdf

The Basic Health Survey 2018 reported that 33.8% of the population over 15 years old consumed tobacco (smoked or chewed). This report did not state the overall proportion of tobacco smokers. However, another source suggests that approximately 9.1% of persons aged 10-18 years old are active smokers (Ministry of Health Republic of Indonesia, 2018).

References:

Ministry of Health Republic of Indonesia. (2018). Riset Kesehatan Dasar 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan. Available at: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf

The rapid situation assessment of the status of drug and substance abuse in Kenya in 2012 revealed that 11% all the sampled respondents (15 – 65 years) were currently smokers (National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA), 2017). In 2019 it was found that  3.2% of primary school attending children smoked (National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA) and Kenya Institute For Public Policy Research And Analysis (KIPPRA), 2019). Overall, 10.1% of Kenyans use smoke, using products that include manufactured cigarettes, hand rolled cigarettes, pipes, and shisha (MoH-Kenya et al., 2015).

References:

MoH-Kenya, KNBS, & WHO. (2015). Kenya STEPwise Survey for Non Communicable Diseases Risk Factors 2015 Report. MoH-Kenya. https://www.health.go.ke/wp-content/uploads/2016/04/Executive-summary-6-2.pdf

National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA). (2017). The rapid situation assessment of the status of drug and substance abuse in Kenya, 2012. Nairobi, Kenya. https://www.nacada.go.ke/sites/default/files/2019-10/National%20ADA%20Survey%20Report%202017_2_2.pdf

National Authority for the Campaign Against Alcohol and Drug Abuse (NACADA) and Kenya Institute For Public Policy Research And Analysis (KIPPRA). (2019). Status of Drugs and Substance Abuse among Primary School Pupils in Kenya. Nairobi, Kenya. https://nacada.go.ke/sites/default/files/2019-10/Report%20on%20the%20Status%20of%20Drugs%20and%20Substance%20Abuse%20among%20Primary%20School%20Pupils%20in%20Kenya.pdf

Please refer to Table 12 under part 06.02.13.11.

Estimates from the WHO showed that, in 2015, 5.8% of the Brazilian population lived with depressive disorders (World Health Organization, 2017). According to the National Health Survey (PNS, 2013), 7.6% of Brazilians aged 18 years and over have been diagnosed with depression. The higher prevalence data were among urban areas (8.0% vs 5.6% in rural), women (10.9% vs 3.9% in men), and people aged 60 to 64 years old (11.1% vs 3.9% among those 19 and 28 years old) (Brazilian Ministry of Health, 2013b).

References:

Brazilian Ministry of Health. (2013b). Pesquisa Nacional de Saúde 2013: Percepção do estado de saúde, estilos de vida e doenças crônicas. https://biblioteca.ibge.gov.br/visualizacao/livros/liv91110.pdf

World Health Organization. (2017). Depression and Other Common Mental Disorders: Global Health Estimates. https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf;jsessionid=F9B8AE77F2B1D3698E01577B2AFCBC03?sequence=1

The National Mental Health Survey 2015-2016 conducted by the National Institute of Mental Health and Neurosciences (NIMHANS) reports that the ICD – 10 DCR prevalence of depressive disorders is 5.1% (lifetime) and 2.7% (current) among adults of over 18 years of age in India (National Institute of Mental Health and Neurosciences [NIMHANS], 2016).

References:

National Institute of Mental Health and Neurosciences. (2016). National Mental Health Survey of India, 2015-2016: Prevalence, Patterns and Outcomes. National Institute of Mental Health and Neurosciences. Available from http://indianmhs.nimhans.ac.in/Docs/Report2.pdf

The Basic Health Survey 2018 reported that 6.1% of the population live with depression. This prevalence estimate is based on an assessment with the Mini International Neuropsychiatric Interview. No information was found on the number of people getting an official diagnosis among this group. However, only 9% of them get medical treatment (Ministry of Health Republic of Indonesia, 2018).

References:

Ministry of Health Republic of Indonesia. (2018). Riset Kesehatan Dasar 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan. Available at: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf

In the recent past, statistics by the WHO ranked Kenya on place eight (4.4%) in the international comparison of countries with the highest number of people (1,952,981) with depression (World Health Organization, 2017a). However, regional studies reveal that 19% to 25% of patients attending primary care settings or seeking care from community health providers, such as traditional healers, faith healers, and community health workers have depression (Musyimi et al., 2018; Musyimi et al., 2017; Mutiso et al., 2018).

References:

Musyimi, C. W., Mutiso, V. N., Haji, Z. R., Nandoya, E. S., & Ndetei, D. M. (2018). Mobile Based mhGAP-IG Depression Screening in Kenya. Community Mental Health Journal, 54(1), 84–91. http://doi.org/10.1007/s10597-016-0072-9

Musyimi, C. W., Mutiso, V. N., Musau, A. M., Matoke, L. K., & Ndetei, D. M. (2017). Prevalence and determinants of depression among patients under the care of traditional health practitioners in a Kenyan setting: policy implications. Transcultural Psychiatry, 54(3), 285–303. https://doi.org/10.1177/1363461517705590

Mutiso, V. N., Musyimi, C. W., Tomita, A., Loeffen, L., Burns, J. K., & Ndetei, D. M. (2018). Epidemiological patterns of mental disorders and stigma in a community household survey in urban slum and rural settings in Kenya. International Journal of Social Psychiatry, 64(2), 120–129. https://doi.org/10.1177/0020764017748180

World Health Organization. (2017a). Depression and Other Common Mental Disorders: Global Health Estimates. Geneva, Switzerland. https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf?sequence=1&isAllowed=y

Data from the ENSANUT 2012 survey (Instituto Nacional de Salud Pública, 2012), taking a cut-off point of 7≥9 of the Center of Epidemiological Studies of Depression Scale (CES–D) (Radloff, 1977), shows that the prevalence of clinically significant depressive symptoms is estimated at 22.7% (95% CI 16.5-28.9) of women and 8.3% (95% CI 3.3-13.2) of men. Looking at these data by age group, it shows that 14.7% (95% CI 10.3-19.1) adults aged 20-59 years, and 26.8% (95% CI 15.2-38.4%) adults aged 60 years and older experience clinically significant symptoms of depression (Salinas-Rodríguez et al., 2013).

References:

Instituto Nacional de Salud Pública. (2012). Encuesta Nacional de Salud y Nutrición 2012. Resultados nacionales. https://ensanut.insp.mx/encuestas/ensanut2012/doctos/informes/ENSANUT2012ResultadosNacionales.pdf

Radloff, L. S. (1977). The CES-D Scale. Applied Psychological Measurement, 1(3), 385–401. https://doi.org/10.1177/014662167700100306

Salinas-Rodríguez, A., En, M. C., Manrique-Espinoza, B., En, D. C., Acosta-Castillo, I., Ma Téllez-Rojo, M., Franco-Núñez, A., Miguel Gutiérrez-Robledo, L., En, D. C., & Luisa Sosa-Ortiz, A. (2013). Validación de un punto de corte para la Escala de Depresión del Centro de Estudios Epidemiológicos, versión abreviada (CESD-7). Salud Pública de México, 55(3), 267–274. http://saludpublica.mx/index.php/spm/article/viewFile/7209/9386

According to the most recent version of the National Health Survey (PNS 2013, in Portuguese), 46.0% of the Brazilian population above 18 years were physically inactive (‘physically inactive’ defined as people who did not practice physical activity or who did practice it for less than 150 minutes per week, considering three domains: leisure, work, and commuting). Among people aged 60 and over, the proportion was 62.7%. In general, women showed higher proportions than men, varying from 50.3% in the Southern region to 53.4% in the Northern region. White people were more likely to be inactive (47.9%), compared to black (42.4%), and mixed race people (44.8%) (Brazilian Ministry of Health, 2013b).

References:

Brazilian Ministry of Health. (2013b). Pesquisa Nacional de Saúde 2013: Percepção do estado de saúde, estilos de vida e doenças crônicas. https://biblioteca.ibge.gov.br/visualizacao/livros/liv91110.pdf

According to an ICMR-INDIAB study (Anjana et al., 2014), physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ) in 14,227 individuals aged above 20 years across 4 parts of India – Tamil Nadu, Maharashtra, Jharkhand, and Chandigarh, representing the south, west, east, and north of India, respectively. In this study, of the 14,227 individuals studied, 54.4% (n = 7,737) were found to be inactive (Anjana et al., 2014). A more recent study analysed data of around 2 lakh individuals from the Niyantrita Madhumeha Bharata 2017 randomised cluster survey and reported that 20% of the sample were physically inactive (Podder et al., 2020).

References:

Anjana, R. M., Pradeepa, R., Das, A. K., Deepa, M., Bhansali, A., Joshi, S. R., … & Subashini, R. (2014). Physical activity and inactivity patterns in India–results from the ICMR-INDIAB study (Phase-1) [ICMR-INDIAB-5]. International Journal of Behavioral Nutrition and Physical Activity, 11(1), 26. https://doi.org/10.1186/1479-5868-11-26

Podder, V., Nagarathna, R., Anand, A., Patil, S. S., Singh, A. K., & Nagendra, H. R. (2020). Physical activity patterns in India stratified by zones, age, region, BMI, and implications for COVID-19: a nationwide study. Annals of Neurosciences27(3-4), 193-203. https://doi.org/10.1177/0972753121998507

It is estimated that 33.5% of the national population were categorised as physically inactive (defined as a cumulative physical activities less than 150 minutes per week) (Ministry of Health Republic of Indonesia, 2018).

References:

Ministry of Health Republic of Indonesia. (2018). Riset Kesehatan Dasar 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan. Available at: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf

 

Based on the global report on physical activity that was released by the World Health Organization (WHO) in 2018, 15.4% (13.9% for males and 16.8% for females) of adult Kenyans are not as active as per the recommended 150 minutes of moderate or 75 minutes of vigorous physical activity by WHO (Guthold et al., 2018).

References:

Guthold, R., Stevens, G. A., Riley, L. M., & Bull, F. C. (2018). Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1· 9 million participants. The Lancet Global Health, 6(10), e1077–e1086. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30357-7/fulltext

While it is widely acknowledged that the Mexican population in general is not very physically active, not much data is available to confirm this. Since 2013, INEGI started to collect data through the Sport and Physical Activity Module[1] (MOPRADEF) and in 2017 it was approved as a key indicator in the design and evaluation of public policies and is now part of INEGI’s National Catalogue of Indicators. The latest report from MOPRADEF in 2017 (INEGI, 2018c) shows that only 42.4% of population 18 years and older practices some sport in their spare time or is physically active[2], showing a slight decrease since 2013 (45.4%) when data was first gathered. Men reported being more active (49.8%) than women (36.0%) and as age increases, people reported being less physically active.

[1] Módulo de Práctica Deportiva y Ejercicio Físico MOPRADEF; http://www.beta.inegi.org.mx/proyectos/enchogares/modulos/mopradef/default.html

[2] Sufficient physical-sport activity was defined as practicing some sport or physical activity at least three times a week, accumulating at least 75 minutes of vigorous or 150 minutes of moderate intensity per week.

References:

INEGI. (2018c). Módulo de Práctica Deportiva y Ejercicio Físico. https://www.inegi.org.mx/contenidos/programas/mopradef/doc/resultados_mopradef_nov_2018.pdf

According to the most recent version of the National Health Survey (PNS 2013, in Portuguese), 6.2% of the Brazilian population above 18 years old were diagnosed with diabetes. The proportion was higher in women (7.0%) than in men (5.4%) and increased with age from 0.6% in the age group 18-29 years to 19.9% among people aged 64 and 75 years old. For those over 75 years old, the proportion of diagnosed diabetes was 19.6%. There was no significant difference among ethnic groups: black people (7.2%), white (6.7%) and mixed race (5.5%). The lower the educational level, the higher the proportion of diabetes (9.6% among people with less than 4 years of formal education) (Brazilian Ministry of Health, 2013b).

References:

Brazilian Ministry of Health. (2013b). Pesquisa Nacional de Saúde 2013: Percepção do estado de saúde, estilos de vida e doenças crônicas. https://biblioteca.ibge.gov.br/visualizacao/livros/liv91110.pdf

The ICMR – INDIAB study reported that the overall prevalence of diabetes in all 15 states of India was 7.3% in 2015 (95% CI 7.0–7.5) (Anjana et al., 2017). The more recent National Diabetes and Diabetic Retinopathy Survey of India 2015-2019 reported the prevalence of diabetes in surveyed population (63,000 aged 50 and above in 21 districts) to be 11.8% (All India Institute of Medical Sciences (AIIMS, 2019)).

References:

All India Institute of Medical Sciences. National Diabetes and Diabetic Retinopathy Survey of India 2015-2019. n.d. National Program for Control of Blindness and Visual Impairment, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India. Available from: https://npcbvi.gov.in/writeReadData/mainlinkFile/File342.pdf

Anjana, R. M., Deepa, M., Pradeepa, R., Mahanta, J., Narain, K., Das, H. K., …. Bhansali, A. (2017). Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR–INDIAB population-based cross-sectional study. The lancet Diabetes & endocrinology, 5(8), 585-596. https://doi.org/10.1016/S2213-8587(17)30174-2

According to the Riset Kesehatan Dasar (Basic Health Survey) 2018 the prevalence of diabetes in people older than 15 years in Indonesia is 2%. This estimated prevalence is based on the existence of clinical diagnosis. However, a blood test-based diagnosis suggested a higher proportion (10.9%) (Ministry of Health Republic of Indonesia, 2018).

References:

Ministry of Health Republic of Indonesia. (2018). Riset Kesehatan Dasar 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan. Available at: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf

As of 2017, 2% (458,900 individuals) of Kenya’s total adult population (estimated at 23,147,000) had diabetes (International Diabetes Federation (IDF), 2017). This is likely to be an underestimation since 60% of people diagnosed with diabetes seek primary health care services for unrelated problems because they are not cognizant that they have the disease (Republic of Kenya, 2015a).

References:

International Diabetes Federation (IDF). (2017). IDF Diabetes Atlas – 8th Edition. https://diabetesatlas.org/upload/resources/previous/files/8/IDF_DA_8e-EN-final.pdf

Republic of Kenya. (2015a). Kenya National Strategy for the Prevention and Control of Non-Communicable Diseases 2015-2020. Nairobi, Kenya. https://www.who.int/nmh/ncd-task-force/kenya-strategy-ncds-2015-2020.pdf

Please refer to Table 12 below under part 06.02.13.11.

The proportion of the population aged 18 years and over who consumed alcohol at least once a week in 2013 was 24.0%. Among men, this proportion was 36.3% and among women it was 13.0%. Besides, 30.5 % of people with university degree consumed alcohol compared with 19.0% of people with less than 4 years of education. Among age groups, those aged 18-24 years represented 27.1% of the population consuming alcohol, people between 25-39 years old accounted for 28.5%, those between 40 and 59 years old for 23.4% and those with 60 years and older represented 14.2% (Brazilian Ministry of Health, 2013b).

References:

Brazilian Ministry of Health. (2013b). Pesquisa Nacional de Saúde 2013: Percepção do estado de saúde, estilos de vida e doenças crônicas. https://biblioteca.ibge.gov.br/visualizacao/livros/liv91110.pdf

According to the World Health Organisation’s Global Health Observatory, the amount of alcohol consumed per capita (15+) in India in 2018 was 3.09 litres (World Health Organization, 2018).

References:

World Health Organization. 2018. Global Health Observatory-Alcohol recorded per capita (15+) consumption (in litres of pure alcohol). World Health Organization. Available from: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/alcohol-recorded-per-capita-(15-)-consumption-(in-litres-of-pure-alcohol)

No data was found regarding the amount of alcohol consumed per capita.

An estimated 3.3% of the population aged 10 and over were reported to consume alcoholic drinks, although only 0.8% were reported to be heavy drinkers (Ministry of Health Republic of Indonesia, 2018).

References:

Ministry of Health Republic of Indonesia. (2018). Riset Kesehatan Dasar 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan. Available at: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf

Kenyans (aged 15 years and above) who are current drinkers for the past one year consume 3.4 litres (5.9 and 0.9 for males and females respectively) of alcohol per capita revealing a higher consumption of alcohol among men compared to women (World Health Organization (WHO), 2018).

References:

World Health Organization (WHO). (2018). Global status report on alcohol and health 2018. Geneva, Switzerland. https://apps.who.int/iris/bitstream/handle/10665/274603/9789241565639-eng.pdf?sequence=1&isAllowed=y

 

According to data reported by the OECD (OECD, 2016a), the number of litres of alcohol consumed per capita by individuals 15 years and older in Mexico was 4.0 in 2014 and 4.4 in 2016.

References:

OECD. (2016a). OECD iLibrary | Alcohol consumption. https://www.oecd-ilibrary.org/social-issues-migration-health/alcohol-consumption/indicator/english_e6895909-en

The PNS 2013 showed that 12.5% of people aged 18 years and over were diagnosed with high cholesterol. The estimated proportion in urban areas was 13.0%, while in rural areas it was 10.0%. The proportion was higher among women (15.1%) than men (9.7%). The frequency of people who referred diagnosis of high cholesterol was more representative in the older age groups: 25.9% among those aged 60 to 64 years, 25.5% among people aged 65 to 74 years, and 20.3% between those aged 75 years and older. The proportion of white people who reported altered cholesterol (13.4%) was higher than for black (11.2%) and mixed race (11.8%) people (Brazilian Ministry of Health, 2013b).

References:

Brazilian Ministry of Health. (2013b). Pesquisa Nacional de Saúde 2013: Percepção do estado de saúde, estilos de vida e doenças crônicas. https://biblioteca.ibge.gov.br/visualizacao/livros/liv91110.pdf

A review of population-based studies in India had reported that high cholesterol is prevalent in 25-30% and 15-20% of urban and rural residents, respectively (Gupta et al., 2017).

References:

Gupta, R., Rao, R. S., Misra, A., & Sharma, S. K. (2017). Recent trends in epidemiology of dyslipidemias in India. Indian heart journal, 69(3), 382-392.

The most recent data on cholesterol levels in the national population aged 15 and over is available from the Riskesdas 2018. High total cholesterol (> 240 mg/dL) was found in 7.6% of the population and borderline results (200-239 mg/dL) were found in 21.2% (Ministry of Health Republic of Indonesia, 2018).

References:

Ministry of Health Republic of Indonesia. (2018). Riset Kesehatan Dasar 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan. Available at: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf

The Kenya STEPwise Survey for Non-Communicable Diseases Risk Factors 2015 Report revealed that about 98% of Kenyans had never had their cholesterol levels measured. Out of those that had been measured, only 13.3% who reported to have been diagnosed with elevated cholesterol levels were on medication. 10% of the respondents had either cholesterol ≥ 5.0 mmol/L or currently on medication for raised cholesterol (MoH-Kenya et al., 2015).

References:

MoH-Kenya, KNBS, & WHO. (2015). Kenya STEPwise Survey for Non Communicable Diseases Risk Factors 2015 Report. MoH-Kenya. https://www.health.go.ke/wp-content/uploads/2016/04/Executive-summary-6-2.pdf

 

 

Please refer to Table 12 below.

Table 12. Prevalence of risk factors in adults 20 years of age or older, by sex and age groups. Mexico

  20-39 40-59 >60 Total
Hypertension
Men 20.2 25.8 43.7 25.11
Women 19.8 38.6 48.3 30.0
Total 20.0 32.3 46.1 27.6
Obesity or overweight (total)
Men 19.6 23.8 31.7 23.3
Women 24.6 37.2 24.9 29.0
Total 22.3 30.9 27.3 26.4
Diabetes
Men 13.7 27.8 44.3 23.0
Women 19.0 46.1 53.7 33.8
Total 16.5 37.8 49.5 28.9
High cholesterol
Men 16.2 42.3 52.2 32.3
Women 19.9 50.2 58.4 38.2
Total 18.2 46.5 55.7 35.5
Smokes*
Men 45.8 42.0 19.7 39.8
Women 25.5 19.3 10.3 20.3
Total 34.8 30.0 14.4 29.3
Alcohol**
Men 44.1 33.0 26.9 36.9
Women 17.0 9.2 4.0 11.8
Total 29.4 20.4 14.2 23.3

Source: ENSANUT, 2012 (Instituto Nacional de Salud Pública, 2012). *Percentage of population aged 20 and over who smoke

**Has been intoxicated with alcohol at least once in the past month.

References:

Instituto Nacional de Salud Pública. (2012). Encuesta Nacional de Salud y Nutrición 2012. Resultados nacionales. https://ensanut.insp.mx/encuestas/ensanut2012/doctos/informes/ENSANUT2012ResultadosNacionales.pdf