Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors.
Despite mortality due to communicable diseases, poverty, and human conflicts, dementia incidence is destined to increase in the developing world in tandem with the ageing population. Current data from developing countries suggest that age-adjusted dementia prevalence estimates in 65 year olds are high (>or=5%) in certain Asian and Latin American countries, but consistently low (1-3%) in India and sub-Saharan Africa; Alzheimer's disease accounts for 60% whereas vascular dementia accounts for approximately 30% of the prevalence. Early-onset familial forms of dementia with single-gene defects occur in Latin America, Asia, and Africa. Illiteracy remains a risk factor for dementia. The APOE epsilon4 allele does not influence dementia progression in sub-Saharan Africans. Vascular factors, such as hypertension and type 2 diabetes, are likely to increase the burden of dementia. Use of traditional diets and medicinal plant extracts might aid prevention and treatment. Dementia costs in developing countries are estimated to be US$73 billion yearly, but care demands social protection, which seems scarce in these regions.
Kalaria
Raj N
RN
Institute for Ageing and Health, Newcastle General Hospital, Newcastle upon Tyne, UK. r.n.kalaria@ncl.ac.uk
Maestre
Gladys E
GE
Arizaga
Raul
R
Friedland
Robert P
RP
Galasko
Doug
D
Hall
Kathleen
K
Luchsinger
José A
JA
Ogunniyi
Adesola
A
Perry
Elaine K
EK
Potocnik
Felix
F
Prince
Martin
M
Stewart
Robert
R
Wimo
Anders
A
Zhang
Zhen-Xin
ZX
Antuono
Piero
P
D000368:Aged; D000544:Alzheimer Disease / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D053327:Apolipoprotein E4 / Q000235:genetics; D015897:Comorbidity; D015140:Dementia, Vascular / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D003906:Developing Countries / Q000706:statistics & numerical data*; D020022:Genetic Predisposition to Disease; D006801:Humans; D015994:Incidence; D011157:Population Dynamics; D015995:Prevalence; D012307:Risk Factors
D053327:Apolipoprotein E4