Estimate of dementia prevalence in a community sample from São Paulo, Brazil.
OBJECTIVE
To estimate dementia prevalence and describe the etiology of dementia in a community sample from the city of São Paulo, Brazil.


METHODS
A sample of subjects older than 60 years was screened for dementia in the first phase. During the second phase, the diagnostic workup included a structured interview, physical and neurological examination, laboratory exams, a brain scan, and DSM-IV criteria diagnosis.


RESULTS
Mean age was 71.5 years (n = 1,563) and 58.3% had up to 4 years of schooling (68.7% female). Dementia was diagnosed in 107 subjects with an observed prevalence of 6.8%. The estimate of dementia prevalence was 12.9%, considering design effect, nonresponse during the community phase, and positive and negative predictive values. Alzheimer's disease was the most frequent cause of dementia (59.8%), followed by vascular dementia (15.9%). Older age and illiteracy were significantly associated with dementia.


CONCLUSIONS
The estimate of dementia prevalence was higher than previously reported in Brazil, with Alzheimer's disease and vascular dementia being the most frequent causes of dementia. Dementia prevalence in Brazil and in other Latin American countries should be addressed by additional studies to confirm these higher dementia rates which might have a sizable impact on countries' health services.
Old Age Research Group (PROTER), Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil. cbottino@usp.br
Cássio M C
CM
Bottino
Dionisio
D
Azevedo
Mariana
M
Tatsch
Sergio R
SR
Hototian
Marco A
MA
Moscoso
Jefferson
J
Folquitto
Andreia Z
AZ
Scalco
Mario C
MC
Bazzarella
Marcos A
MA
Lopes
Julio
J
Litvoc
D000367:Age Factors; D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology / Q000523:psychology; D001921:Brain / Q000000981:diagnostic imaging; D001938:Brazil / Q000453:epidemiology; D016000:Cluster Analysis; D003704:Dementia / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000523:psychology; D015140:Dementia, Vascular / Q000453:epidemiology / Q000523:psychology; D004493:Education; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011877:Radionuclide Imaging; D012044:Regression Analysis; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors