title: Prevalence of stroke and related burden among older people living in Latin America, India and China.
abstract: OBJECTIVE
  Despite the growing importance of stroke in developing countries, little is known of stroke burden in survivors. The authors investigated the prevalence of self-reported stroke, stroke-related disability, dependence and care-giver strain in Latin America (LA), China and India.
  
  
  METHODS
  Cross-sectional surveys were conducted on individuals aged 65+ (n=15 022) living in specified catchment areas. Self-reported stroke diagnosis, disability, care needs and care giver burden were assessed using a standardised protocol. For those reporting stroke, the correlates of disability, dependence and care-giver burden were estimated at each site using Poisson or linear regression, and combined meta-analytically.
  
  
  RESULTS
  The prevalence of self-reported stroke ranged between 6% and 9% across most LA sites and urban China, but was much lower in urban India (1.9%), and in rural sites in India (1.1%), China (1.6%) and Peru (2.7%). The proportion of stroke survivors needing care varied between 20% and 39% in LA sites but was higher in rural China (44%), urban China (54%) and rural India (73%). Comorbid dementia and depression were the main correlates of disability and dependence.
  
  
  CONCLUSIONS
  The prevalence of stroke in urban LA and Chinese sites is nearly as high as in industrialised countries. High levels of disability and dependence in the other mainly rural and less-developed sites suggest underascertainment of less severe cases as one likely explanation for the lower prevalence in those settings. As the health transition proceeds, a further increase in numbers of older stroke survivors is to be anticipated. In addition to prevention, stroke rehabilitation and long-term care needs should be addressed.
authors.affiliation: King’s College London (Institute of Psychiatry), Health Service and Population Research Department, Section of Epidemiology, London, UK. cleusa.ferri@kcl.ac.uk
authors.forename: Cleusa P
authors.initials: CP
authors.lastname: Ferri
authors.forename: Claudia
authors.initials: C
authors.lastname: Schoenborn
authors.forename: Lalit
authors.initials: L
authors.lastname: Kalra
authors.forename: Daisy
authors.initials: D
authors.lastname: Acosta
authors.forename: Mariella
authors.initials: M
authors.lastname: Guerra
authors.forename: Yueqin
authors.initials: Y
authors.lastname: Huang
authors.forename: K S
authors.initials: KS
authors.lastname: Jacob
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Llibre Rodriguez
authors.forename: Aquiles
authors.initials: A
authors.lastname: Salas
authors.forename: Ana Luisa
authors.initials: AL
authors.lastname: Sosa
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Williams
authors.forename: Zhaorui
authors.initials: Z
authors.lastname: Liu
authors.forename: Tais
authors.initials: T
authors.lastname: Moriyama
authors.forename: Adolfo
authors.initials: A
authors.lastname: Valhuerdi
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Prince
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data*; D002681:China; D015897:Comorbidity; D017281:Cost of Illness; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology; D003906:Developing Countries; D004185:Disability Evaluation; D005260:Female; D005544:Forecasting; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D007194:India; D007843:Latin America; D008297:Male; D008875:Middle Aged; D011157:Population Dynamics; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D014505:Urban Population / Q000706:statistics & numerical data