title: Impacts of Illiteracy on the Risk of Dementia: A Global Health Perspective.
abstract: Despite its significance as a contributing factor for late-life dementia risk, illiteracy is frequently underappreciated in the management of dementia. In this study, we estimated the proportion of dementia cases attributable to illiteracy using the population attributable fraction (PAF), and calculated to what extent the monetary cost of dementia could be saved in the future by reducing illiteracy from the South Korean, Latin American, South Asian/Middle Eastern, and African populations. We collected necessary data from the 2011 United Nations Human Development Report and prevalence studies conducted in these regions. Additional variables not included in the above sources were estimated using a logit model under a "trend scenario"-based assumption. Around 16% of the total number of dementia cases in South Korea in 2015 can be attributed to illiteracy, with this figure predicted to decline to around 2% by 2050. This translates to a saving in dementia care costs of approximately 52 billion USD, providing we are successful in theoretically eradicating illiteracy as of 2015, in the population aged 65 years or under. Likewise, reducing illiteracy to 50% in Latin America, South Asia/The Middle East, and Africa by 2050 could generate further cost savings of between 71 and 244 billion, 13 and 94 billion, and 17 and 78 billion USD, respectively. Even public policies aimed solely at reducing illiteracy in the childhood, adolescent, or middle-aged population could potentially have a role in the primary prevention of dementia. Moving forward, governments will need to address this issue in a purposeful and systematic manner.
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.
authors.forename: Seung Wan
authors.initials: SW
authors.lastname: Suh
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Han
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Park
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Hong
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Kayoung
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Taehyun
authors.initials: T
authors.lastname: Kim
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Kyoung Hwan
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Guehee
authors.initials: G
authors.lastname: Han
authors.affiliation: Department of Psychiatry, Woori-Seongsim Psychiatric Clinic, Siheung, Korea.
authors.forename: Hyeon
authors.initials: H
authors.lastname: Jeong
authors.affiliation: Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Korea.
authors.forename: Jiyeong
authors.initials: J
authors.lastname: Seo
authors.affiliation: Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea.
authors.forename: Tae Hui
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.|Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Korea.
authors.forename: Dong Young
authors.initials: DY
authors.lastname: Lee
authors.affiliation: Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, Korea.
authors.forename: Dong Woo
authors.initials: DW
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Ryu
authors.affiliation: Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Shin-Gyeom
authors.initials: SG
authors.lastname: Kim
authors.affiliation: Department of Neuropsychiatry, Gyeonggi Provincial Hospital for the Elderly, Yongin, Korea.
authors.forename: Jong Chul
authors.initials: JC
authors.lastname: Youn
authors.affiliation: Department of Neuropsychiatry, Kangwon National University Hospital, Chuncheon, Korea.
authors.forename: Jin Hyeong
authors.initials: JH
authors.lastname: Jhoo
authors.affiliation: Department of Psychiatry, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Jeong Lan
authors.initials: JL
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Dankook University Hospital, Cheonan, Korea.
authors.forename: Seok Bum
authors.initials: SB
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Dankook University Hospital, Cheonan, Korea.
authors.forename: Jung Jae
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Korea.
authors.forename: Kyung Phil
authors.initials: KP
authors.lastname: Kwak
authors.affiliation: Department of Psychiatry, Gyeongsang National University, School of Medicine, Jinju, Korea.
authors.forename: Bong-Jo
authors.initials: BJ
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Konkuk University, School of Medicine, Chungju, Korea.
authors.forename: Seok Woo
authors.initials: SW
authors.lastname: Moon
authors.affiliation: Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea.
authors.forename: Joon Hyuk
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.|Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Korea.|Department of Brain and Cognitive Sciences, Seoul National University, College of Natural Sciences, Seoul, Korea.
authors.forename: Ki Woong
authors.initials: KW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000349:Africa / Q000453:epidemiology; D017677:Age Distribution; D000368:Aged; D003704:Dementia / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D005260:Female; D014943:Global Health / Q000706:statistics & numerical data*; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D000067010:Literacy / Q000523:psychology* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology
keywords: Africa; Latin America; Republic of Korea; cognitive reserve; dementia; dementia care costs; health expenditure; literacy; population attributable fraction