Background: Dementia is becoming a major public health problem in Latin America (LA), yet epidemiological information on dementia remains scarce in this region. This study analyzes data from epidemiological studies on the prevalence of dementia in LA and compares the prevalence of dementia and its causes across countries in LA and attempts to clarify differences from those of developed regions of the world. Methods: A database search for population studies on rates of dementia in LA was performed. Abstracts were also included in the search. Authors of the publications were invited to participate in this collaborative study by sharing missing or more recent data analysis with the group. Results: Eight studies from six countries were included. The global prevalence of dementia in the elderly (≥65 years) was 7.1% (95% CI: 6.8-7.4), mirroring the rates of developed countries. However, prevalence in relatively young subjects (65-69 years) was higher in LA studies The rate of illiteracy among the elderly was 9.3% and the prevalence of dementia in illiterates was two times higher than in literates. Alzheimer's disease was the most common cause of dementia. Conclusions: Compared with studies from developed countries, the global prevalence of dementia in LA proved similar, although a higher prevalence of dementia in relatively young subjects was evidenced, which may be related to the association between low educational level and lower cognitive reserve, causing earlier emergence of clinical signs of dementia in the LA elderly population.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S1041610209009430

Prevalence of dementia in Latin America: a collaborative study of population-based cohorts.

Several community-based surveys on the prevalence of Parkinsonism and Parkinson's disease have been conducted worldwide, with variations on their methodology and results. The objective of this study is to assess the prevalence of Parkinsonism and its causes in a cohort of individuals age 64 years or older in Bambui, a Brazilian town. In phase I, 1,186 people older than 64 years responded to a 9-question screening questionnaire for Parkinsonism. In phase II, all subjects who scored ≥ 2 points on the test were examined independently by at least 2 movement disorder-trained physicians. A movement disorder senior specialist excluded or confirmed the diagnosis in all suspected cases. The response rate was high for both phases (96% for phase I and 94% for phase II). The prevalence rate per 100 population over 64 years of age in this group was 7.2% for Parkinsonism of all types (n = 86). The most frequent causes were idiopathic Parkinson's disease and drug-induced Parkinsonism, with prevalence rates of 3.3% (n = 39) and 2.7% (n = 32), respectively. The prevalence of vascular Parkinsonism was 1.1% (n = 13). We found 1 case of posttraumatic Parkinsonism and another with multiple system atrophy. In this first population-based study of Parkinsonism conducted in Brazil, the prevalence in a cohort of elderly subjects was higher than the observed in other populations worldwide, especially because of the high rates of drug-induced and vascular Parkinsonism. The prevalence of Parkinson's disease was similar to that observed in elderly people in door-to-door surveys in other American, European, and Eastern countries. © 2006 Movement Disorder Society

Parkinsonism and Parkinson's disease in the elderly: a community-based survey in Brazil (the Bambuí study).

Understanding the burden of epilepsy in Latin America: A systematic review of its prevalence and incidence

Summary: Purpose: A national study was performed in Colombia to determine the general and regional prevalence of epilepsy, clinical profiles, seizure types, and clinical syndromes.



Methods: Based on the National Epidemiological Study of Neurological Diseases (EPINEURO), we evaluated and followed up for 1 year all the subjects with epilepsy from the National Sample. Clinical profiles were further assessed. Seizure types and epilepsy syndromes were established according to the international classifications.



Results: General prevalence was found to be 11.3 per 1,000, with little variation among regions, except the eastern region, where prevalence was 23 per 1,000; prevalence for active epilepsy was 10.1 per 1,000. Women have a slightly greater (not statistically significant) risk. Most seizures are focal (partial), frequently with secondary generalization. The most frequent epilepsy syndrome encountered was partial symptomatic/cryptogenic (80%). Epilepsy onset in Colombia occurs most frequently in childhood.



Conclusions: Prevalence rates of epilepsy in Colombia are similar to those reported in nations with comparable developmental status and have diminished over time. The study presents the distribution of seizures and syndromes. The most frequent types are focal syndromes.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1528-1167.2006.00387.x

Epilepsy in Colombia: epidemiologic profile and classification of epileptic seizures and syndromes.

Introduccion. La enfermedad de Alzheimer es un problema de importancia creciente en salud publica por su caracter incapacitante y su alto costo individual, familiar y social. La evaluacion neuropsicologica contribuye significativamente a la identificacion temprana de una demencia o de un deterioro cognitivo. La bateria neuropsicologica del Consorcio para el Establecimiento de un Registro de la Enfermedad de Alzheimer (CERAD) se usa ampliamente para la evaluacion y diagnostico del deficit cognitivo asociado con demencia tipo Alzheimer (DTA). Esta bateria de pruebas neuropsicologicas se ha adaptado por el Grupo de Neurociencias de la Universidad de Antioquia (Colombia) con el nombre de CERAD-Col. Objetivo. Establecer la validez y fiabilidad del CERAD-Col en individuos con edades mayores o iguales a 50 anos. Sujetos y metodos. Se realizo un estudio de validacion, con 848 participantes seleccionados de la poblacion general y 151 pacientes con DTA. La validez de constructo se determino de tres formas: analisis factorial confirmatorio, correlacion con las escalas funcionales FAST (Functional Assessment Staging) y EDG (escala de deterioro global), y comparacion de ambos grupos. La consistencia interna se estimo mediante el coeficiente alfa de Cronbach. Resultados. Se encontraron tres factores, memoria, lenguaje y praxias, que explicaron el 88% de la varianza total. Se hallaron correlaciones significativas entre las pruebas y las escalas FAST y EDG. La consistencia interna y la reproducibilidad test-retest fueron altas. El grupo con DTA mostro puntuaciones mas bajas y significativas (p < 0,05) frente al grupo control. Conclusion. El CERAD-Col es valido y fiable para el diagnostico de la DTA en la poblacion colombiana hispanoparlante mayor de 50 anos.

Validez y fiabilidad de la batería neuropsicológica CERAD-Col

OBJETIVO: Determinar la prevalencia de ocho problemas neurologicos -migrana, enfermedad cerebrovascular, enfermedad de Parkinson, neuropatia periferica, trastornos del desarrollo neurologico, epilepsia, demencia y secuelas de traumatismo craneoencefalico- en Colombia como parte del estudio neuroepidemiologico nacional (EPINEURO). METODOS: Se realizo una encuesta transversal en dos fases entre septiembre de 1995 y agosto de 1996. En la primera fase se identifico a las personas que podian estar padeciendo alguna enfermedad neurologica y en la segunda se hizo el diagnostico especifico. Se examino una muestra de 8 910 personas distribuidas en proporcion con la poblacion de cada una de las cinco zonas geograficas de Colombia, que son las regiones central, sudoccidental, noroccidental, oriental y la costa caribe. La evaluacion se realizo segun una version modificada del protocolo de neuroepidemiologia de la Organizacion Mundial de la Salud, ademas de un examen fisico simplificado. A los posibles pacientes de demencia identificados se les aplico un examen neuropsicologico, disenado para este estudio, con el fin de profundizar en los aspectos cognoscitivos. Se aplicaron las escalas de Hachinski, Yesavage y Blessed y los criterios diagnosticos del NINCDS-ADRDA para la enfermedad de Alzheimer, los del NINDS-AIREN para la demencia de origen vascular y los del DSM-IV para todo tipo de demencia. Se realizo una encuesta para determinar si habia secuelas de traumatismo craneoencefalico. Las personas mayores de 12 anos fueron evaluadas por neurologos de adultos y los menores de 12 anos por un neuropediatra. Se calcularon las prevalencias de trastornos neurologicos por edad y sexo, tanto por region como para el pais en su totalidad, y sus intervalos de confianza de 95%. RESULTADOS: La prevalencia por 1 000 habitantes de los trastornos investigados fueron las siguientes: migrana, 71,2 (intervalo de confianza de 95% [IC95%]: 65,5 a 76,8); trastornos del desarrollo neurologico, 46,1 (IC95%: 35,5 a 58,9); enfermedad cerebrovascular, 19,9 (IC95%: 14,3 a 27,4); demencia, 13,1 (IC95%: 8,5 a 19,3); epilepsia, 10,3 (IC95%: 8,5 a 13,0); neuropatia periferica, 8,5 (IC95%: 6,8 a 10,7); secuelas de traumatismo craneoencefalico, 6,4 (IC95%: 5,0 a 7,8) y enfermedad de Parkinson 4,7 (IC95%: 2,2 a 8,9). En todos los casos, menos en el de traumatismos craneoencefalicos, la prevalencia fue mayor en mujeres. CONCLUSIONES: Estos resultados permiten disenar politicas de salud mas actuales dirigidas a lograr una prevencion mas eficaz, un mejor control y un tratamiento mas adecuado de los trastornos neurologicos en Colombia. La facil aplicacion de las encuestas y el bajo costo de este tipo de investigaciones hacen que esta metodologia sea ideal para paises con carencia de recursos humanos especializados.

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Boris E. Vesga A.

Papers

Estudio neuroepidemiológico nacional (EPINEURO) colombiano