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Dementia Rate May Be Underestimated in Some Areas

So-called 10/66 algorithm finds higher dementia prevalence in low- and middle-income countries

MONDAY, July 28 (HealthDay News) -- Usage of the DSM-IV may markedly underestimate the prevalence of dementia in less developed areas of the world, according to research published online July 28 in The Lancet.

Juan J. Llibre Rodriguez, M.D., of the Medical University of Havana in Cuba and colleagues analyzed data from 14,960 adults aged 65 and older in seven low- and middle-income countries. Dementia diagnosis was based on the 10/66 diagnostic algorithm and on criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Assessments of participants included an interview and examination.

The prevalence of 10/66 dementia ranged from 5.6 percent in rural China to 11.7 percent in the Dominican Republic. The prevalence of DSM-IV dementia was lower in every site, ranging from 0.3 percent in rural India to 6.3 percent in Cuba, and was generally half that of 10/66 dementia. High levels of associated disability were found in the 847 of 1,345 cases of 10/66 dementia not confirmed by the DSM-IV.

"Progress made to achieve higher levels of education worldwide and better general health and control of cardiovascular risk factors could help postpone disease processes, delaying dementia as lifespan becomes increasingly genetically determined; as environmental factors are recognised and controlled, genetic factors become more important. Education of successive generations might multiply the delay of dementia," write the authors of an accompanying commentary.

The study was supported by Alzheimer's Disease International, which receives grants from the pharmaceutical industry.

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