Diagnosis and management of dementia in LMICs

CITATION: Ferri CP, Jacob KS (2017) Dementia in low-income and middle-income countries: Different realities mandate tailored solutions. PLoS Med 14(3): e1002271. doi:10.1371/journal.pmed.1002271


‘The ageing of populations is the most significant social transformation of the 21st century [1] and has highlighted the importance of age-related conditions such as dementia, which has been recognised across regions, countries, and cultures. The number of people living with dementia has been increasing and is estimated to reach 75 million worldwide by 2030, with the majority of these individuals living in low-income and middle-income countries (LMICs) [2]. The assessment, recognition, and care of people living with dementia in LMICs are complex issues. Dementia is often seen as part of the ageing process, and even when recognized, there still remain problems related to stigma, lack of resources for the adequate care of people with dementia (PWD), variations in the way the condition is assessed and perceived, and how it is addressed in noncommunicable disease (NCD) policies and prevention strategies…

‘Dementia is under-recognised, underdisclosed, undertreated, and undermanaged, particularly in LMICs…

‘A strategy of employing community health workers to identify mental illnesses in general and dementia in particular in resource-poor settings has been recommended [9]; however, it has been found that this strategy leads to a very high false positive rate. The reasons for this rate include the fact that disorders with low prevalence at the community level cannot be diagnosed accurately unless a referral system is in place…’

Best wishes, Neil

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