The proportion of adults living with dementia has increased substantially in several regions of Latin America and the Caribbean over the past decades, a trend opposite to the decline of this disease recorded in many wealthy countries.
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This has been confirmed by a team of researchers from the School of Medicine at Washington University in St. Louis and Newcastle University in the United Kingdom, who studied data from nearly 17,000 adults aged 65 or older in Cuba, the Dominican Republic, Mexico, Peru, and Puerto Rico, collected first in the early 2000s and then about 20 years later; today they publish the results of their work in the journal Jama Neurology.
During that period, the prevalence of dementia in Mexico, Peru, and Puerto Rico increased significantly, rising from about one in ten older adults to nearly one in six, and dementia rates remained stable in Cuba and the Dominican Republic.
The research associates this negative trend with the increase in obesity and lack of control over metabolic and cardiovascular diseases in the region, and points out that the stability observed in Cuba offers hope, as it suggests that prevention is possible through better lifestyle habits.
In some high-income countries, including the United States, the prevalence of dementia—the percentage of older adults living with this neurodegenerative disease—has remained stable or even decreased in recent decades, likely due to improvements in access to education and healthier lifestyles, leading to better blood pressure control and improved heart and metabolic health.
To address the near total lack of evidence on dementia trends in Latin America, the researchers turned to the 10/66 Dementia Research Group, a multinational initiative created in the early 2000s to collect population data on dementia in low- and middle-income countries, including five sites in Latin America and the Caribbean.
At each site, interviewers visited participants’ homes, interviewing all adults aged 65 or older who gave their consent; this home visit method allows researchers to reach people who might never attend a clinic or specialist and who therefore are often excluded from data collected in hospitals or medical offices.
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The survey was conducted between 2003 and 2006, and then between 2016 and 2020, to record long-term trends in dementia prevalence.
The diagnosis was based on a validated combination of cognitive tests, a clinical interview, and an interview with a person close to the participant, designed to identify dementia fairly across different cultures and educational levels.
The overall prevalence of dementia in the five sites increased from 10.6 to 16.9 percent over two decades; examining each site individually, the researchers found that dementia prevalence increased significantly in Mexico (from 9.6 to 14.5 percent), Peru (from 7.6 to 11.7), and Puerto Rico (from 10.7 to 15.7), even after accounting for population aging between the different time periods.
In the other two study locations, Cuba and the Dominican Republic, dementia rates remained stable, and the authors have suggested this could be because those populations have not experienced the same rapid increase in obesity, sedentary lifestyle, and uncontrolled metabolic diseases that have characterized other parts of the region in the last two decades.
Extrapolating nationally, the study’s dementia rates at the most recent time point translate to approximately 1.2 million people living with dementia in Mexico, 416,800 in Peru, 133,200 in Cuba, 100,400 in Puerto Rico, and 111,200 in the Dominican Republic.
The researchers emphasized that it is known how to address risk factors—staying physically active, controlling blood pressure and blood sugar, not smoking, seeking medical care immediately with symptoms, and being socially connected—and therefore suggested the importance of investment to monitor dementia and prevention programs.
