The prevalence of dementia in a Portuguese community sample: a 10/66 Dementia Research Group study

Manuel Gonçalves-Pereira, Ana Cardoso, Ana Verdelho, Joaquim Alves da Silva, Manuel Caldas de Almeida, Alexandra Fernandes, Cátia Raminhos, Cleusa P Ferri, A Matthew Prina, Martin Prince, Miguel Xavier

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Dementia imposes a high burden of disease worldwide. Recent epidemiological studies in European community samples are scarce. In Portugal, community prevalence data is very limited. The 10/66 Dementia Research Group (DRG) population-based research programmes are focused in low and middle income countries, where the assessments proved to be culture and education fair. We applied the 10/66 DRG prevalence survey methodology in Portugal, where levels of illiteracy in older populations are still high.

METHODS: A cross-sectional comprehensive one-phase survey was conducted of all residents aged 65 and over of two geographically defined catchment areas in Southern Portugal (one urban and one rural site). Nursing home residents were not included in the present study. Standardized 10/66 DRG assessments include a cognitive module, an informant interview and the Geriatric Mental State-AGECAT, providing data on dementia diagnosis and subtypes, mental disorders including depression, physical health, anthropometry, demographics, disability/functioning, health service utilization, care arrangements and caregiver strain.

RESULTS: We interviewed 1405 old age participants (mean age 74.9, SD = 6.7 years; 55.5% women) after 313 (18.2%) refusals to participate. The prevalence rate for dementia in community-dwellers was 9.23% (95% CI 7.80-10.90) using the 10/66 DRG algorithm and 3.65% (95% CI 2.97-4.97) using DSM-IV criteria. Pure Alzheimer's disease was the most prevalent dementia subtype (41.9%). The prevalence of dementia was strongly age-dependent for both criteria, but there was no association with sex.

CONCLUSIONS: Dementia prevalence was higher than previously reported in Portugal. The discrepancy between prevalence according to the 10/66 DRG algorithm and the DSM-IV criteria is consistent with that observed in less developed countries; this suggests potential underestimation using the latter approach, although relative validity of these two approaches remains to be confirmed in the European context. We improved the evidence base to raise awareness and empower advocacy about dementia in Portugal, so that the complex needs of frail older people may be met in better ways.

Original languageEnglish
Pages (from-to)261
JournalBMC Geriatrics
Volume17
Issue number1
DOIs
Publication statusPublished - 7 Nov 2017

Fingerprint

Dementia
Portugal
Research
Diagnostic and Statistical Manual of Mental Disorders
Refusal to Participate
Anthropometry
European Union
Nursing Homes
Population Groups
Mental Disorders
Geriatrics
Caregivers
Developing Countries
Health Services
Epidemiologic Studies
Alzheimer Disease
Demography
Interviews
Depression
Education

Keywords

  • Dementia
  • Alzheimer’s disease
  • Epidemiology
  • Prevalence
  • Questionnaires
  • Cross-cultural psychiatry

Cite this

Gonçalves-Pereira, Manuel ; Cardoso, Ana ; Verdelho, Ana ; Alves da Silva, Joaquim ; Caldas de Almeida, Manuel ; Fernandes, Alexandra ; Raminhos, Cátia ; Ferri, Cleusa P ; Prina, A Matthew ; Prince, Martin ; Xavier, Miguel. / The prevalence of dementia in a Portuguese community sample: a 10/66 Dementia Research Group study. In: BMC Geriatrics. 2017 ; Vol. 17, No. 1. pp. 261.
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abstract = "BACKGROUND: Dementia imposes a high burden of disease worldwide. Recent epidemiological studies in European community samples are scarce. In Portugal, community prevalence data is very limited. The 10/66 Dementia Research Group (DRG) population-based research programmes are focused in low and middle income countries, where the assessments proved to be culture and education fair. We applied the 10/66 DRG prevalence survey methodology in Portugal, where levels of illiteracy in older populations are still high.METHODS: A cross-sectional comprehensive one-phase survey was conducted of all residents aged 65 and over of two geographically defined catchment areas in Southern Portugal (one urban and one rural site). Nursing home residents were not included in the present study. Standardized 10/66 DRG assessments include a cognitive module, an informant interview and the Geriatric Mental State-AGECAT, providing data on dementia diagnosis and subtypes, mental disorders including depression, physical health, anthropometry, demographics, disability/functioning, health service utilization, care arrangements and caregiver strain.RESULTS: We interviewed 1405 old age participants (mean age 74.9, SD = 6.7 years; 55.5{\%} women) after 313 (18.2{\%}) refusals to participate. The prevalence rate for dementia in community-dwellers was 9.23{\%} (95{\%} CI 7.80-10.90) using the 10/66 DRG algorithm and 3.65{\%} (95{\%} CI 2.97-4.97) using DSM-IV criteria. Pure Alzheimer's disease was the most prevalent dementia subtype (41.9{\%}). The prevalence of dementia was strongly age-dependent for both criteria, but there was no association with sex.CONCLUSIONS: Dementia prevalence was higher than previously reported in Portugal. The discrepancy between prevalence according to the 10/66 DRG algorithm and the DSM-IV criteria is consistent with that observed in less developed countries; this suggests potential underestimation using the latter approach, although relative validity of these two approaches remains to be confirmed in the European context. We improved the evidence base to raise awareness and empower advocacy about dementia in Portugal, so that the complex needs of frail older people may be met in better ways.",
keywords = "Dementia, Alzheimer’s disease, Epidemiology, Prevalence, Questionnaires, Cross-cultural psychiatry",
author = "Manuel Gon{\cc}alves-Pereira and Ana Cardoso and Ana Verdelho and {Alves da Silva}, Joaquim and {Caldas de Almeida}, Manuel and Alexandra Fernandes and C{\'a}tia Raminhos and Ferri, {Cleusa P} and Prina, {A Matthew} and Martin Prince and Miguel Xavier",
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The prevalence of dementia in a Portuguese community sample: a 10/66 Dementia Research Group study. / Gonçalves-Pereira, Manuel; Cardoso, Ana; Verdelho, Ana; Alves da Silva, Joaquim; Caldas de Almeida, Manuel; Fernandes, Alexandra; Raminhos, Cátia; Ferri, Cleusa P; Prina, A Matthew; Prince, Martin; Xavier, Miguel.

In: BMC Geriatrics, Vol. 17, No. 1, 07.11.2017, p. 261.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The prevalence of dementia in a Portuguese community sample: a 10/66 Dementia Research Group study

AU - Gonçalves-Pereira, Manuel

AU - Cardoso, Ana

AU - Verdelho, Ana

AU - Alves da Silva, Joaquim

AU - Caldas de Almeida, Manuel

AU - Fernandes, Alexandra

AU - Raminhos, Cátia

AU - Ferri, Cleusa P

AU - Prina, A Matthew

AU - Prince, Martin

AU - Xavier, Miguel

N1 - info:eu-repo/grantAgreement/FCT/3599-PPCDT/113652/PT# UID/Multi/04462/2013# This study was supported by a research grant from FCT - Fundacao para a Ciencia e a Tecnologia, the Portuguese national funding agency for science, research and technology (Project reference PTDC/SAU-EPI/113652/2009: "Prevalence of old age neuropsychiatric disorders: contribution to mental health policy in Portugal"; PI: Miguel Xavier). A. Matthew Prina was supported by the MRC (MR/K021907/1). iNOVA4Health - UID/Multi/04462/2013, a program financially supported by Fundacao para a Ciencia e Tecnologia / Ministerio da Educacao e Ciencia, through national funds and co-funded by FEDER under the PT2020 Partnership Agreement is acknowledged.

PY - 2017/11/7

Y1 - 2017/11/7

N2 - BACKGROUND: Dementia imposes a high burden of disease worldwide. Recent epidemiological studies in European community samples are scarce. In Portugal, community prevalence data is very limited. The 10/66 Dementia Research Group (DRG) population-based research programmes are focused in low and middle income countries, where the assessments proved to be culture and education fair. We applied the 10/66 DRG prevalence survey methodology in Portugal, where levels of illiteracy in older populations are still high.METHODS: A cross-sectional comprehensive one-phase survey was conducted of all residents aged 65 and over of two geographically defined catchment areas in Southern Portugal (one urban and one rural site). Nursing home residents were not included in the present study. Standardized 10/66 DRG assessments include a cognitive module, an informant interview and the Geriatric Mental State-AGECAT, providing data on dementia diagnosis and subtypes, mental disorders including depression, physical health, anthropometry, demographics, disability/functioning, health service utilization, care arrangements and caregiver strain.RESULTS: We interviewed 1405 old age participants (mean age 74.9, SD = 6.7 years; 55.5% women) after 313 (18.2%) refusals to participate. The prevalence rate for dementia in community-dwellers was 9.23% (95% CI 7.80-10.90) using the 10/66 DRG algorithm and 3.65% (95% CI 2.97-4.97) using DSM-IV criteria. Pure Alzheimer's disease was the most prevalent dementia subtype (41.9%). The prevalence of dementia was strongly age-dependent for both criteria, but there was no association with sex.CONCLUSIONS: Dementia prevalence was higher than previously reported in Portugal. The discrepancy between prevalence according to the 10/66 DRG algorithm and the DSM-IV criteria is consistent with that observed in less developed countries; this suggests potential underestimation using the latter approach, although relative validity of these two approaches remains to be confirmed in the European context. We improved the evidence base to raise awareness and empower advocacy about dementia in Portugal, so that the complex needs of frail older people may be met in better ways.

AB - BACKGROUND: Dementia imposes a high burden of disease worldwide. Recent epidemiological studies in European community samples are scarce. In Portugal, community prevalence data is very limited. The 10/66 Dementia Research Group (DRG) population-based research programmes are focused in low and middle income countries, where the assessments proved to be culture and education fair. We applied the 10/66 DRG prevalence survey methodology in Portugal, where levels of illiteracy in older populations are still high.METHODS: A cross-sectional comprehensive one-phase survey was conducted of all residents aged 65 and over of two geographically defined catchment areas in Southern Portugal (one urban and one rural site). Nursing home residents were not included in the present study. Standardized 10/66 DRG assessments include a cognitive module, an informant interview and the Geriatric Mental State-AGECAT, providing data on dementia diagnosis and subtypes, mental disorders including depression, physical health, anthropometry, demographics, disability/functioning, health service utilization, care arrangements and caregiver strain.RESULTS: We interviewed 1405 old age participants (mean age 74.9, SD = 6.7 years; 55.5% women) after 313 (18.2%) refusals to participate. The prevalence rate for dementia in community-dwellers was 9.23% (95% CI 7.80-10.90) using the 10/66 DRG algorithm and 3.65% (95% CI 2.97-4.97) using DSM-IV criteria. Pure Alzheimer's disease was the most prevalent dementia subtype (41.9%). The prevalence of dementia was strongly age-dependent for both criteria, but there was no association with sex.CONCLUSIONS: Dementia prevalence was higher than previously reported in Portugal. The discrepancy between prevalence according to the 10/66 DRG algorithm and the DSM-IV criteria is consistent with that observed in less developed countries; this suggests potential underestimation using the latter approach, although relative validity of these two approaches remains to be confirmed in the European context. We improved the evidence base to raise awareness and empower advocacy about dementia in Portugal, so that the complex needs of frail older people may be met in better ways.

KW - Dementia

KW - Alzheimer’s disease

KW - Epidemiology

KW - Prevalence

KW - Questionnaires

KW - Cross-cultural psychiatry

U2 - 10.1186/s12877-017-0647-5

DO - 10.1186/s12877-017-0647-5

M3 - Article

VL - 17

SP - 261

JO - BMC Geriatrics

JF - BMC Geriatrics

SN - 1471-2318

IS - 1

ER -