Socioeconomic Disparities and Gender Inequalities in Dementia: a Community-Dwelling Population Study from a Middle-Incom
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Socioeconomic Disparities and Gender Inequalities in Dementia: a Community-Dwelling Population Study from a Middle-Income Country Silvia Mejia-Arango 1 & Elkin Garcia-Cifuentes 2,3 & Rafael Samper-Ternent 4 & Miguel G. Borda 2,3,5,6 & Carlos A. Cano-Gutierrez 2,3,5 Accepted: 4 November 2020/ # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract
The proportion of the world’s older adults and of its dementia cases is increasing in low and middle-income countries. This is particularly true in Colombia. There, the number of individuals with dementia may increase five-fold by 2050. Yet research is lacking on dementia in such settings. This work estimates the prevalence of dementia in a community-dwelling population in Colombia. It also assesses how gender-based differences in cardiovascular conditions and socioeconomic disparities affect dementia. This work analyzes data on 2000 respondents at least 60 years of age in the Health, Well-Being, And Aging (SABE) study in Bogota. Respondents with dementia are those who have cognitive impairment and at least two limitations in instrumental activities of daily living. The SABE study finds 8.4% of respondents have dementia. Age, cardiovascular risks, and socioeconomic disparities contributed to higher odds of dementia. The contributors to dementia can differ for men and women. For example, socioeconomic disparities were a larger contributor to dementia for women than men. The findings support the cognitive reserve hypothesis on dementia. This holds that preexisting cognitive processes and compensatory mechanisms influence dementia. Women in Latin America are more likely to suffer from socioeconomic disparities that limit their cognitive reserve. This research points to several policy implications that can help offset these disparities and reduce the prevalence of dementia. Keywords Colombia . Dementia . Gender-based . Gender disparity . Latin America . Socioeconomic disparity
Introduction More than two-thirds of the world population 60 or older live in low- and middle-income countries (LMIC) where many do not have the resources to manage the social and health * Silvia Mejia-Arango [email protected] Extended author information available on the last page of the article
Journal of Cross-Cultural Gerontology
challenges of aging (Feng and Phillips 2017). The single greatest of these challenges is dementia. By 2030, dementia will affect 50 million persons and their families in LMIC (Prince et al. 2013). Among LMIC, the Andean region of South America, comprising Bolivia, Colombia, Ecuador, Peru, and Venezuela, will see one of the more rapid increases in dementia. There, the number of individuals with dementia is expected to increase 445% between 2010 and 2050, including a 460% increase in Colombia (Pot and Petrea 2013). Across Latin America, the 10/66 study shows the prevalence of dementia is 8.5%, in contrast to other LMICs where age-standardized prevalence rates for dementia range from 5% to 7% (Llibre et al. 2008). Within Colombia, local dementia prevale
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