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INTRODUCTION: There are few longitudinal studies of dementia in developing countries. We used longitudinal data from the Maracaibo Aging Study to accurately determine the age- and sex-specific incidence of dementia in elderly Latin Americans. METHODS: The Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) was used to diagnose dementia, which was classified as Alzheimer's disease, vascular dementia, or other. Age- and sex-specific incidence was estimated as the number of new cases of dementia divided by person-years (p-y) of follow-up. RESULTS: The incidence of all dementia diagnoses was 9.10 per 1000 p-y (95% confidence interval [CI] 7.13-11.44; 8026 total p-y), 5.18 for Alzheimer's disease (95% CI 3.72-7.03; 7916 total p-y), and 3.35 for vascular dementia (95% CI 2.19-4.91; 7757 total p-y). DISCUSSION: Among Maracaibo Aging Study participants younger than 65 years, the incidence of dementia was higher than that of US Whites. Among individuals older than 65 years, the incidence was comparable to the mean of previous incidence estimates for other populations worldwide.
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Envejecimiento , Demencia/epidemiología , Evaluación Geriátrica , Factores de Edad , Anciano , Anciano de 80 o más Años , Apolipoproteína E4/genética , Planificación en Salud Comunitaria , Demencia/diagnóstico , Demencia/genética , Femenino , Humanos , Incidencia , América Latina/epidemiología , Modelos Logísticos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pruebas NeuropsicológicasRESUMEN
The relationship between total homocysteine (tHcy) and dementia risk remains controversial, as the association varies among populations and dementia subtypes. We studied a Venezuelan population that has high prevalence of both elevated tHcy and dementia. We tested the hypotheses that (1) elevated tHcy is associated with increased dementia risk, (2) the risk is greater for vascular dementia (VaD) than for Alzheimer's disease (AD), and (3) a history of stroke may partly explain this association. 2100 participants (>/=55 years old) of the Maracaibo Aging Study underwent standardized neurological, neuropsychiatric, and cardiovascular assessments. Elevated tHcy was significantly associated with dementia, primarily VaD. When history of stroke and other confounding factors were taken into account, elevated tHcy remained a significant risk factor in older (>66 years), but not in younger (55-66 years) subjects. Ongoing studies of this population may provide insight into the mechanism by which tHcy increases risk for dementia.
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BACKGROUND/AIMS: People in Caribbean countries are thought to be at particularly high risk for dementia. Basic descriptive epidemiology of dementia is required for populations in the region to determine the validity of this hypothesis. The main objectives of the study were to assess the prevalence, types and severity of dementia among elderly people (>or=55 years old) in an urban area on the Caribbean coast of Venezuela, and to determine the gender and age distribution of affected people. METHODS: The population-based Maracaibo Aging Study included 3,657 subjects, all of whom underwent a standardized, in-person interview. 2,438 of these subjects underwent neuropsychological, neuropsychiatric, cardiovascular and nutritional assessment. RESULTS: The overall prevalence rate of dementia in elderly subjects was 8.04% and was not significantly different for women and men. Alzheimer's disease was the most frequent type of dementia (50%), followed by vascular dementia (27%). Of all cases of dementia, 41.84% were ranked as mild, 30.10% as moderate and 28.06% as severe. CONCLUSION: The prevalence of dementia in elderly people from the Caribbean coast of Venezuela is much higher than frequencies previously reported for developing countries.
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Demencia/epidemiología , Distribución por Edad , Anciano , Anciano de 80 o más Años , Región del Caribe/epidemiología , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Prevalencia , Índice de Severidad de la Enfermedad , Distribución por Sexo , Salud Urbana , Venezuela/epidemiologíaRESUMEN
OBJECTIVES: The present study generated baseline data for total homocysteine (tHcy) in elderly Caribbeans of Hispanic ancestry, residing in Venezuela, their country of origin. DESIGN AND METHODS: 2106 participants in the Maracaibo Aging Study (MAS), older than 55 years, underwent standardized clinical and laboratory assessments, including measurement of plasma tHcy levels, folate, and vitamin B12 in fasting samples. RESULTS: tHcy concentration in the healthy, normative group ranged from 4.1 to 31.8 micromol/L, with a median of 11.5+/-4.7 micromol/L. tHcy level increased with age, was significantly higher in men than in women, and exhibited inverse correlations with folate and vitamin B12. CONCLUSIONS: tHcy levels of the MAS participants were generally higher than levels previously reported for community-dwelling elderly populations from other countries. The normative centile curves for tHcy can be used in disease risk analysis for this population, and possibly for other Hispanic populations residing in the Caribbean.
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Homocisteína/sangre , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , VenezuelaRESUMEN
The Maracaibo Aging Study is a longitudinal, population-based, one-step multidisciplinary study of age-related diseases, with a particular focus on memory-related disorders, among subjects over 55 years living in a neighborhood of the city of Maracaibo, Venezuela. Three phases were scheduled for this study. First, a door-to-door survey was conducted in order to build a registry and to obtain general and sociodemographic characteristics. During the second phase, information regarding changes in the abilities of the subjects was collected. The third phase consisted of a full neuropsychiatric examination, cardiovascular evaluation, nutritional assessment, neuropsychological testing, routine laboratory tests and genetic analysis. 3,657 subjects were surveyed between January and August, 1998. There were more women than men, and the average number of years of formal education was low, particularly among women. The limitations and strengths of the study are discussed.