Prevalence of cognitive impairment in Brazilian indigenous community from Amazonas

Anna Paula de Carvalho, S. Brucki, R. Nitrini, Camila Carlos Bezerra, Fernanda Luz Gonzaga da Silva, J. Souza-Talarico
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Abstract

ABSTRACT. Studies on the prevalence of dementia in the indigenous population are still scarce worldwide. In the few available studies, prevalence evidence varies from low to very high, with early onset of the disease and high mortality rate after the initial diagnosis. Still, little is known about the rate of dementia in indigenous populations from low- and middle-income countries, where the dementia prevalence in the general population is estimated to increase significantly in the next decades. Objective: This study aimed to determine the prevalence of cognitive impairment and associated factors in Brazilian indigenous people of the Mura ethnicity in Amazonas, Brazil. Methods: A total of 217 indigenous individuals aged 50 years and older from Amazonas, Brazil, were submitted to cognitive assessment. Attention, memory, verbal fluency, visuospatial performance, and mood state composed the cognitive impairment diagnosis. Results: The prevalence of cognitive impairment was 43.3% (95%CI 36.6-49.7) and varied according to age [OR=1.03 (95%CI 1.00-1.06)], education [OR=0.74 (95%CI 0.62-0.87)], body mass index [OR=0.91 (95%CI 0.83-0.98)], and income [OR=0.52 (95%CI 0.27-0.99)]. Conclusions: Cognitive impairment had an early onset in an indigenous community, and its prevalence was greater in older individuals with low education and low family income. These findings highlight the importance of implementing public indigenous health policies focusing on health professional training for early cognitive impairment detection.
亚马孙地区巴西土著社区认知障碍患病率
摘要在世界范围内,关于土著居民痴呆症患病率的研究仍然很少。在为数不多的现有研究中,患病率证据从低到高不等,发病早,初步诊断后死亡率高。尽管如此,人们对低收入和中等收入国家土著居民的痴呆症发病率知之甚少,据估计,在这些国家,痴呆症在一般人群中的发病率在未来几十年将显著增加。目的:本研究旨在确定巴西亚马逊地区穆拉族土著居民认知障碍的患病率及其相关因素。方法:对217名巴西亚马逊地区50岁及以上的土著居民进行认知评估。注意、记忆、语言流畅性、视觉空间表现和情绪状态构成认知障碍的诊断。结果:认知障碍患病率为43.3% (95%CI 36.6 ~ 49.7),且因年龄[OR=1.03 (95%CI 1.00 ~ 1.06)]、教育程度[OR=0.74 (95%CI 0.62 ~ 0.87)]、体重指数[OR=0.91 (95%CI 0.83 ~ 0.98)]、收入[OR=0.52 (95%CI 0.27 ~ 0.99)]而异。结论:认知障碍在土著社区早发,在低教育水平和低收入的老年人中患病率更高。这些发现强调了实施土著公共卫生政策的重要性,重点是对早期认知障碍检测进行卫生专业培训。
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