Dementia care in public health in Brazil and the world: A systematic review

Cieto, Bianca Bolzan; Valera, Gabriela Gallego; Soares, Glaucia Bueno; Cintra, Roberta Hehl de Sylos; Vale, Francisco Assis Carvalho

doi:10.1590/S1980-57642014DN81000007

ABSTRACT

OBJECTIVE:

This study aimed to identify in the recent scientific literature, information on health care provided to people with dementia, dementia costs and its resource implications for public health.

METHODS:

This was a systematic review of the literature in which the articles were consulted from the databases PubMed/MEDLINE, LILACS and SciELO. The review sample consisted of 45 articles.

RESULTS:

Examination of the studies identified the current scenario of dementia in relation to public health and public policy in Brazil and the world. The analyzed studies revealed key information on aspects of dementia in the world. There was consensus on the high prevalence of the syndrome and on the significant cost of health care and public policy for assisting the elderly with dementia.

CONCLUSION:

The importance of planning and implementing new public policies was recognized, since these are essential for the organization and management of health services and directly influence the country's ability to provide health care for people with dementia.

Key words:
dementia; public health; health policy

RESUMO

OBJETIVO

Este estudo objetivou identificar na literatura científica recente, informações sobre a atenção à saúde proporcionada à pessoa com demência, os custos com demência e sua implicação nos recursos destinados a saúde pública.

MÉTODOS

Trata-se de uma revisão sistemática da literatura em que foram consultados artigos das bases de dados PubMed/MEDLINE, LILACS e SciELO. A amostra da revisão constituiu-se de 45 artigos.

RESULTADOS

A análise dos estudos possibilitou identificar o contexto atual da demência em relação a saúde pública e políticas públicas, no Brasil e no mundo. Observou-se que os estudos analisados trouxe aspectos importantes informativos sobre a demência no mundo. Houve um consenso de que a prevalência desta síndrome é elevado, assim como o custo dos cuidados de saúde e da política pública é relevante para a saúde do idoso com demência.

CONCLUSÃO

Concluiu-se que há pertinência e necessidade de planejar e implementar novas políticas públicas, uma vez que são fundamentais na estruturação e gerenciamento de serviços de saúde e influenciam diretamente na capacidade do país prover atenção à saúde as pessoas com demência.

Palavras-chave:
demência; saúde pública; política de saúde

Texto completo disponível apenas em PDF.

Full text available only in PDF format

REFERENCES

¹
Ballard C, Gauthier S, Corbett A, Brayne C, Aarsland D, Jones E. Alzheimer's disease. Lancet 2011;377:1019-1031.
²
Associação Brasileira de Alzheimer [Internet]. São Paulo: Doença de Alzheimer; 2012. Disponível em: http://www.abrazsp.org.br
³
World Health Organization, Dementia: A Public Health Priority, Geneva, Switzerland; 2012. Available from: http://whqlibdoc.who.int/publications/2012/9789241564458_eng.pdf
» http://whqlibdoc.who.int/publications/2012/9789241564458_eng.pdf
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Wimo, A, Prince, M. World Alzheimer Report 2010: The Global Economic Impact of Dementia. London: Alzheimer's Disease International; 2010. Available from: http://www.alz.co.uk/research/files/WorldAlzheimerReport2010.pdf
» http://www.alz.co.uk/research/files/WorldAlzheimerReport2010.pdf
⁵
Garrido R, Menezes PR. O Brasil está envelhecendo: boas e más notícias por uma perspectiva epidemiológica. Rev Bras Psiquiatr 2002; 24:3-6.
⁶
Camacho ACLF, Coelho MJ. Políticas públicas para a saúde do idoso: revisão sistemática. Rev Bra Enferm 2010;63:279-284.
⁷
Chaufan C, Hollister B, Nazareno J, Fox P. Medical ideology as a double-edged sword: the politics of cure and care in the making of Alzheimer's disease. Soc Sci Med 2012;74:788-795.
⁸
Faure-Delage A, Mouanga AM, M'Belesso, et al. Socio-cultural perceptions and representations of demente in Brazzaville, Republico f Congo: the EDAC survey. Dement Geriatr Cogn Disord 2012;2:84-96.
⁹
Mitchell SL, Black BS, Ersek M, et al. Advanced dementia: state of the art and priorities for the next decade. Ann Intern Med 2012;156:45-51.
¹⁰
Toure K, Coume M, Ndiaye M, et al. Risk factors for dementia in a senegalese elderly population aged 65 years and over. Dement Geriatr Cogn Disord 2012;2:160-168.
¹¹
Sosa AL, Albanese E, Stephan BC, et al. Prevalence, distribution, and impact of mild cognitive impairment in Latin America, China, and India: a 10/66 population-based study. PLoS Med 2012;9:e1001170.
¹²
Maestre GE. Assessing dementia in resource-poor regions. Curr Neurol Neurosci Rep 2012;12:511-519.
¹³
McParland P, Devine P, Innes A, Gayle V. Dementia knowledge and attitudes of the general public in Northen Ireland: as analysis of national survey data. Int Psychogeriatr 2012;24:1600-1613.
¹⁴
Llibre Jde J, Valhuerdi A, Calvo M, et al. Dementia and other chronic diseases in older adults in Havana and Matanzas: the 10/66 study in Cuba. MEDICC Rev 2011;13:30-37.
¹⁵
Abbott A. Dementia: a problem for our age. Nature 2011;475:S2-S4.
¹⁶
Carias CM, Vieira FS, Giordano CV, Zucchi P. Medicamentos de dispensação excepcional: histórico e gastos do Ministério da Saúde do Brasil. Rev Saude Publica 2011;45:233-240.
¹⁷
Rosow K, Holzapfel A, Karlawish JH, Baumgart M, Bain LJ, Khachaturian AS. Countrywide strategic plans on Alzheimer's disease: developing the framework for the international battle against Alzheimer's disease. Alzheimers Dement 2011;7:615-621.
¹⁸
Gustavsson A, Svensson M, Jacobi F, et al. Cost of disorders oh the brain in Europe 2010. Eur Neuropsychoparmacol 2011;21:718-779.
¹⁹
Wittchen HU, Jacobi F, Rehm J, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol 2011;21:655-679.
²⁰
Luengo-Fernandez R, Leal J, Gray AM. Cost of dementia in the pre-enlargement countries of the Europe Union. J Alzheimers Dis 2011;27:187-196.
²¹
Guerra M, Ferri CP, Fonseca M, Banerjee S, Prince M. Helping carers to care: the 10/66 dementia research group's randomized control trial of a caregiver intervention in Peru. Rev Bras Psiquiatr 2011;33:47-54.
²²
Jacinto AF, Brucki S, Porto CS, Martind Mde A, Nitrini R. Detection of cognitive impairment in the elderly by general internists in Brazil. Clinics 2011;66:1379-1384.
²³
Rapp T, Grand A, Cantet C, et al. Public financial support receipt and non-medical resource utilization in Alzheimer's disease results from the PLASA study. Soc Sci Med 2011;72:1310-1316.
²⁴
Miranda LFJR, Matoso RO, Rodrigues MV, Lima TOL, Nascimento AF, Carvalho FC, et al. Factors influencing possible delay in the diagnosis of Alzheimer's disease: Findings from a tertiary Public University Hospital. Dement Neuropsychol 2011;5:328-331.
²⁵
Wimo A, Winblad B, Jonsson L. The worldwide societal costs of dementia: estimates for 2009. Alzheimer Dement 2010;6:98-103.
²⁶
Brosselin P, Duport N, Bloch J. Mortality with Alzheimer's disease and dementia in France, 2006. Rev Epidemiol Sante Publique 2010;58:269-276.
²⁷
Awata S. New national health program against dementia in Japan: the medical center for dementia. Psychogeriatrics 2010;10:102-106.
²⁸
Todd S, Wilson D, McGuinness B, Craig D, Passmore AP. Northern Ireland dementia strategy. Int J Geriatr Psychiatry 2010;25:902-904.
²⁹
Cahill S. Developing a national dementia strategy for Ireland. Int J Geriatr Psychiatry 2010;25:912-916.
³⁰
Castro DM, Dillon C, Machnicki G, Allegri RF. The economic cost of Alzheimer's disease: family or public-health burden? Dement Neuropsychol 2010;4:262-267.
³¹
Larson EB. Prospects for delaying the rising tide of worldwide, late-life dementias. Int Psychogeriatr 2010;22:1196-202.
³²
Wang Y, Huang Y, Liu Z, Zhuo C, Li S, Prince M. A five-year community-based longitudinal survival study of dementia in Beijing, China: a 10/66 Dementia Research Group population-based study. Int Psychogeriatr 2010;22:761-768.
³³
Banerjee S. Living well with dementia-development of the national dementia strategy for England. Int J Geriatr Psychiatry 2010;25:917-922.
³⁴
Prince MJ. The 10/66 dementia research group - 10 years on. Indian J Psychiatry 2009;51(Suppl 1):S8-S15.
³⁵
Sowmini CV, De Vries R. A cross cultural review of the ethical issues in dementia care in Kerala, India and The Netherlands. Int J Geriatr Psychiatry 2009;24:329-334.
³⁶
Travers C, Martin-Khan M, Lie D. Barriers and enablers to inform the Australian prevention and early intervention in primary care: evidence to inform the Australian national dementia strategy. Australas J Ageing 2009;28:51-57.
³⁷
Llibre JJ, Fernandez Y, Marcheco B, et al. Prevalence of Dementia and Alzheimer's Disease in a Havana Municipality: A Community-Based Study among Elderly Residents. MEDICC Rev 2009;11:29-35.
³⁸
Guerchet M, Houinato D, Paraiso MN, et al. Cognitive impairment and dementia in elderly people living in rural Benin, West Africa. Dement Geriatr Cogn Disord 2009;27:34-41.
³⁹
Justiss MD, Boustani M, Fox C, et al. Patients' attitudes of dementia screening across the Atlantic. Int J Geriatr Psychiatry 2009;24: 632-637.
⁴⁰
Nitrini R, Bottino CM, Albala C, et al. Prevalence of dementia in Latin America: a collaborative study of population-based cohorts. Int Psychogeriatr 2009;21:622-630.
⁴¹
Uwakne R, Ibeh CC, Modebe AI, et al. The epidemiology of dependence in older people in Nigeria: prevalence, determinants, informal care, and healt service utilization. A 10/66 dementia research group cross-sectional survey. J Am Geriatr Soc 2009;57:1620-1627.
⁴²
Prince M, Acosta D, Albanese E, et al. Ageing and dementia in low and middle income countries - Using research to engage with public and policy makers. Int Rev Psychiatry 2008;20:332-343.
⁴³
Dias A, Dewey ME, D'Souza J, et al. The effectiveness of a home care program for supporting caregivers of persons with dementia in developing countries: a randomised controlled trial from Goa, India. PLoS One 2008;3:e2333.
⁴⁴
Magalhães MO, Peixoto JM, Frank MH, et al. Risk factors for dementia in a rural area of Northeatern Brazil. Arq Neuropsiquiatr 2008;66: 157-162.
⁴⁵
Pavarini SCI, Mendiondo EM, Montaño M, et al. Sistema de informações geográficas para a gestão de programas municipais de cuidado a idosos. Texto Contexto Enferm 2008;17:17-25.
⁴⁶
Fuh JL, Wang SJ. Dementia in Taiwan: past, present, and future. Acta Neurol Taiwan 2008;17:153-161.
⁴⁷
Scazufca M, Menezes PR, Vallada HP, et al. High prevalence of dementia among older adults from por socioeconomic backgrounds in São Paulo, Brazil. Int Psychogeriatr 2008;20:394-405.
⁴⁸
Brunton M, Jordan C, Fouche C. Managing public health care policy: who's being forgotten? Health Policy 2008;88:348-358.
⁴⁹
Lopes MA, Hototian SR, Bustamante SE, et al. Prevalence of cognitive and functional impairment in a community simple in Ribeirão Preto, Brazil. Int J Geriatr Psychiatry 2007;22:770-776.
⁵⁰
Purandare N, Luthra V, Swarbrick C, Burns A. Knowledge of dementia among South Asian (Indian) older people in Manchester, UK. Int J Geriatr Psychiatry 2007;22:777-781.
⁵¹
Allegri RF, Butman J, Arizaga RL, et al. Economic impacti of dementia in developin countries: an evaluation of costs of Alzheimer-type dementia in Argentina. Int Psychogeriatr 2007;19:705-718.
⁵²
Fernandes MTO, Soares, SM. O desenvolvimento de políticas públicas de atenção ao idoso no Brasil. Rev Esc Enferm USP 2012;46:6: 1494-1502.
⁵³
Veras RP, Caldas CP. Promovendo a saúde e a cidadania do idoso: o movimento das universidades da terceira idade. Ciênc Saúde Colet 2004;9:2:423-432.

Publication Dates

Publication in this collection
Jan-Mar 2014

History

Received
24 Oct 2013
Accepted
20 Jan 2014

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] ¹
Ballard C, Gauthier S, Corbett A, Brayne C, Aarsland D, Jones E. Alzheimer's disease. Lancet 2011;377:1019-1031.

[2] ²
Associação Brasileira de Alzheimer [Internet]. São Paulo: Doença de Alzheimer; 2012. Disponível em: http://www.abrazsp.org.br

[3] ³
World Health Organization, Dementia: A Public Health Priority, Geneva, Switzerland; 2012. Available from: http://whqlibdoc.who.int/publications/2012/9789241564458_eng.pdf
» http://whqlibdoc.who.int/publications/2012/9789241564458_eng.pdf

[4] ⁴
Wimo, A, Prince, M. World Alzheimer Report 2010: The Global Economic Impact of Dementia. London: Alzheimer's Disease International; 2010. Available from: http://www.alz.co.uk/research/files/WorldAlzheimerReport2010.pdf
» http://www.alz.co.uk/research/files/WorldAlzheimerReport2010.pdf

[5] ⁵
Garrido R, Menezes PR. O Brasil está envelhecendo: boas e más notícias por uma perspectiva epidemiológica. Rev Bras Psiquiatr 2002; 24:3-6.

[6] ⁶
Camacho ACLF, Coelho MJ. Políticas públicas para a saúde do idoso: revisão sistemática. Rev Bra Enferm 2010;63:279-284.

[7] ⁷
Chaufan C, Hollister B, Nazareno J, Fox P. Medical ideology as a double-edged sword: the politics of cure and care in the making of Alzheimer's disease. Soc Sci Med 2012;74:788-795.

[8] ⁸
Faure-Delage A, Mouanga AM, M'Belesso, et al. Socio-cultural perceptions and representations of demente in Brazzaville, Republico f Congo: the EDAC survey. Dement Geriatr Cogn Disord 2012;2:84-96.

[9] ⁹
Mitchell SL, Black BS, Ersek M, et al. Advanced dementia: state of the art and priorities for the next decade. Ann Intern Med 2012;156:45-51.

[10] ¹⁰
Toure K, Coume M, Ndiaye M, et al. Risk factors for dementia in a senegalese elderly population aged 65 years and over. Dement Geriatr Cogn Disord 2012;2:160-168.

[11] ¹¹
Sosa AL, Albanese E, Stephan BC, et al. Prevalence, distribution, and impact of mild cognitive impairment in Latin America, China, and India: a 10/66 population-based study. PLoS Med 2012;9:e1001170.

[12] ¹²
Maestre GE. Assessing dementia in resource-poor regions. Curr Neurol Neurosci Rep 2012;12:511-519.

[13] ¹³
McParland P, Devine P, Innes A, Gayle V. Dementia knowledge and attitudes of the general public in Northen Ireland: as analysis of national survey data. Int Psychogeriatr 2012;24:1600-1613.

[14] ¹⁴
Llibre Jde J, Valhuerdi A, Calvo M, et al. Dementia and other chronic diseases in older adults in Havana and Matanzas: the 10/66 study in Cuba. MEDICC Rev 2011;13:30-37.

[15] ¹⁵
Abbott A. Dementia: a problem for our age. Nature 2011;475:S2-S4.

[16] ¹⁶
Carias CM, Vieira FS, Giordano CV, Zucchi P. Medicamentos de dispensação excepcional: histórico e gastos do Ministério da Saúde do Brasil. Rev Saude Publica 2011;45:233-240.

[17] ¹⁷
Rosow K, Holzapfel A, Karlawish JH, Baumgart M, Bain LJ, Khachaturian AS. Countrywide strategic plans on Alzheimer's disease: developing the framework for the international battle against Alzheimer's disease. Alzheimers Dement 2011;7:615-621.

[18] ¹⁸
Gustavsson A, Svensson M, Jacobi F, et al. Cost of disorders oh the brain in Europe 2010. Eur Neuropsychoparmacol 2011;21:718-779.

[19] ¹⁹
Wittchen HU, Jacobi F, Rehm J, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol 2011;21:655-679.

[20] ²⁰
Luengo-Fernandez R, Leal J, Gray AM. Cost of dementia in the pre-enlargement countries of the Europe Union. J Alzheimers Dis 2011;27:187-196.

[21] ²¹
Guerra M, Ferri CP, Fonseca M, Banerjee S, Prince M. Helping carers to care: the 10/66 dementia research group's randomized control trial of a caregiver intervention in Peru. Rev Bras Psiquiatr 2011;33:47-54.

[22] ²²
Jacinto AF, Brucki S, Porto CS, Martind Mde A, Nitrini R. Detection of cognitive impairment in the elderly by general internists in Brazil. Clinics 2011;66:1379-1384.

[23] ²³
Rapp T, Grand A, Cantet C, et al. Public financial support receipt and non-medical resource utilization in Alzheimer's disease results from the PLASA study. Soc Sci Med 2011;72:1310-1316.

[24] ²⁴
Miranda LFJR, Matoso RO, Rodrigues MV, Lima TOL, Nascimento AF, Carvalho FC, et al. Factors influencing possible delay in the diagnosis of Alzheimer's disease: Findings from a tertiary Public University Hospital. Dement Neuropsychol 2011;5:328-331.

[25] ²⁵
Wimo A, Winblad B, Jonsson L. The worldwide societal costs of dementia: estimates for 2009. Alzheimer Dement 2010;6:98-103.

[26] ²⁶
Brosselin P, Duport N, Bloch J. Mortality with Alzheimer's disease and dementia in France, 2006. Rev Epidemiol Sante Publique 2010;58:269-276.

[27] ²⁷
Awata S. New national health program against dementia in Japan: the medical center for dementia. Psychogeriatrics 2010;10:102-106.

[28] ²⁸
Todd S, Wilson D, McGuinness B, Craig D, Passmore AP. Northern Ireland dementia strategy. Int J Geriatr Psychiatry 2010;25:902-904.

[29] ²⁹
Cahill S. Developing a national dementia strategy for Ireland. Int J Geriatr Psychiatry 2010;25:912-916.

[30] ³⁰
Castro DM, Dillon C, Machnicki G, Allegri RF. The economic cost of Alzheimer's disease: family or public-health burden? Dement Neuropsychol 2010;4:262-267.

[31] ³¹
Larson EB. Prospects for delaying the rising tide of worldwide, late-life dementias. Int Psychogeriatr 2010;22:1196-202.

[32] ³²
Wang Y, Huang Y, Liu Z, Zhuo C, Li S, Prince M. A five-year community-based longitudinal survival study of dementia in Beijing, China: a 10/66 Dementia Research Group population-based study. Int Psychogeriatr 2010;22:761-768.

[33] ³³
Banerjee S. Living well with dementia-development of the national dementia strategy for England. Int J Geriatr Psychiatry 2010;25:917-922.

[34] ³⁴
Prince MJ. The 10/66 dementia research group - 10 years on. Indian J Psychiatry 2009;51(Suppl 1):S8-S15.

[35] ³⁵
Sowmini CV, De Vries R. A cross cultural review of the ethical issues in dementia care in Kerala, India and The Netherlands. Int J Geriatr Psychiatry 2009;24:329-334.

[36] ³⁶
Travers C, Martin-Khan M, Lie D. Barriers and enablers to inform the Australian prevention and early intervention in primary care: evidence to inform the Australian national dementia strategy. Australas J Ageing 2009;28:51-57.

[37] ³⁷
Llibre JJ, Fernandez Y, Marcheco B, et al. Prevalence of Dementia and Alzheimer's Disease in a Havana Municipality: A Community-Based Study among Elderly Residents. MEDICC Rev 2009;11:29-35.

[38] ³⁸
Guerchet M, Houinato D, Paraiso MN, et al. Cognitive impairment and dementia in elderly people living in rural Benin, West Africa. Dement Geriatr Cogn Disord 2009;27:34-41.

[39] ³⁹
Justiss MD, Boustani M, Fox C, et al. Patients' attitudes of dementia screening across the Atlantic. Int J Geriatr Psychiatry 2009;24: 632-637.

[40] ⁴⁰
Nitrini R, Bottino CM, Albala C, et al. Prevalence of dementia in Latin America: a collaborative study of population-based cohorts. Int Psychogeriatr 2009;21:622-630.

[41] ⁴¹
Uwakne R, Ibeh CC, Modebe AI, et al. The epidemiology of dependence in older people in Nigeria: prevalence, determinants, informal care, and healt service utilization. A 10/66 dementia research group cross-sectional survey. J Am Geriatr Soc 2009;57:1620-1627.

[42] ⁴²
Prince M, Acosta D, Albanese E, et al. Ageing and dementia in low and middle income countries - Using research to engage with public and policy makers. Int Rev Psychiatry 2008;20:332-343.

[43] ⁴³
Dias A, Dewey ME, D'Souza J, et al. The effectiveness of a home care program for supporting caregivers of persons with dementia in developing countries: a randomised controlled trial from Goa, India. PLoS One 2008;3:e2333.

[44] ⁴⁴
Magalhães MO, Peixoto JM, Frank MH, et al. Risk factors for dementia in a rural area of Northeatern Brazil. Arq Neuropsiquiatr 2008;66: 157-162.

[45] ⁴⁵
Pavarini SCI, Mendiondo EM, Montaño M, et al. Sistema de informações geográficas para a gestão de programas municipais de cuidado a idosos. Texto Contexto Enferm 2008;17:17-25.

[46] ⁴⁶
Fuh JL, Wang SJ. Dementia in Taiwan: past, present, and future. Acta Neurol Taiwan 2008;17:153-161.

[47] ⁴⁷
Scazufca M, Menezes PR, Vallada HP, et al. High prevalence of dementia among older adults from por socioeconomic backgrounds in São Paulo, Brazil. Int Psychogeriatr 2008;20:394-405.

[48] ⁴⁸
Brunton M, Jordan C, Fouche C. Managing public health care policy: who's being forgotten? Health Policy 2008;88:348-358.

[49] ⁴⁹
Lopes MA, Hototian SR, Bustamante SE, et al. Prevalence of cognitive and functional impairment in a community simple in Ribeirão Preto, Brazil. Int J Geriatr Psychiatry 2007;22:770-776.

[50] ⁵⁰
Purandare N, Luthra V, Swarbrick C, Burns A. Knowledge of dementia among South Asian (Indian) older people in Manchester, UK. Int J Geriatr Psychiatry 2007;22:777-781.

[51] ⁵¹
Allegri RF, Butman J, Arizaga RL, et al. Economic impacti of dementia in developin countries: an evaluation of costs of Alzheimer-type dementia in Argentina. Int Psychogeriatr 2007;19:705-718.

[52] ⁵²
Fernandes MTO, Soares, SM. O desenvolvimento de políticas públicas de atenção ao idoso no Brasil. Rev Esc Enferm USP 2012;46:6: 1494-1502.

[53] ⁵³
Veras RP, Caldas CP. Promovendo a saúde e a cidadania do idoso: o movimento das universidades da terceira idade. Ciênc Saúde Colet 2004;9:2:423-432.

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