Abstract
Background: Despite the assumption that dementia is increasing in rural areas of Latin America,
there is no information on the burden and risk factors leading to dementia in these
settings. Aims: To assess prevalence and incidence of dementia, and its cerebrovascular correlates
in an established cohort of community-dwelling older adults living in rural Ecuador,
and to explore the impact of dementia on functional disability and the role of the
social determinants of health in the above-mentioned relationships. Design: Population-based, cohort study with cross-sectional and longitudinal components.
Baseline clinical interviews will focus on the assessment of cognitive performance
and dementia by means of the clinical dementia rating scale (CDRS). Functional disability
and social determinants of health will be correlated with CDRS scores. In addition,
participants will undergo interviews and procedures to assess cardiovascular risk
factors and signatures of brain damage, cerebral small vessel disease, and other stroke
subtypes. The CDRS and the Functional Activities Questionnaire will be administered
every year to assess the rate of incident dementia and the severity of functional
disability. Neuroimaging studies will be repeated at the end of the study (5 years)
to assess the impact of newly appeared cerebral and vascular lesions on cognitive
decline. Comment: This study will allow determine whether cerebrovascular diseases are in the path
of dementia development in these rural settings. This may prove cost-effective for
the development of preventive strategies aimed to control modifiable factors and reduce
disability in patients with dementia living in underserved populations.
Key Words
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Article info
Publication history
Published online: February 04, 2020
Accepted:
January 9,
2020
Received in revised form:
December 1,
2019
Received:
October 16,
2019
Footnotes
Financial Disclosures: Study supported by Universidad Espíritu Santo – Ecuador.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104656
Copyright
© 2020 Elsevier Inc. All rights reserved.
