(Prof A Ibáñez PhD, S D Pina-Escudero MD, K L Possin PhD, F A Peres MS, Prof B L Miller MD); (Prof A Ibáñez, S D Pina-Escudero, K L Possin, F A Peres, Prof B L Miller); (Prof A Ibáñez); (Prof A Ibáñez); (Prof A Ibáñez); (S D Pina-Escudero, K L Possin, Prof B L Miller); (Y T Quiroz PhD); (Prof A Slachevsky PhD); (Prof A Slachevsky); (Prof A L Sosa PhD); (Prof S M D Brucki PhD).
Lancet Healthy Longev. 2021 Apr;2(4):e222-e231. doi: 10.1016/s2666-7568(21)00031-3. Epub 2021 Mar 31.
The prevalence of dementia in Latin America and the Caribbean is growing rapidly, increasing the burden placed on caregivers. Exacerbated by fragile health-care systems, unstable economies, and extensive inequalities, caregiver burden in this region is among the highest in the world. We reviewed the major challenges to caregiving in Latin America and the Caribbean, and we propose regional and coordinated actions to drive future change. Current challenges include the scarcity of formal long-term care, socioeconomic and social determinants of health disparities, gender-biased burdens, growing dementia prevalence, and the effect of the current COVID-19 pandemic on families affected by dementia. Firstly, we propose local and regional short-term strategic recommendations, including systematic identification of specific caregiver needs, testing of evidence-based local interventions, contextual adaptation of strategies to different settings and cultures, countering gender bias, strengthening community support, provision of basic technology, and better use of available information and communications technology. Additionally, we propose brain health diplomacy (ie, global actions aimed to overcome the systemic challenges to brain health by bridging disciplines and sectors) and convergence science as frameworks for long-term coordinated responses, integrating tools, knowledge, and strategies to expand access to digital technology and develop collaborative models of care. Addressing the vast inequalities in dementia caregiving across Latin America and the Caribbean requires innovative, evidence-based solutions coordinated with the strengthening of public policies.
拉丁美洲和加勒比地区的痴呆症患病率正在迅速增长,这给护理人员带来了更大的负担。该地区的护理人员负担是世界上最重的,这是脆弱的医疗保健系统、不稳定的经济和广泛的不平等加剧的结果。我们回顾了拉丁美洲和加勒比地区护理工作面临的主要挑战,并提出了区域协调行动,以推动未来的变革。目前的挑战包括正规长期护理的匮乏、健康的社会经济和社会决定因素的差异、性别偏见负担、痴呆症患病率的上升,以及当前 COVID-19 大流行对受痴呆症影响的家庭的影响。首先,我们提出了地方和区域短期战略建议,包括系统地确定特定护理人员的需求,测试基于证据的本地干预措施,将策略适应当地和文化背景,消除性别偏见,加强社区支持,提供基本技术,以及更好地利用现有信息和通信技术。此外,我们提出了大脑健康外交(即通过跨越学科和部门来克服大脑健康系统性挑战的全球行动)和趋同科学作为长期协调应对的框架,整合工具、知识和策略,以扩大数字技术的获取并开发协作护理模式。解决拉丁美洲和加勒比地区在痴呆症护理方面的巨大不平等问题需要创新的、基于证据的解决方案,并与加强公共政策相协调。