Bezerra Camila Carlos, Toledo Noeli das Neves, Sampaio Rebeca Lima, Barbosa Breno José Alencar Pires, Dozzi Brucki Sonia Maria, Souza-Talarico Juliana Nery
Department of Medical-Surgical Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil.
School of Nursing at Manaus, Federal University of Amazonas, Manaus, Brazil.
Dement Geriatr Cogn Dis Extra. 2024 Dec 19;15(1):8-18. doi: 10.1159/000542587. eCollection 2025 Jan-Dec.
Studies about dementia in Indigenous communities are still scarce worldwide, especially in low-middle-income countries, limiting timely intervention in minority groups. Our research aimed to bridge this gap by determining the prevalence of dementia and mild cognitive impairment no dementia (CIND), and the associated factors, in a multiethnic Indigenous community in Manaus, Brazil.
A cross-sectional observational study evaluated the cognitive and functional performances of 141 Indigenous individuals (aged 50 and above). A panel of dementia neurologist experts independently analyzed cognitive (Mini-Mental State Exam [MMSE], Brief Cognitive Screening Battery, verbal fluency), functional (Pfeffer questionnaire) performances, and depression symptoms (Geriatric Depression Scale) to classify participants as cognitively unimpaired, CIND, and dementia.
CIND rate was 11.3% and 12.8% for dementia. None of the participants classified as CIND had a prior diagnosis, and only three out of 18 participants with dementia had a diagnosis. Stratified analysis showed that age ( = 0.017) and lower education ( = 0.047) were associated with higher CIND and dementia. However, only age was significantly associated with dementia in the regression models (OR = 1.078; 95% CI: 1.011-1.149). Sex, living in extreme poverty, hypertension, diabetes, smoking, or excessive alcohol use was not linked to CIND or dementia.
The Indigenous community of Manaus exhibited higher rates of dementia and CIND than national and global estimates. These findings may set the stage for additional research into the interplay of social, economic, biological, and behavioral factors affecting dementia risk in underrepresented groups such as Indigenous communities.
全球范围内，关于原住民社区痴呆症的研究仍然很少，尤其是在中低收入国家，这限制了对少数群体的及时干预。我们的研究旨在通过确定巴西玛瑙斯一个多民族原住民社区中痴呆症和轻度认知障碍但无痴呆症（CIND）的患病率及其相关因素来填补这一空白。
一项横断面观察性研究评估了141名50岁及以上原住民个体的认知和功能表现。一组痴呆症神经科专家独立分析了认知（简易精神状态检查表[MMSE]、简易认知筛查量表、语言流畅性）、功能（普费弗问卷）表现以及抑郁症状（老年抑郁量表），以将参与者分类为认知未受损、CIND和痴呆症患者。
CIND患病率为11.3%，痴呆症患病率为12.8%。被分类为CIND的参与者之前均未被诊断过，在18名痴呆症患者中只有3人曾被诊断过。分层分析表明，年龄（P = 0.017）和较低的教育程度（P = 0.047）与较高的CIND和痴呆症患病率相关。然而，在回归模型中只有年龄与痴呆症显著相关（比值比 = 1.078；95%置信区间：1.011 - 1.149）。性别、生活在极端贫困中、高血压、糖尿病、吸烟或过度饮酒与CIND或痴呆症无关。
玛瑙斯的原住民社区痴呆症和CIND患病率高于国家和全球估计水平。这些发现可能为进一步研究社会、经济、生物和行为因素在原住民社区等代表性不足群体中影响痴呆症风险的相互作用奠定基础。
