Brazil has almost 1 million people with Alzheimer’s – 09/21/2023 – Balance and Health

In Brazil, 1.757 million people have some type of dementia, and Alzheimer’s disease alone accounts for 55% of these cases (966,594).

The numbers were presented by Abraz (Brazilian Alzheimer’s Association) at the 1st Big Data Abraz, at Hospital Israelita Albert Einstein, in São Paulo, this Thursday (21), World Alzheimer’s Disease Awareness Day.

In addition, there are another 2.3 million Brazilians with some type of cognitive decline with symptoms related to memory and cognition, but not yet showing signs of dementia.

According to the Brazilian Longitudinal Study of Aging (ELSI-Brazil), the estimate is that by 2030 there will be 2.78 million and, by 2050, more than 5.5 million Brazilians aged 60 or over living with dementia.

The research was based on data from 2019. 5,249 individuals aged 60 or over were included, from 70 small, medium and large municipalities, in urban and rural areas, considering the five regions of the country. Participants were classified as having normal cognitive function, non-demented cognitive impairment (characterized by loss of memory or cognitive functions transitional between normal cognition and dementia), and dementia.

According to Abraz, the prevalence rate of dementia in the country in 2019 was calculated at 5.8%, considering the population over 60 years old. According to IBGE estimates for the same year, the Brazilian population in this age group was 22.3 million people.

The data is worrying mainly due to two factors: the increase in the aging of the population and the burden that falls on family members of people with Alzheimer’s, generally women, related to caring for relatives. It is estimated that two-thirds of informal caregivers of patients with dementia are women, and this number is significantly higher in low- and middle-income countries, such as Brazil.

“Dementia is the first cause of disability in rich countries, and the tenth in low- and middle-income countries, but we observe that there is a tendency for cases of dementia to triple in developed countries by 2050, while in low- and middle-income countries average income they should increase fivefold”, says Claudia Suemoto, professor of geriatrics at the USP Faculty of Medicine.

If the prevalence of dementia is growing around the world, Alzheimer’s diagnoses still present a major bottleneck. While new tests and exams for early detection are made available around the world, Brazil still has gaps in the data on how many people live with dementia in the country.

The Alzheimer’s diagnosis rate is around 1.2%, according to Pinheiro. “We see a huge rate of undiagnosed people, and this is worrying when we see that therapeutic results are much more satisfactory when treatment is started in the initial phase”, says Celene Pinheiro, geriatrician and president of Abraz-SP.

Other data presented by the panel show that factors such as age, education and gender can have an effect on the prevalence of dementia. People over 80 still represent the majority (77%) of dementia cases, with 13% in the 80 to 84 age group, 21% among those aged 85 to 89, and almost half (43%) of cases in the age group over 90 years.

Low education also affects the condition, with a prevalence of 16.5% in individuals with no level of education (illiterate), 5.1% among those with four or less years of education, 3.6% for four years of education, 2.2% among people with complete primary education, 1.5% for secondary education and 2.1% among those with higher education.

Estimates also indicate that more women are living with dementia than men in Brazil: 6.8% of women aged 60 or over have dementia, compared to 4.6% of men.

“International and national studies already present consolidated data on risk factors for dementia, but, when comparing data from the Northern Hemisphere with that from Brazil, what we saw was not a change in the factors themselves, but in their order. So, here , the risk factors for dementia are, in order of size, illiteracy, hypertension, hearing loss and obesity”, explains Pinheiro.

The big issue is that many of these factors are called modifiable. A study published late last year in the journal Alzheimer’s and Dementia by Suemoto and colleagues found that modifying some of these factors can reduce the prevalence of dementia by up to 54% in some regions.

Because patients with this condition require a network of care, the social cost of dementia, including Alzheimer’s, is also high.

The general cost of caring for a person with dementia is US$1,379 per month (R$6,790, in values ​​not adjusted for inflation), with US$610 (R$3,000) for direct expenses and US$769 (R$3,790 ) indirect. Considering the total number of people living with dementia estimated for 2019, this is equivalent to an annual expenditure of approximately US$30 billion (R$150 billion per year, or 1.5% of Brazilian GDP).

In addition to the burden on the family budget, caring for family members with dementia represents a greater burden for women, as they represent 9 out of 10 (92.2%) of informal caregivers, according to a cross-sectional study conducted in a geriatric outpatient clinic in São Paulo. The average age of these caregivers is 57 years old, their average level of education is 9.5 years and the majority are married (56.7%) and have some occupation (68.6%) in addition to caring for the patient.

“The scenario is very cruel, because the vast majority of caregivers are women, daughters of patients, who need to stop working to dedicate themselves to caring for their father or mother with dementia. And when this family member dies, on average a decade Afterwards, they have been out of the job market for a long time and are unable to reinsert themselves. So the social cost is huge for these families”, says Pinheiro.

This weight is also felt in the proportion of caregivers (62.2%) who say they suffer from some type of mental disorder, with 50% symptoms of anxiety, 52.2% depression and 66.7% overload in relation to care.

“That’s why we work in the caregiver support network, so that this single person, often the daughter, doesn’t feel overwhelmed. And we talk to other family members so that they also understand that it’s not just one person who has to care”, says Aline Gratão, coordinator of the Gerontology Outpatient Clinic at the University Hospital of UFScar (Federal University of São Carlos).