Purpose: To estimate the prevalence of cognitive impairment in 4 Latin American cities: La Havana, Cuba, ciudad de Mexico, Mexico, Santiago, Chile and Sao Paulo, Brazil. A diagnostic test previously validated, consisting in a short version of MMSE plus the Pffefer Activities Questionnaire (PFAQ).
Methods: Cross sectional survey in representative samples of subjects aged 60 and older residing in each of the selected cities. The sampling design allows the calculation of the probability of selection of each target individual. This, plus the non-response rates, provided the information to estimate expansion factors that convert the sample into population equivalent units. Cognitive impairment was defined by a score below 13 on the short MMSE (max score 19) and above 5 (max score 33) in the PFAQ. In all the subjects, a short version of MMSE was applied and when scoring < 13, PFAQ was applied to a surrogate.
Results: There was a significant increase with aging in all 4 cities that reached roughly 30% of positives in people aged 85 or over. The prevalence of cognitive impairment increases sharply with aging, as shown in Table 2 (Table 2). Prevalence of cognitive impairment by groups of age in 4 selected cities. The SABE Project:
City 60-64 64-74 75+ Total Sao Paulo 3.2 6 23.4 8.9 Santiago 3.6 4.7 18.2 8.1 Havana 1.2 4.4 18.9 8.0 Mexico City 1.7 4.6 24.3 8.4
Prevalence of cognitive impairment was more prevalent in women than in men in all the cities studied The interaction between gender and age resulted in a higher prevalence in women. Cognitive impairment was significantly higher in less educated subjects. Among women, the prevalence of cognitive impairment was lower in estrogen anytime users after adjustment by age and schooling in all the four cities studied.
Conclusion: The total prevalence of cognitive impairment in all the three cities studied was 8-9% similar to figures in developed countries, the more frequent the older and the less educated. The higher prevalence in women is due to the interaction of age and illiteracy. In women, Estrogen use appears as a protective factor for cognitive impairment in three cities: Santiago, Mexico and Sao Paulo. The estrogen users in Havana’s women was so small that it didn't allow any analysis.
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