Llibre Rodríguez J, Valhuerdi A, Sanchez II, Reyna C, Guerra MA, Copeland JR, McKeigue P, Ferri CP, Prince MJ. The prevalence, correlates and impact of dementia in Cuba. A 10/66 group population-based survey. Neuroepidemiology. 2008;31(4):243-51. Epub 2008 Oct 20.

BACKGROUND: We aimed to estimate the prevalence, correlates and impact of dementia in Havana and Matanzas, Cuba. METHODS: A 1-phase catchment area survey of all over 65-year-old residents of 7 catchment areas in Havana and 1 in Matanzas was conducted. Dementia diagnosis was established according to DSM-IV and our own, pre-validated 10/66 criteria. The impact of dementia was assessed through associations with needs for care, cutting back on work to care and caregiver psychological morbidity. RESULTS: We interviewed 2,944 older people, a response proportion of 96.4%. The prevalence of DSM-IV dementia was 6.4% and that of 10/66 dementia 10.8%. Both dementia outcomes were associated with older age, less education, a family history of dementia, shorter leg length and smaller skull circumference. Dementia, rather than physical health problems or depression, was the main contributor to needs for care (population-attributable prevalence fraction = 64.6%) and caregiver cutting back on work (population-attributable prevalence fraction = 57.3%). CONCLUSION: The prevalence of dementia in Cuba is similar to Europe. Among health conditions, dementia is the major contributor to dependency and caregiver economic and psychological strain. More attention needs to be given to it and other chronic diseases associated more with disability than premature mortality. Copyright 2008 S. Karger AG, Basel.

Domínguez YL, Hernández M, Matos CM, Zhou D. Is B vitamins deficiency associated with prevalence of Alzheimer's disease in Cuban elderly? Nutr Health. 2006;18(2):103-18.

Alzheimer's disease (AD), is a major public health problem among the elderly in industrialized countries and a growing problem in developing countries. In Cuba, 14,6% of the population is older than 60 years. The AD prevalence in Cuba lies between 5,13-7,14%. Several studies have shown the relationship between the low nutritional status of B vitamins, hyperhomocysteinaemia with loss of neuro-cognitive function and AD. In studies during the epidemic neuropathy that affected Cuba between 1992-1993, B vitamins deficiency and smoking habits were strongly associated with the epidemic. Some studies in healthy adults and elderly after this epidemic have shown a sub-clinical deficiency of some B vitamins and a high prevalence of infection by Helicobacter pylori. The possibility that B vitamin deficiencies could be an additional risk factor for the high prevalence of the AD in Cuba is discussed.

Llibre JJ, Guerra MA, Pérez-Cruz H, Bayarre H, Fernández-Ramírez S, González-Rodríguez M, Samper JA. [Dementia syndrome and risk factors in adults older than 60 years old residing in Habana] Rev Neurol. 1999 Nov 16-30;29(10):908-11.

INTRODUCTION: The dementias and Alzheimer's disease are a growing problem in countries with a long life expectancy. OBJECTIVE: To find the prevalence of the dementia syndrome in the population aged over 60 years in the municipality of Marianao, La Habana, during the first three months of 1998, and the relationship with certain associated biosocial factors. PATIENTS AND METHODS: A descriptive transversal study in which 799 elderly persons were assessed in their homes, out of a population of 22,590 elderly persons, by means of conglomerate sampling in two stages. In the same way, we selected a sample from the municipality of Bauta representing 340 adults. The probable diagnosis of dementia syndrome or Alzheimer's disease was based on criteria of DSM III R and NINCDS-ADRDA. A second analytical phase was done by studying cases and witnesses. Univariate and multivariate hypothesis tests were done by means of the multiple logistic regression method. RESULTS AND CONCLUSIONS: The prevalence of the dementia syndrome was 8.2% (6.27-10.42); and that of Alzheimer's disease and vascular dementia was 5.13% and 1.93% respectively. Age, female sex, previous clinical history and no spouse (due to widowhood or being single), were risk factors in this population. Early detection of the dementia syndrome allows development of projects to intervene in old people to actively improve their state of health and socio-familial adaptation.