Frontiers in Neurology (Mar 2022)
Facilitators and Barriers to Dementia Assessment and Diagnosis: Perspectives From Dementia Experts Within a Global Health Context
- Alissa Bernstein Sideman,
- Alissa Bernstein Sideman,
- Alissa Bernstein Sideman,
- Tala Al-Rousan,
- Tala Al-Rousan,
- Elena Tsoy,
- Elena Tsoy,
- Stefanie D. Piña Escudero,
- Stefanie D. Piña Escudero,
- Maritza Pintado-Caipa,
- Maritza Pintado-Caipa,
- Suchanan Kanjanapong,
- Suchanan Kanjanapong,
- Lingani Mbakile-Mahlanza,
- Lingani Mbakile-Mahlanza,
- Maira Okada de Oliveira,
- Maira Okada de Oliveira,
- Maira Okada de Oliveira,
- Myriam De la Cruz-Puebla,
- Myriam De la Cruz-Puebla,
- Myriam De la Cruz-Puebla,
- Myriam De la Cruz-Puebla,
- Myriam De la Cruz-Puebla,
- Stelios Zygouris,
- Stelios Zygouris,
- Aya Ashour Mohamed,
- Aya Ashour Mohamed,
- Hany Ibrahim,
- Hany Ibrahim,
- Collette A. Goode,
- Bruce L. Miller,
- Bruce L. Miller,
- Victor Valcour,
- Victor Valcour,
- Katherine L. Possin,
- Katherine L. Possin
Affiliations
- Alissa Bernstein Sideman
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States
- Alissa Bernstein Sideman
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Alissa Bernstein Sideman
- Department of Humanities and Social Sciences, University of California, San Francisco, San Francisco, CA, United States
- Tala Al-Rousan
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Tala Al-Rousan
- Herbert Wertheim School of Public Health, University of California, La Jolla, CA, United States
- Elena Tsoy
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Elena Tsoy
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
- Stefanie D. Piña Escudero
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Stefanie D. Piña Escudero
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
- Maritza Pintado-Caipa
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Maritza Pintado-Caipa
- Research Department, Peruvian Institute of Neurosciences, Lima, Peru
- Suchanan Kanjanapong
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Suchanan Kanjanapong
- Division of Geriatrics, Department of Preventive Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Lingani Mbakile-Mahlanza
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Lingani Mbakile-Mahlanza
- Department of Psychology, Faculty of Social Sciences, University of Botswana, Gaborone, Botswana
- Maira Okada de Oliveira
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Maira Okada de Oliveira
- Cognitive and Behavioral Neurology Unit, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil
- Maira Okada de Oliveira
- 0Hospital Santa Marcelina, São Paulo, São Paulo, Brazil
- Myriam De la Cruz-Puebla
- 1Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Myriam De la Cruz-Puebla
- 2Neurosciences Institute, Autonomous University of Barcelona, Barcelona, Spain
- Myriam De la Cruz-Puebla
- 3Cognition and Brain Plasticity Unit, University of Barcelona, Barcelona, Spain
- Myriam De la Cruz-Puebla
- 4Bellvitge Institute for Biomedical Research, Barcelona, Spain
- Myriam De la Cruz-Puebla
- 5Technical University of Ambato, Tungurahua, Ecuador
- Stelios Zygouris
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Stelios Zygouris
- 6Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece
- Aya Ashour Mohamed
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Aya Ashour Mohamed
- 7Department of Neurology, Ain Shams University, Cairo, Egypt
- Hany Ibrahim
- 1Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Hany Ibrahim
- 8Geriatric Medicine Department, Ain Shams University, Cairo, Egypt
- Collette A. Goode
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
- Bruce L. Miller
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Bruce L. Miller
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
- Victor Valcour
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Victor Valcour
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
- Katherine L. Possin
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Katherine L. Possin
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
- DOI
- https://doi.org/10.3389/fneur.2022.769360
- Journal volume & issue
-
Vol. 13
Abstract
ObjectivesDementia poses one of the greatest global health challenges, affecting 50 million people worldwide. With 10 million new cases each year, dementia is a growing burden, particularly in low- and middle-income countries (LMIC). This study aimed to identify the facilitators and barriers to providing quality dementia assessment and care in LMICs from a global health perspective.Methods/DesignA qualitative semi-structured interview study with 20 dementia expert healthcare providers from 19 countries. To be included, providers had to: practice dementia assessment or care in LMICs where the population over age 60 is projected to more than double by 2050 and be recognized as a leading dementia expert in the region based on position, research publications, and/or policy leadership. Interviews were analyzed by a multidisciplinary team of researchers using thematic analysis.ResultsBarriers to dementia assessment and care included stigma about dementia, poor patient engagement in and access to healthcare, inadequate linguistic and cultural validation, limited dementia capable workforce, competing healthcare system priorities, and insufficient health financing. Facilitators included the rise in dementia awareness campaigns, dementia training for general practitioners, availability of family support and family caregivers, and national and international collaborations including coordinated policy efforts and involvement in international research initiatives.ConclusionsFindings from this study provide insights for prioritizing dementia assessment and care capacity-building in LMICs as a global health priority and for tailored public health approaches to strengthen dementia assessment and care at the individual, community, national, and multi-national levels.
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