{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:17:41Z","timestamp":1792059461317,"version":"4.4.0"},"reference-count":45,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"\n Importance<\/jats:title>\n Reliable estimates of dementia prevalence trends are essential for health policy planning. Latin America is undergoing rapid population aging, yet it remains unclear whether dementia prevalence mirrors declining patterns reported in high-income countries.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine 2-decade trends in dementia prevalence across 5 Latin American and Caribbean sites participating in the 10\/66 Dementia Research Group.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cross-sectional, population-based study included data from 5 population-based catchment areas participating in the 10\/66 study: Cuba, the Dominican Republic, Mexico, Peru, and Puerto Rico. Data were collected at 2 time points: 2003 to 2006 and 2016 to 2020. Participants were community-dwelling adults aged 65 years or older, identified through exhaustive door-to-door enumeration across 2 survey waves. Data were analyzed between March 2025 and May 2026.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Survey wave (2003-2006 vs 2016-2020) was the primary temporal comparison. Secondary exposures included modifiable dementia risk factors from the Lancet Commission on dementia prevention.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The main outcome was crude and age- and sex-standardized dementia prevalence using the 10\/66 dementia diagnostic algorithm. Adjusted prevalence differences between waves were estimated using Poisson regression with sequential adjustment for education, health behaviors, and health risk factors.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 23\u202f709 eligible individuals identified, 5892 declined or could not be traced and 17\u202f817 were assessed. After excluding participants with missing dementia diagnosis or data, the analytic sample included 16\u202f950 participants (wave 1: n\u2009=\u200910\u202f374; wave 3: n\u2009=\u20096576; mean [SD] age, 76.0 [7.5] years; 63.7% women). Pooled crude prevalence increased from 10.6% (95% CI, 10.0%-11.2%) at 2003 to 2006 to 16.9% (95% CI, 15.9%-17.8%) at 2016 to 2020. After age and sex standardization to 2025 United Nations population structures, prevalence remained stable in Cuba and the Dominican Republic but increased substantially in Mexico (4.9 percentage points [pp]; 95% CI, 3.0-6.8 pp), Peru (4.1 pp; 95% CI, 1.9-6.4 pp), and Puerto Rico (5.0 pp; 95% CI, 1.8-8.2 pp). Increasing trends in Mexico (adjusted difference: 6.3%; 95% CI, 4.1%-8.5%) and Puerto Rico (7.2%; 95% CI, 3.8%-10.6%) persisted after full adjustment for health behaviors and risk factors.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This study found that dementia prevalence has increased over 2 decades across several Latin American 10\/66 catchment sites, contrasting with declining trends reported in high-income countries. These findings, while specific to the 5 studied sites, highlight the growing and uneven burden of dementia in the region and underscore the need for strengthened surveillance, risk reduction strategies, and investment in dementia care infrastructure.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaneurol.2026.2305","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T10:30:19Z","timestamp":1783938619000},"page":"906","source":"Crossref","is-referenced-by-count":1,"title":["Trends in Dementia Prevalence Across Latin America and the Caribbean"],"prefix":"10.1001","volume":"83","author":[{"given":"Jorge J.","family":"Llibre-Guerra","sequence":"first","affiliation":[{"name":"Department of Neurology, Washington University in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Tzu","family":"Wu","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issac","family":"Acosta","sequence":"additional","affiliation":[{"name":"Laboratory of the Dementias, National Institute of Neurology and Neurosurgery, National Autonomous University of Mexico, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Soria","sequence":"additional","affiliation":[{"name":"Department of Demography, University of California, Berkeley, Berkeley, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Luisa","family":"Sosa","sequence":"additional","affiliation":[{"name":"Department of Demography, University of California, Berkeley, Berkeley, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisy","family":"Acosta","sequence":"additional","affiliation":[{"name":"Geriatric Section, Internal Medicine Department, Universidad Nacional Pedro Henriquez Ure\u00f1a (UNPHU), Santo Domingo, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivonne Z.","family":"Jim\u00e9nez-Vel\u00e1zquez","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Geriatrics Program, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariella","family":"Guerra","sequence":"additional","affiliation":[{"name":"Instituto de la Memoria Depresion y Enfermedades de Riesgo IMEDER, Lima, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aquiles","family":"Salas","sequence":"additional","affiliation":[{"name":"Medicine Department, Caracas University Hospital, Faculty of Medicine, Universidad Central de Venezuela, Caracas, Venezuela"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruijin","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Washington University in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan J.","family":"Llibre-Rodriguez","sequence":"additional","affiliation":[{"name":"Dementia Research Unit, Medical University of Havana, Havana, Cuba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Prina","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"3","key":"noi260043r1","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1212\/CON.0000000000001131","article-title":"Alzheimer disease.","volume":"28","author":"McDade","year":"2022","journal-title":"Continuum (Minneap Minn)"},{"key":"noi260043r2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101580","article-title":"Global and regional projections of the economic burden of Alzheimer's disease and related dementias from 2019 to 2050: a value of statistical life approach.","volume":"51","author":"Nandi","year":"2022","journal-title":"EClinicalMedicine"},{"issue":"12","key":"noi260043r3","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1016\/S1474-4422(16)30235-6","article-title":"Research priorities to reduce the global burden of dementia by 2025.","volume":"15","author":"Shah","year":"2016","journal-title":"Lancet Neurol"},{"issue":"11","key":"noi260043r4","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1016\/S1474-4422(18)30295-3","article-title":"Global, regional, and national burden of Parkinson\u2019s disease, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.","volume":"17","author":"GBD 2016 Parkinson\u2019s Disease Collaborators","year":"2018","journal-title":"Lancet Neurol"},{"issue":"1","key":"noi260043r5","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.jalz.2010.11.002","article-title":"Trends in the incidence and prevalence of Alzheimer\u2019s disease, dementia, and cognitive impairment in the United States.","volume":"7","author":"Rocca","year":"2011","journal-title":"Alzheimers Dement"},{"issue":"12","key":"noi260043r6","doi-asserted-by":"publisher","first-page":"1242","DOI":"10.1001\/jamaneurol.2022.3543","article-title":"Estimating the prevalence of dementia and mild cognitive impairment in the US: The 2016 Health and Retirement Study Harmonized Cognitive Assessment Protocol Project.","volume":"79","author":"Manly","year":"2022","journal-title":"JAMA Neurol"},{"issue":"9902","key":"noi260043r7","doi-asserted-by":"publisher","first-page":"1405","DOI":"10.1016\/S0140-6736(13)61570-6","article-title":"A two-decade comparison of prevalence of dementia in individuals aged 65 years and older from three geographical areas of England: results of the Cognitive Function and Ageing Study I and II.","volume":"382","author":"Matthews","year":"2013","journal-title":"Lancet"},{"issue":"JUL","key":"noi260043r9","doi-asserted-by":"publisher","first-page":"221","DOI":"10.3389\/fnagi.2017.00221","article-title":"Dementia in Latin America: epidemiological evidence and implications for public policy.","volume":"9","author":"Custodio","year":"2017","journal-title":"Front Aging Neurosci"},{"issue":"9836","key":"noi260043r10","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/S0140-6736(12)60399-7","article-title":"Dementia incidence and mortality in middle-income countries, and associations with indicators of cognitive reserve: a 10\/66 Dementia Research Group population-based cohort study.","volume":"380","author":"Prince","year":"2012","journal-title":"Lancet"},{"issue":"4","key":"noi260043r11","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1080\/09540260802094712","article-title":"Ageing and dementia in low and middle income countries-Using research to engage with public and policy makers.","volume":"20","author":"Prince","year":"2008","journal-title":"Int Rev Psychiatry"},{"issue":"5","key":"noi260043r12","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1212\/WNL.0000000000004897","article-title":"Dementia in Latin America: assessing the present and envisioning the future.","volume":"90","author":"Parra","year":"2018","journal-title":"Neurology"},{"issue":"9","key":"noi260043r13","doi-asserted-by":"publisher","first-page":"2248","DOI":"10.1038\/s41591-023-02495-1","article-title":"Factors associated with healthy aging in Latin American populations.","volume":"29","author":"Santamaria-Garcia","year":"2023","journal-title":"Nat Med"},{"key":"noi260043r14","article-title":"The 10\/66 dementia research group\u201410 years on.","author":"Prince","year":"2009","journal-title":"Indian J Psychiatry"},{"issue":"1","key":"noi260043r15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00127-018-1626-7","article-title":"A review of the 10\/66 dementia research group.","volume":"54","author":"Prina","year":"2019","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"issue":"2","key":"noi260043r16","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1093\/ije\/dyw056","article-title":"Cohort profile: the 10\/66 study.","volume":"46","author":"Prina","year":"2017","journal-title":"Int J Epidemiol"},{"issue":"1","key":"noi260043r17","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1186\/1471-2458-7-165","article-title":"The protocols for the 10\/66 dementia research group population-based research programme.","volume":"7","author":"Prince","year":"2007","journal-title":"BMC Public Health"},{"issue":"5","key":"noi260043r18","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010712","article-title":"Development of a brief assessment and algorithm for ascertaining dementia in low-income and middle-income countries: the 10\/66 short dementia diagnostic schedule.","volume":"6","author":"Stewart","year":"2016","journal-title":"BMJ Open"},{"issue":"7","key":"noi260043r19","doi-asserted-by":"publisher","DOI":"10.1002\/gps.6115","article-title":"Longitudinal associations of loneliness and social isolation with care dependence among older adults in Latin America and China: a 10\/66 dementia research group population-based cohort study.","volume":"39","author":"Gao","year":"2024","journal-title":"Int J Geriatr Psychiatry"},{"key":"noi260043r20","doi-asserted-by":"publisher","DOI":"10.3389\/ijph.2021.604449","article-title":"Loneliness among older adults in Latin America, China, and India: prevalence, correlates and association with mortality.","volume":"66","author":"Gao","year":"2021","journal-title":"Int J Public Health"},{"issue":"16","key":"noi260043r21","doi-asserted-by":"publisher","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity.","volume":"120","author":"Alberti","year":"2009","journal-title":"Circulation"},{"issue":"16","key":"noi260043r22","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1001\/archinte.158.16.1789","article-title":"The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test.","volume":"158","author":"Bush","year":"1998","journal-title":"Arch Intern Med"},{"issue":"APR","key":"noi260043r23","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1192\/bjp.174.4.330","article-title":"Development of the EURO-D scale\u2013a European, Union initiative to compare symptoms of depression in 14 European centres.","volume":"174","author":"Prince","year":"1999","journal-title":"Br J Psychiatry"},{"issue":"10452","key":"noi260043r24","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/S0140-6736(24)01296-0","article-title":"Dementia prevention, intervention, and care: 2024 report of the Lancet Standing Commission.","volume":"404","author":"Livingston","year":"2024","journal-title":"Lancet"},{"issue":"4","key":"noi260043r26","doi-asserted-by":"publisher","first-page":"817","DOI":"10.2307\/1912934","article-title":"A heteroskedasticity-consistent covariance matrix estimator and a direct test for heteroskedasticity.","volume":"48","author":"White","year":"1980","journal-title":"Econometrica"},{"issue":"1","key":"noi260043r28","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1001\/jamainternmed.2016.6807","article-title":"A comparison of the prevalence of dementia in the United States in 2000 and 2012.","volume":"177","author":"Langa","year":"2017","journal-title":"JAMA Intern Med"},{"issue":"19","key":"noi260043r29","doi-asserted-by":"publisher","first-page":"1456","DOI":"10.1212\/WNL.0b013e3182553be6","article-title":"Is dementia incidence declining?: trends in dementia incidence since 1990 in the Rotterdam Study.","volume":"78","author":"Schrijvers","year":"2012","journal-title":"Neurology"},{"issue":"3","key":"noi260043r30","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002235","article-title":"Dementia incidence trend over 1992-2014 in the Netherlands: Analysis of primary care data.","volume":"14","author":"van Bussel","year":"2017","journal-title":"PLoS Med"},{"issue":"6","key":"noi260043r31","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1056\/NEJMoa1504327","article-title":"Incidence of dementia over three decades in the Framingham Heart Study.","volume":"374","author":"Satizabal","year":"2016","journal-title":"N Engl J Med"},{"issue":"3","key":"noi260043r32","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1001\/jamaneurol.2020.4471","article-title":"Trends in relative incidence and prevalence of dementia across non-Hispanic Black and White individuals in the United States, 2000-2016.","volume":"78","author":"Power","year":"2021","journal-title":"JAMA Neurol"},{"issue":"11","key":"noi260043r33","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-063891","article-title":"Trends in prevalence and incidence of registered dementia and trends in multimorbidity among patients with dementia in general practice in Flanders, Belgium, 2000-2021: a registry-based, retrospective, longitudinal cohort study.","volume":"12","author":"Beerten","year":"2022","journal-title":"BMJ Open"},{"issue":"5","key":"noi260043r34","doi-asserted-by":"publisher","first-page":"e519","DOI":"10.1212\/WNL.0000000000010022","article-title":"Twenty-seven-year time trends in dementia incidence in Europe and the United States: the Alzheimer Cohorts Consortium.","volume":"95","author":"Wolters","year":"2020","journal-title":"Neurology"},{"issue":"2","key":"noi260043r35","doi-asserted-by":"publisher","first-page":"e105","DOI":"10.1016\/S2468-2667(21)00249-8","article-title":"Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019.","volume":"7","author":"Nichols","year":"2022","journal-title":"Lancet Public Health"},{"issue":"9","key":"noi260043r36","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1016\/S1474-4422(11)70072-2","article-title":"The projected effect of risk factor reduction on Alzheimer\u2019s disease prevalence.","volume":"10","author":"Barnes","year":"2011","journal-title":"Lancet Neurol"},{"issue":"4","key":"noi260043r37","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1037\/neu0000141","article-title":"Differing effects of education on cognitive decline in diverse elders with low versus high educational attainment.","volume":"29","author":"Zahodne","year":"2015","journal-title":"Neuropsychology"},{"issue":"5","key":"noi260043r38","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1212\/01.wnl.0000341782.71418.6c","article-title":"Educational attainment and cognitive decline in old age.","volume":"72","author":"Wilson","year":"2009","journal-title":"Neurology"},{"issue":"8","key":"noi260043r39","doi-asserted-by":"publisher","first-page":"1403","DOI":"10.1111\/j.1532-5415.2011.03499.x","article-title":"A life course model of cognitive activities, socioeconomic status, education, reading ability, and cognition.","volume":"59","author":"Jefferson","year":"2011","journal-title":"J Am Geriatr Soc"},{"issue":"2","key":"noi260043r40","doi-asserted-by":"publisher","first-page":"433","DOI":"10.3233\/JAD-190148","article-title":"Associations between depression, depressive symptoms, and incidence of dementia in Latin America: a 10\/66 Dementia Research Group Study.","volume":"69","author":"Johansson","year":"2019","journal-title":"J Alzheimers Dis"},{"issue":"12","key":"noi260043r41","doi-asserted-by":"publisher","first-page":"1691","DOI":"10.1080\/13607863.2018.1506742","article-title":"Social isolation, cognitive reserve, and cognition in older people with depression and anxiety.","volume":"23","author":"Evans","year":"2019","journal-title":"Aging Ment Health"},{"issue":"6","key":"noi260043r42","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1001\/jama.2019.10575","article-title":"Association of midlife to late-life blood pressure patterns with incident dementia.","volume":"322","author":"Walker","year":"2019","journal-title":"JAMA"},{"issue":"24","key":"noi260043r43","doi-asserted-by":"publisher","first-page":"2447","DOI":"10.1212\/WNL.0000000000004741","article-title":"Blood pressure from mid- to late life and risk of incident dementia.","volume":"89","author":"McGrath","year":"2017","journal-title":"Neurology"},{"issue":"3","key":"noi260043r44","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1001\/archneurol.2008.582","article-title":"Midlife and late-life obesity and the risk of dementia: cardiovascular health study.","volume":"66","author":"Fitzpatrick","year":"2009","journal-title":"Arch Neurol"},{"issue":"1","key":"noi260043r45","doi-asserted-by":"publisher","first-page":"15298","DOI":"10.1038\/s41598-022-19696-2","article-title":"Association of late-life body mass index with the risk of Alzheimer disease: a 10-year nationwide population-based cohort study.","volume":"12","author":"Cho","year":"2022","journal-title":"Sci Rep"},{"key":"noi260043r25","volume-title":"Sampling Techniques, 3rd Edition","author":"Cochran"},{"key":"noi260043r27","author":"Huber"},{"key":"noi260043r8","unstructured":"Steering Committee for the Workshop on Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean; Committee on Population; Division of Behavioral and Social Sciences and Education; The National Academies of Sciences, Engineering, and Medicine. Aging in Latin America and the Caribbean in global perspective. In: Strengthening the Scientific Foundation for Policymaking to Meet the Challenges of Aging in Latin America and the Caribbean: Summary of a Workshop. National Academies Press; September 18, 2015. Accessed July 10, 2020. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK322002\/"}],"container-title":["JAMA Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaneurology\/articlepdf\/2851645\/jamaneurology_llibreguerra_2026_oi_260043_1789047964.09733.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:02:30Z","timestamp":1789398150000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaneurology\/fullarticle\/2851645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":45,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaneurol.2026.2305","relation":{},"ISSN":["2168-6149"],"issn-type":[{"value":"2168-6149","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,1]]}}}