World dementia: One approach does not fit all

Neurology
Suvarna Alladi, Vladimir Hachinski

Abstract

To highlight the broad global diversity in the diagnosis, management, and research of dementia in different regions of the world. A critical review of the limited literature from the global South compared with advances that have emerged from key studies in the West and observations from the authors' experiences. The last several decades have witnessed major advances in dementia research and include an understanding of epidemiologic trends in the global burden of disease, the development of biomarkers for Alzheimer disease, the identification of novel therapeutic targets, and the recognition of the role of protective life-course experiential factors. For the effective translation of these research advances into societies, a "world approach" to dementia is vital. Developing societies substantially differ from Western countries in their attitudes toward dementia, as well as their clinical manifestations and risk factor profiles, marked by lower education and socioeconomic status, a higher cardiovascular disease burden, and genetic variability. Emerging evidence emphasizes the interaction among ethnicity, genetics, epigenetics, environment, culture, and neurobiology in influencing manifestations of dementia. Therefore, the investig...Continue Reading

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