Cerebrovascular Correlates of Dementia in Community-Dwelling Older Adults Living in Rural Communities - The Three Villages Study. Rationale and Protocol of a Population-Based Prospective Cohort Study.
BACKGROUND
Despite the assumption that dementia is increasing in rural areas of Latin America, there is no information on the burden and risk factors leading to dementia in these settings.


AIMS
To assess prevalence and incidence of dementia, and its cerebrovascular correlates in an established cohort of community-dwelling older adults living in rural Ecuador, and to explore the impact of dementia on functional disability and the role of the social determinants of health in the above-mentioned relationships.


DESIGN
Population-based, cohort study with cross-sectional and longitudinal components. Baseline clinical interviews will focus on the assessment of cognitive performance and dementia by means of the clinical dementia rating scale (CDRS). Functional disability and social determinants of health will be correlated with CDRS scores. In addition, participants will undergo interviews and procedures to assess cardiovascular risk factors and signatures of brain damage, cerebral small vessel disease, and other stroke subtypes. The CDRS and the Functional Activities Questionnaire will be administered every year to assess the rate of incident dementia and the severity of functional disability. Neuroimaging studies will be repeated at the end of the study (5 years) to assess the impact of newly appeared cerebral and vascular lesions on cognitive decline.


COMMENT
This study will allow determine whether cerebrovascular diseases are in the path of dementia development in these rural settings. This may prove cost-effective for the development of preventive strategies aimed to control modifiable factors and reduce disability in patients with dementia living in underserved populations.
['Del Brutto|Oscar H|OH|', 'Mera|Robertino M|RM|', 'Del Brutto|Victor J|VJ|', 'Costa|Aldo F|AF|', 'Recalde|Bettsy Y|BY|']
D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D002561:Cerebrovascular Disorders D003071:Cognition D000066492:Cognitive Aging D003430:Cross-Sectional Studies D003704:Dementia D004185:Disability Evaluation D004484:Ecuador D005260:Female D015577:Geriatric Assessment D006801:Humans D015994:Incidence D057187:Independent Living D008137:Longitudinal Studies D008297:Male D008875:Middle Aged D015995:Prevalence D011379:Prognosis D011446:Prospective Studies D012107:Research Design D012307:Risk Factors D012423:Rural Health D064890:Social Determinants of Health D013997:Time Factors
Dementia cohort study social determinants of health cerebral small vessel disease cognitive decline rural settings cerebrovascular disorders functional ability