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How do socioeconomic factors impact the level of cognitive impairment in an underserved country?
Kuripacha Alcamari Tituana Vega, M.D.
Universidad San Francisco de Quito
Quito, Ecuador
Background
As the number of individuals with Alzheimer’s and other dementias grows around the world, researchers are looking for better ways of monitoring cognitive (brain function) health in underserved, low- and middle-income countries. Previous surveys of national cognitive health, such as the 2010 National Survey of Well-Being and Aging in Ecuador, did not take into account social determinants of health (SDOH) factors when measuring cognitive impairment in the country. SDOH factors include racial discrimination, education level and socioeconomic status. Omitting SDOH may have led to inaccurate analyses, such as over-diagnosing cognitive impairment in rural areas, where lower cognitive performance may have been related to low education levels and higher exposure to negative SDOH. Future assessments will need to incorporate SDOH when assessing brain health in a national population.
Research Plan
Dr. Kuripacha Alcamari Tituana Vega and colleagues will conduct a more thorough survey of cognitive impairment in a rural region of Ecuador. They will recruit 80 older individuals with cognitive impairment and their loved one or partner from two communities in the mountainous Cotacachi region, which lies north of Quito, the nation’s capital. All of the participants will undertake an interview, in which they will be asked questions about their education, housing, food security, access to health care and other socioeconomic factors. They will also undergo tests of cognition and mental health. Further, their partners will be asked to identify cognitive changes in their loved ones that the participants may not have noticed. Investigators will then analyze data from these interviews to determine levels of SDOH in the individuals and to analyze how SDOH exposure may be linked to changes in cognitive health.
Impact
The results of this project will refine our understanding of how social and economic factors impact brain function. They may also identify a novel survey tool for better measuring cognitive impairment in countries most vulnerable to dementia.
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