Cargando…

Systematic review estimating the burden of dementia in the WHO Southeast Asia Region using Bayesian and frequentist approaches

BACKGROUND: Rapid increase in life expectancy in low- and middle-income countries including the World Health Organization’s Southeast Asia Region (SEAR) has resulted in an increase in the global burden of dementia, which is expected to become a leading cause of morbidity. Accurate burden estimates a...

Descripción completa

Detalles Bibliográficos
Autores principales: Poon, Adrienne N, Xiang, Yawen, Zavalishina, Yelena, Ayanian, Shant, Aitken, Christopher F, Procter, Andrew C, Rudan, Igor, Chan, Kit Yee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Society of Global Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7688200/
https://www.ncbi.nlm.nih.gov/pubmed/33282225
http://dx.doi.org/10.7189/jogh.10.020701
_version_ 1783613664215957504
author Poon, Adrienne N
Xiang, Yawen
Zavalishina, Yelena
Ayanian, Shant
Aitken, Christopher F
Procter, Andrew C
Rudan, Igor
Chan, Kit Yee
author_facet Poon, Adrienne N
Xiang, Yawen
Zavalishina, Yelena
Ayanian, Shant
Aitken, Christopher F
Procter, Andrew C
Rudan, Igor
Chan, Kit Yee
author_sort Poon, Adrienne N
collection PubMed
description BACKGROUND: Rapid increase in life expectancy in low- and middle-income countries including the World Health Organization’s Southeast Asia Region (SEAR) has resulted in an increase in the global burden of dementia, which is expected to become a leading cause of morbidity. Accurate burden estimates are key for informing policy and planning. Given the paucity of data, estimates were developed using both a Bayesian methodology and as well as a traditional frequentist approach to gain better insights into methodological approaches for disease burden estimates. METHODS: Seven databases were searched for studies published between 2010-2018 regarding dementia prevalence in SEAR, generating 8 relevant articles. A random-effects model (REM) and a Bayesian normal-normal hierarchical model (NNHM) were used to obtain the pooled prevalence estimate of dementia for people aged 60 and above in SEAR. The latter model was also developed to estimate age-specific dementia prevalence. Using UN population estimates for SEAR, total and age-specific projections of the burden of dementia in 2015, 2020 and 2030 were calculated. RESULTS: The prevalence of dementia in SEAR was found to be 3% (95% confidence interval (CI) = 2-6%) in those above age 60 based on REM, and 3.1% (95% credible interval = 1.5-5.0%) based on the NNHM. The estimated prevalence varies with age, increasing from 1.6% (95% credible interval = 0.8-2.5%) in people aged 60-69 to 12.4% (95% credible interval = 5.6-20%) in people above the age of 80. The risk of developing dementia increased exponentially with age. The number of people living with dementia in SEAR in 2015 was estimated at 5.51 million (95% credible interval = 2.66-8.82), with projections of 6.66 million (95% credible interval = 3.21-10.7) in 2020 and 9.6 million (95% credible interval = 4.62-15.36) in 2030. CONCLUSION: The burden of dementia in SEAR is substantial and will continue to increase rapidly by 2030. The lack of research focusing on dementia in SEAR points to a significant under-recognition of this disease. The projected rise in dementia cases in the future should prompt urgent governmental response to address this growing public health issue. We also argue that given the overall paucity of data for the region, the Bayesian approach offers a promising methodology for improved estimates of disease prevalence and burden and should continue to be explored.
format Online
Article
Text
id pubmed-7688200
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher International Society of Global Health
record_format MEDLINE/PubMed
spelling pubmed-76882002020-12-03 Systematic review estimating the burden of dementia in the WHO Southeast Asia Region using Bayesian and frequentist approaches Poon, Adrienne N Xiang, Yawen Zavalishina, Yelena Ayanian, Shant Aitken, Christopher F Procter, Andrew C Rudan, Igor Chan, Kit Yee J Glob Health Research Theme 3: Global Dementia Prevention Programme (GloDePP) BACKGROUND: Rapid increase in life expectancy in low- and middle-income countries including the World Health Organization’s Southeast Asia Region (SEAR) has resulted in an increase in the global burden of dementia, which is expected to become a leading cause of morbidity. Accurate burden estimates are key for informing policy and planning. Given the paucity of data, estimates were developed using both a Bayesian methodology and as well as a traditional frequentist approach to gain better insights into methodological approaches for disease burden estimates. METHODS: Seven databases were searched for studies published between 2010-2018 regarding dementia prevalence in SEAR, generating 8 relevant articles. A random-effects model (REM) and a Bayesian normal-normal hierarchical model (NNHM) were used to obtain the pooled prevalence estimate of dementia for people aged 60 and above in SEAR. The latter model was also developed to estimate age-specific dementia prevalence. Using UN population estimates for SEAR, total and age-specific projections of the burden of dementia in 2015, 2020 and 2030 were calculated. RESULTS: The prevalence of dementia in SEAR was found to be 3% (95% confidence interval (CI) = 2-6%) in those above age 60 based on REM, and 3.1% (95% credible interval = 1.5-5.0%) based on the NNHM. The estimated prevalence varies with age, increasing from 1.6% (95% credible interval = 0.8-2.5%) in people aged 60-69 to 12.4% (95% credible interval = 5.6-20%) in people above the age of 80. The risk of developing dementia increased exponentially with age. The number of people living with dementia in SEAR in 2015 was estimated at 5.51 million (95% credible interval = 2.66-8.82), with projections of 6.66 million (95% credible interval = 3.21-10.7) in 2020 and 9.6 million (95% credible interval = 4.62-15.36) in 2030. CONCLUSION: The burden of dementia in SEAR is substantial and will continue to increase rapidly by 2030. The lack of research focusing on dementia in SEAR points to a significant under-recognition of this disease. The projected rise in dementia cases in the future should prompt urgent governmental response to address this growing public health issue. We also argue that given the overall paucity of data for the region, the Bayesian approach offers a promising methodology for improved estimates of disease prevalence and burden and should continue to be explored. International Society of Global Health 2020-12 2020-09-23 /pmc/articles/PMC7688200/ /pubmed/33282225 http://dx.doi.org/10.7189/jogh.10.020701 Text en Copyright © 2020 by the Journal of Global Health. All rights reserved. http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License.
spellingShingle Research Theme 3: Global Dementia Prevention Programme (GloDePP)
Poon, Adrienne N
Xiang, Yawen
Zavalishina, Yelena
Ayanian, Shant
Aitken, Christopher F
Procter, Andrew C
Rudan, Igor
Chan, Kit Yee
Systematic review estimating the burden of dementia in the WHO Southeast Asia Region using Bayesian and frequentist approaches
title Systematic review estimating the burden of dementia in the WHO Southeast Asia Region using Bayesian and frequentist approaches
title_full Systematic review estimating the burden of dementia in the WHO Southeast Asia Region using Bayesian and frequentist approaches
title_fullStr Systematic review estimating the burden of dementia in the WHO Southeast Asia Region using Bayesian and frequentist approaches
title_full_unstemmed Systematic review estimating the burden of dementia in the WHO Southeast Asia Region using Bayesian and frequentist approaches
title_short Systematic review estimating the burden of dementia in the WHO Southeast Asia Region using Bayesian and frequentist approaches
title_sort systematic review estimating the burden of dementia in the who southeast asia region using bayesian and frequentist approaches
topic Research Theme 3: Global Dementia Prevention Programme (GloDePP)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7688200/
https://www.ncbi.nlm.nih.gov/pubmed/33282225
http://dx.doi.org/10.7189/jogh.10.020701
work_keys_str_mv AT poonadriennen systematicreviewestimatingtheburdenofdementiainthewhosoutheastasiaregionusingbayesianandfrequentistapproaches
AT xiangyawen systematicreviewestimatingtheburdenofdementiainthewhosoutheastasiaregionusingbayesianandfrequentistapproaches
AT zavalishinayelena systematicreviewestimatingtheburdenofdementiainthewhosoutheastasiaregionusingbayesianandfrequentistapproaches
AT ayanianshant systematicreviewestimatingtheburdenofdementiainthewhosoutheastasiaregionusingbayesianandfrequentistapproaches
AT aitkenchristopherf systematicreviewestimatingtheburdenofdementiainthewhosoutheastasiaregionusingbayesianandfrequentistapproaches
AT procterandrewc systematicreviewestimatingtheburdenofdementiainthewhosoutheastasiaregionusingbayesianandfrequentistapproaches
AT rudanigor systematicreviewestimatingtheburdenofdementiainthewhosoutheastasiaregionusingbayesianandfrequentistapproaches
AT chankityee systematicreviewestimatingtheburdenofdementiainthewhosoutheastasiaregionusingbayesianandfrequentistapproaches