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      The protocols for the 10/66 dementia research group population-based research programme

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          Abstract

          Background

          Latin America, China and India are experiencing unprecedentedly rapid demographic ageing with an increasing number of people with dementia. The 10/66 Dementia Research Group's title refers to the 66% of people with dementia that live in developing countries and the less than one tenth of population-based research carried out in those settings. This paper describes the protocols for the 10/66 population-based and intervention studies that aim to redress this imbalance.

          Methods/design

          Cross-sectional comprehensive one phase surveys have been conducted of all residents aged 65 and over of geographically defined catchment areas in ten low and middle income countries (India, China, Nigeria, Cuba, Dominican Republic, Brazil, Venezuela, Mexico, Peru and Argentina), with a sample size of between 1000 and 3000 (generally 2000). Each of the studies uses the same core minimum data set with cross-culturally validated assessments (dementia diagnosis and subtypes, mental disorders, physical health, anthropometry, demographics, extensive non communicable disease risk factor questionnaires, disability/functioning, health service utilisation, care arrangements and caregiver strain). Nested within the population based studies is a randomised controlled trial of a caregiver intervention for people with dementia and their families (ISRCTN41039907; ISRCTN41062011; ISRCTN95135433; ISRCTN66355402; ISRCTN93378627; ISRCTN94921815). A follow up of 2.5 to 3.5 years will be conducted in 7 countries (China, Cuba, Dominican Republic, Venezuela, Mexico, Peru and Argentina) to assess risk factors for incident dementia, stroke and all cause and cause-specific mortality; verbal autopsy will be used to identify causes of death.

          Discussion

          The 10/66 DRG baseline population-based studies are nearly complete. The incidence phase will be completed in 2009. All investigators are committed to establish an anonymised file sharing archive with monitored public access. Our aim is to create an evidence base to empower advocacy, raise awareness about dementia, and ensure that the health and social care needs of older people are anticipated and met.

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          Most cited references87

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          Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization.

          This two-part article provides an overview of the global burden of atherothrombotic cardiovascular disease. Part I initially discusses the epidemiologic transition which has resulted in a decrease in deaths in childhood due to infections, with a concomitant increase in cardiovascular and other chronic diseases; and then provides estimates of the burden of cardiovascular (CV) diseases with specific focus on the developing countries. Next, we summarize key information on risk factors for cardiovascular disease (CVD) and indicate that their importance may have been underestimated. Then, we describe overarching factors influencing variations in CVD by ethnicity and region and the influence of urbanization. Part II of this article describes the burden of CV disease by specific region or ethnic group, the risk factors of importance, and possible strategies for prevention.
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            Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop.

            Criteria for the diagnosis of vascular dementia (VaD) that are reliable, valid, and readily applicable in a variety of settings are urgently needed for both clinical and research purposes. To address this need, the Neuroepidemiology Branch of the National Institute of Neurological Disorders and Stroke (NINDS) convened an International Workshop with support from the Association Internationale pour la Recherche et l'Enseignement en Neurosciences (AIREN), resulting in research criteria for the diagnosis of VaD. Compared with other current criteria, these guidelines emphasize (1) the heterogeneity of vascular dementia syndromes and pathologic subtypes including ischemic and hemorrhagic strokes, cerebral hypoxic-ischemic events, and senile leukoencephalopathic lesions; (2) the variability in clinical course, which may be static, remitting, or progressive; (3) specific clinical findings early in the course (eg, gait disorder, incontinence, or mood and personality changes) that support a vascular rather than a degenerative cause; (4) the need to establish a temporal relationship between stroke and dementia onset for a secure diagnosis; (5) the importance of brain imaging to support clinical findings; (6) the value of neuropsychological testing to document impairments in multiple cognitive domains; and (7) a protocol for neuropathologic evaluations and correlative studies of clinical, radiologic, and neuropsychological features. These criteria are intended as a guide for case definition in neuroepidemiologic studies, stratified by levels of certainty (definite, probable, and possible). They await testing and validation and will be revised as more information becomes available.
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              Subjective burden of husbands and wives as caregivers: a longitudinal study.

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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                2007
                20 July 2007
                : 7
                : 165
                Affiliations
                [1 ]King's College London, Health Service and Population Research Department, Section of Epidemiology, De Crespigny Park, SE5 8AF, London, UK
                [2 ]Internal Medicine Department, Geriatric Section Universidad Nacional Pedro Henriquez Ureña (UNPHU), John F Kennedy Avenue, Santo Domingo, Dominican Republic
                [3 ]Behavioral and Cognitive Neurology Unit, Neuraxis Institute – Neurological Foundation, Buenos Aires – Argentina
                [4 ]Mental Health Research Centre Russian Academy of Medical Sciences, Moscow, Russia
                [5 ]Psychogeriatric Unit, National Institute of Mental Health "Honorio Delgado Hideyo Noguchi", Lima – Perú
                [6 ]Institute of Mental Health; Peking University, # 51 Hua Yuan Bei Road Haidian District Beijing, 100083, China
                [7 ]Christian Medical College, Vellore, India
                [8 ]Srinivasan Centre for Clinical Neurosciences. The Institute of Neurological Sciences, Voluntary Health Services, Taramani, Chennai, India
                [9 ]Genetics & Epidemiology Department Conway Institute – University College Dublin, Belfield Campus Belfield, Dublin, Ireland
                [10 ]Facultad de Medicina Finley-Albarran, Medical University of Havana, Cuba
                [11 ]Medicine Department, Caracas University Hospital, Faculty of Medicine, Universidad Central de Venezuela, Caracas
                [12 ]The Cognition and Behavior Unit, National Institute of Neurology and Neurosurgery of Mexico, Av. Insurgentes # 3877. Col. La Fama. ZIP Code 14269. Delegacion Tlalpan. Mexico City, Mexico
                [13 ]Dept. of Mental Health, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, NIGERIA
                Article
                1471-2458-7-165
                10.1186/1471-2458-7-165
                1965476
                17659078
                bbc17a23-dced-484e-be7d-cae25c6a2f20
                Copyright © 2007 Prince et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 9 February 2007
                : 20 July 2007
                Categories
                Study Protocol

                Public health
                Public health

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