The prevalence and depth of poverty are higher among adults with dementia, finds a new study of people 50 and older in South Africa.
“Among existing challenges the low and middle income countries have been facing in the last decades, including communicable diseases, economic hardship, climate, political instability and sometimes violence, a growing aging population will make dementia and other forms of cognitive disorders another important socioeconomic burden, primarily for families,” said Jean-Francois Trani, associate professor at the Brown School and first author of the study “Association of Multidimensional Poverty With Dementia in Adults Aged 50 Years or Older in South Africa,” published in JAMA Open Network.
“This burden is largely driven by social determinants of health,” he said. Trani collaborated on the project with Ganesh M. Babulal, assistant professor of neurology at the Washington University School of Medicine whose expertise in dementia Trani said “was essential for the success of our work”; and with Jacqueline Moodley from the University of Johannesburg, with whom Trani worked in South Africa. Trani and his co-authors conducted a cross-sectional study of 227 adults aged 50 years or older living in Soweto, Johannesburg, South Africa. They found that 20% of adults with dementia were poor compared with 10% of those without dementia, with a difference of 118% on the Multidimensional Poverty Index. The risk of dementia was 2.31 times higher for adults who were multidimensionally poor.
A lack of education, poor health and unemployment were major dimensions of poverty that were associated with a higher prevalence of dementia, the authors concluded. Long-term interventions beginning early in life may affect social determinants of health through targeted structural policies and prevent dementia later in life.
“These results suggest that public policies addressing factors associated with poverty may be helpful to delay the onset and reduce the prevalence of dementia among older adults,” the authors said.
“Countries like South Africa could partly prevent the severity of the problem by providing quality and low-cost services, particularly healthcare and education, to the general population, and therefore reduce over a generation the impact of multidimensional poverty on the prevalence of dementia,” Trani said.
Although the study was limited to South Africa, Trani said its findings suggest that poverty can be associated with dementia in other parts of the world as well, including the U.S. “Social determinants of health can become daily stressors, particularly for vulnerable people,” he said. “Further research that shows a link with cognitive disorders will have implications for the U.S., where poor social determinants of health affect cognitive abilities as well.”