The
Lancet doesn’t publish many papers on mental health but what it does do well is
the coverage of global health issues (that is health issues not just related to
North America, Europe and Australasia). The most recent example of this is a cohort study on the
incidence and mortality of dementia in Cuba, the Dominion Republic, Venezuala,
Peru, Mexico and China.
The
authors hypothesized that because education and occupational attainment seem to
protect against dementia, then in countries with elderly populations with
limited education and who have done manual or unskilled work, that the
incidence of dementia would be higher than in developed countries. They were
able to follow up about two thirds of the original cohort of 13000 people over
three to five years.
What
they found was the incidence rate of dementia was about the same as in
countries with higher incomes. This was most striking when they used a broader
definition of dementia than the DSM IV which they found underestimated the true
incidence of dementia in middle income countries. They also found that
education and occupational attainment protected against dementia in middle
income countries just as it does in high income countries.
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