Public Health

Public Health Overview

Study Title: Early Dementia Diagnosis in Cuba

Reference: Alzheimers Dement. 2024 Dec;20 Suppl 7:e086012. doi: 10.1002/alz.086012

Background

A large number of the 57 million people with dementia live in low- and middle-income countries, where research on dementia is limited. Our goal was to improve early diagnosis and the use of standard cognitive assessments by primary care physicians (PCPs) in Cuba.

Method

We selected 16 primary care clinics with about 160-200 providers. These clinics were paired based on the number of providers and patient demographics before being divided into two groups: one received a targeted intervention, while the other continued usual care. The intervention included a training program focusing on dementia and cognitive assessments. We surveyed GP attitudes toward technology and cognitive management at the start, 6 months, and 12 months after training. The main goal was to see how dementia diagnosis rates changed after 12 months.

Results

The group that received the intervention showed a marked improvement in:

Confidence in conducting neurocognitive evaluations
Performing memory screenings during health visits
Interpreting diagnostic tests (p-value = 0.004)
Selecting appropriate tests (p-value = 0.001)
Understanding diagnostic criteria for various dementias

Moreover, the intervention group increased cognitive diagnoses and referrals to specialists by 141% and raised the use of standardized assessments by 83%. The overall dementia prevalence at these clinics was found to be 10.6%.

Conclusion

This study demonstrates that training PCPs can significantly improve early detection and treatment of dementia, benefiting patients and their families.

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