Prevalence and Risk of Mild Cognitive Impairment in Low and Middle-Income Countries: A Systematic Review

Andrea M. McGrattan, Yueping Zhu, Connor D. Richardson, Devi Mohan, Yee Chang Soh, Ayesha Sajjad, Carla Van Aller, Shulin Chen, Stella Maria Paddick, Matthew Prina, Mario Siervo, Louise A. Robinson, Blossom C.M. Stephan

    Research output: Contribution to journalReview ArticleResearchpeer-review

    1 Citation (Scopus)

    Abstract

    Background: Mild cognitive impairment (MCI) is a cognitive state associated with increased risk of dementia. Little research on MCI exists from low-and middle-income countries (LMICs), despite high prevalence of dementia in these settings. Objective: This systematic review aimed to review epidemiological reports to determine the prevalence of MCI and its associated risk factors in LMICs. Methods: Medline, Embase, and PsycINFO were searched from inception until November 2019. Eligible articles reported on MCI in population or community-based studies from LMICs and were included as long as MCI was clearly defined. Results: 5,568 articles were screened, and 78 retained. In total, n = 23 different LMICs were represented; mostly from China (n = 55 studies). Few studies were from countries defined as lower-middle income (n = 14), low income (n = 4), or from population representative samples (n = 4). There was large heterogeneity in how MCI was diagnosed; with Petersen criteria the most commonly applied (n = 26). Prevalence of amnesic MCI (aMCI) (Petersen criteria) ranged from 0.6%to 22.3%. Similar variability existed across studies using the International Working Group Criteria for aMCI (range 4.5%to 18.3%) and all-MCI (range 6.1%to 30.4%). Risk of MCI was associated with demographic (e.g., age), health (e.g., cardio-metabolic disease), and lifestyle (e.g., social isolation, smoking, diet and physical activity) factors. Conclusion: Outside of China, few MCI studies have been conducted in LMIC settings. There is an urgent need for population representative epidemiological studies to determine MCI prevalence in LMICs. MCI diagnostic methodology also needs to be standardized. This will allow for cross-study comparison and future resource planning.

    Original languageEnglish
    Pages (from-to)743-762
    Number of pages20
    JournalJournal of Alzheimer's Disease
    Volume79
    Issue number2
    DOIs
    Publication statusPublished - 19 Jan 2021

    Keywords

    • Epidemiology
    • low-and middle-income country,
    • mild cognitive impairment
    • prevalence
    • risk factors
    • systematic review

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