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In , the European Commission published predicted population changes in European Union countries for the following 50 years [ 1 ]. This effect is likely to be particularly relevant to Spain, where female life expectancy already reaches 85 years, which is the highest in Europe [ 2 ].
In this context, neurological diseases, especially dementia, pose a challenge for healthcare systems worldwide [ 3 ]. For , the overall cost of dementia was estimated at billion USD in Western Europe alone [ 4 ]. The most recent systematic review of worldwide dementia prevalence and future projections was published in [ 5 ].
The estimate for Western Europe 7. These projections assume that disease prevalence will remain stable over time, which can greatly limit their validity [ 7 ]. These estimates can be substantially altered by a better control of vascular risk factors [ 8 ] or by the emergence of treatments that can alter the course of the disease, slow its progress, or increase survival rates.
Moreover, study methods themselves can potentially introduce important sources of variability in the prevalence rates [ 9 ]. Therefore, it is necessary to monitor the epidemiology of dementia in different parts of the world. In that respect, the decrease in the number of studies on dementia prevalence in developed countries since is alarming [ 5 ]. Several population-based studies on dementia have been conducted in Spain over the last two decades. These studies have shown varying prevalence rates, which are largely due to methodological differences [ 10 , 11 ].
The prevalences of other primary dementias, such as dementia with Lewy bodies DLB or frontotemporal dementia FTD , have barely been addressed [ 12 , 13 ]. They analyzed nine Spanish population samples, which were obtained from the population of survivors who participated in prior population-based studies [ 14 ]. Its main objectives are to 1 describe the prevalence of dementia and its subtypes; 2 identify the frequency, characteristics, and determining factors of undiagnosed dementia in the community; and 3 assess the effects of nutritional status and diet characteristics on dementia.
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In this report, we present the results of the prevalence study and analyze the effects of age, gender, education level, and place of residence rural or urban setting on dementia prevalence. The prevalence date was February 1, A detailed description of the study methods, main demographic and sociocultural findings, and analysis of the participant attrition can be found elsewhere [ 15 ].
A mixed urban and rural population was selected. Community-dwelling and nursing home residents were included. This region is characterized by low population density and lower socioeconomic status among individuals belonging to this age category. Due to the large population size, the survey was based on a The size was calculated in order to provide an estimated 6. Participants were selected from the registry of Social Security health card holders, which provides virtually universal coverage for the population in this province. The data were provided by the local healthcare authorities and had been updated most recently on November 1, The screening phase was conducted between February and February The study was extensively advertised to increase participation, and an information letter was sent to all of the selected participants.
Screening was conducted by 27 primary care doctors and 1 geriatrician, all of whom were trained specifically for the study protocol.