Public Health.

Area of Science:

• Neurology
• Public Health
• Geriatrics

Background:

• Effective dementia management relies on early diagnosis, yet low- and middle-income countries like Brazil face resource disparities.
• Specialized dementia care centers in Brazil exhibit significant heterogeneity in diagnostic resources and practices.

Purpose of the Study:

• To assess diagnostic methods and clinical practice tools in specialized dementia care centers across Brazil.
• To identify disparities in dementia diagnosis resources and practices within Brazil.

Main Methods:

• An online survey was distributed to neurologists in specialized dementia centers across Brazil.
• Data collected included infrastructure, cognitive tests, biomarker availability (CSF and imaging), and sociodemographic data.
• Responses were gathered in July 2024 from neurologists affiliated with the Brazilian Academy of Neurology.

Main Results:

• Twenty-four centers across 10 states participated, with 87% linked to the Public Health System.
• Clinical and cognitive assessments are widely used (e.g., Mini-Mental State Examination, Montreal Cognitive Assessment), but advanced biomarkers (CSF, PET scans) and genetic testing are scarce.
• Significant gaps exist in data collection, with ethnicity and socioeconomic status often omitted, and limited use of dementia staging tools.

Conclusions:

• Dementia diagnosis in Brazil is characterized by heterogeneity and a reliance on traditional methods over biomarker-based approaches.
• Standardizing data collection and expanding access to advanced diagnostic tools are essential for improving dementia care.
• Harmonizing diagnostic practices is necessary to align with current criteria emphasizing biomarkers for accurate dementia diagnosis.