Project Lead(s): Regina Ocampo Barba
The world’s population is aging and the incidence of dementia is increasing, with an estimated 4.6 million new cases annually.
In Bolivia, the response by various levels of government to the challenge of the growing number of patients with dementia has been minimal, with mental health services accessible to fewer than one percent of the population.
Specialized care for patients with dementia is limited and, in communities, there is little capacity to cope with dementia cases, with ignorance and stigma leading to mistreatment and abandonment.
The project team developed and validated an integrated care approach for dementia diagnosis and treatment involving many actors, including patients, families, health services, authorities and communities in Bolivia.
The team installed a “neurocognition laboratory” in Santa Cruz, which focuses on screening for dementia, with diagnostic tools, stimulation and rehabilitation for patients with cognitive impairment, and training for families and caregivers.
To provide continuity of care, the lab is coordinating its work with the Northern primary health care (PHC) network in Santa Cruz, private health centres, and the second and third level of care in the public and private health sectors.
In the project, 650 health providers from 16 health facilities in La Paz and 12 in Santa Cruz/northern zone were trained in dementia diagnosis and management.
A virtual telemedicine platform was also developed and has been used in rural areas of La Paz since September 2015.
Results of the project show it is feasible to deploy an integrated care approach for dementia diagnosis and treatment, developed with the involvement of all stakeholders in the health care system.
As a result, 47% of older people enrolled in the project feel their health has improved and 51% report improved functionality.
As a result of better screening, and the availability of services and information through the project, an estimated 15% of the older population in the project catchment area has access to mental health services (an increase from the baseline of 5%).
The team reports that 40/95 (42%) of people referred from PHC were diagnosed with dementia at the laboratory, and were then treated or referred for more intense care. These people would not have been identified or followed before the lab was in place.
More than 11,000 people from the different communities have received information about dementia, as a result of the project.
Details of the project have been reported through international events, awareness-building campaigns and in the media.
The team wants to explore the role of the virtual platform in rural La Paz, and is seeking external funding for this initiative.
The concept of the neurocognition laboratory will be presented to national health authorities in Bolivia, with the hope that it will be extended to all municipalities.