Systematic and Comparative Analysis of the Burden of Alzheimer´s Disease and Other Dementias in Mexico. Results at the National and Subnational Levels, 1990-2019.

INTRODUCTION: Dementias, including Alzheimer´s disease (AD), are one of the leading causes of disability and mortality in older people. It is a growing health problem in low- and middle-income countries, where epidemiological information is scarce and deficient. The aim of this study was to analyze the burden of AD and other dementias in Mexico from 1990 to 2019 by sex, subnational level, and age groups. METHODS: A secondary analysis was conducted using data from the 2019 Global Burden of Disease, Injury, and Risk Factors Study (GBD). Data on prevalence, incidence, mortality, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY) due to AD and other dementias were obtained. A joinpoint regression analysis was performed to describe the changes in the trend of age-standardized DALY rates by AD and other dementias during the analysis period. RESULTS: AD and other dementias ranked second among neurological disorders producing the most DALY in Mexico. Between 1990 and 2019, prevalence and incidence increased by almost 203%. In 2019, the age-standardized rate per 100,000 inhabitants was: 512 for prevalence, 79.3 for incidence, 73.3 for YLD, 256.9 for YLL and 272.2 for DALY. Likewise, five states concentrated 39% of AD and other dementias cases: Ciudad de México, Estado de México, Veracruz, Jalisco and Puebla. Differences were also observed by sex and age groups. DISCUSSION: Given that the number of older adults in Mexico will significantly rise over the next few decades, AD and other dementias represent one of the most important health challenges. The fact that epidemiological and demographic transformations take place in Mexico in a very diverse way makes it difficult for the country to adequately plan for the growing demands of both people with AD and other dementias and their families.

Impact of a Maternal Motivational Interviewing on Oral Health in the Mother-Child Dyad.

Motivational Interviewing (MI) has been included in dentistry programs. There exists a need for interventions in the mother-child dyad. The aim of this paper was to compare the effects of a MI-based educational program on oral care knowledge, attitudes, and practices (KAP) in the mother-child dyad to a Traditional Education-based program (TE). A community intervention trial was carried out. The experimental and control groups were made up of women between 18 and 45 years of age in the sixth month of gestation. Both groups were provided with TE. The experimental group additionally received a session based on the principles of the MI. Socio-demographic data, children's oral health KAP (COHKAP), that of the mother (MOHKAP), and maternal self-efficacy (MSE) in relation to children's oral health (COHMSE) were recorded. A baseline measurement was made, as well as a six-month follow up. The participants included 135 women with an average age of 24.88 ± 6.00. After intervention, the experimental group's COHKAP, MOHKAP, and COHMSE all increased (p < 0.001). When MI-based interventions are combined with TE, MSE and dental care KAP for the mother-child dyad in pregnant women can be improved.