516 conducted in developing countries, the decision to dis- close a diagnosis must depend on the probable impact on a particular patient: “If a patient is likely to benefit, he or she should be told, but if benefit is not likely, or if disclosure is instead apt to bring about an adverse reaction, the disclosure is not advised” [94]. The Role of International Partnerships in Improving Diagnosis of Dementia in Resource-Poor Countries Partnerships between wealthy countries and LMICs (North/South partnerships) and partnerships between LMICs that have expertise in dementia and adjacent countries with no such expertise (South/South partner- ships) are two strategies for improving diagnosis of dementia in resource-poor populations. However, those strategies have been implemented parsimoniously, and with few exceptions, large international funding organ- izations have shown little interest in partnering with LMICs to build capacity for dementia diagnosis. Some genuine partnerships encompassing research and capacity building for delivery of services in devel- oping countries have been extremely successful, not only in terms of scientific productivity, but also in the creation of services and dementia care options [95–97]. The research components of these partnerships have primarily been funded through governments and chari- table organizations of high-income countries (North/ South partnerships). Several agencies, including the Fogarty International Center of the NIH, have developed a program called “Brain Disorders in the Developing World: Research Across the Lifespan.” The program includes research and capacity building and has funded several initiatives devoted to dementia. Only 8 % of mental health projects to date involved collaboration between LMICs, as compared with 30 % that involved collaboration with high-income countries [98]. Capacity building has less often been included in South/ South partnerships, which have generally been supported by a variety of sources, including individual donors and char- itable organizations. In most cases, the resulting programs have been expected to be self-sustaining after the develop- ment of services. However, the potential of South/South collaborations is beginning to emerge as a significant mech- anism for empowering countries in resource-poor areas. Such partnerships can provide alternative sources of finan- cial and technical assistance [99], like the collaboration in which Indian universities have provided virtual classes for medical staff and online consultations in Africa [99]. How- ever, funding allocated for research on mental and neuro- logical conditions in LMICs is vastly insufficient, and lobbying of international organizations by coalitions of Curr Neurol Neurosci Rep (2012) 12:511–519 LMICs might be needed to gain external support for South/South partnerships. The main goals of international partnerships should be to accelerate diagnosis and provision of services for dementia in resource-poor regions, empowering locals through training programs that include dementia as one component. The partnerships should develop connec- tions with the governments of LMICs and should edu- cate the general population about dementia as a public health problem. Conclusions As infant and childhood mortality rates decline and life expectancies lengthen in LMICs, increases in both total population size and the proportion of elderly individuals will make dementia an increasingly severe burden on healthcare resources. Prevalence of dementia is already high in some developing countries. In Africa, India, and Bangladesh, where prevalence of dementia is currently low, rapidly increasing populations of elderly and in- creasing prevalence of risk factors, such as HIV-related dementia and traumatic brain injury, foretell a rise in dementia patients that is a disaster waiting to happen. Local governments are unlikely to switch their attention from ongoing problems of malnutrition and communica- ble disorders to an “incurable” disease like dementia. Furthermore, prevalence of many preventable chronic diseases, such as diabetes and cardiovascular disease, is increasing as LMICs adopt westernized lifestyles, further increasing pressure on limited healthcare resources. There are currently no preventive measures or cures for dementia. Even if promising immunological approaches, gene therapy, or other strategies turn out to be safe and effective, they are likely to be expensive. Therefore, better management is the most appropriate approach for dealing with dementia in the developing world. However, it appears unlikely that funding agencies will develop initiatives to improve diagnosis of dementia in developing countries in the near future. Thus, it is vital for the international health- care community to take action now to strengthen existing initiatives, develop North/South and South/South partner- ships, and build capacity for dementia diagnosis in resource- poor populations. Acknowledgements The author thanks innumerable colleagues who have been involved in designing, reviewing, and executing programs for amelioration of dementia in developing countries. The progress to date would not have been possible without the help of Raj Kalaria, Martin Prince, Richard Mayeux, Yaakov Stern, Raul Arizaga, Francisco Lopera, Ricardo Nitrini, Daisy Acosta, Ciro Gaona, and Martin Medrano. Finally, thanks go to Evelyn Córdoba Villanueva for her extraordinary help with the bibliographic references.