Curr Neurol Neurosci Rep (2012) 12:511–519 DOI 10.1007/s11910-012-0300-9 DEMENTIA (KS MARDER, SECTION EDITOR) Assessing Dementia in Resource-Poor Regions Gladys E. Maestre Published online: 5 August 2012 # The Author(s) 2012. This article is published with open access at Springerlink.com Abstract The numbers and proportions of elderly are in- creasing rapidly in developing countries, where prevalence of dementia is often high. Providing cost-effective services for dementia sufferers and their caregivers in these resource- poor regions poses numerous challenges; developing resour- ces for diagnosis must be the first step. Capacity building for diagnosis involves training and education of healthcare pro- viders, as well as the general public, development of infra- structure, and resolution of economic and ethical issues. Recent progress in some low-to-middle-income countries (LMICs) provides evidence that partnerships between wealthy and resource-poor countries, and between de- veloping countries, can improve diagnostic capabilities. Without the involvement of the mental health commu- nity of developed countries in such capacity-building programs, dementia in the developing world is a disas- ter waiting to happen. Keywords Developing countries . Low-to-middle-income countries . Resource-poor . Population demography . Elderly . Dementia . Prevalence . Diagnosis . Capacity building . Challenges . Obstacles . International partnerships . Cost–benefit analysis . Economics . Ethics G. E. Maestre (*) Laboratory of Neurosciences, University of Zulia, Edificio del Instituto de Enfermedades Cardiovasculares de la Universidad del Zulia, Primer Piso, Av Universidad diagonal al MACZUL, Maracaibo 4002 Zulia, Venezuela e-mail: gem6@columbia.edu G. E. Maestre Departments of Psychiatry and Neurology, and Gertrude H. Sergievsky Center, Columbia University, PH 19 Room 315, 622 West 168th Street, New York, NY 10032, USA Introduction Dementia disrupts normal functioning of affected individu- als and their families, imposing significant social and eco- nomic burdens. The problem is especially severe in low-to- middle-income countries (LMICs), where dementia is the most important independent contributor to disability in the elderly [1] and resources to diagnose and treat dementia are limited. By the mid-21st century, 78 % of the world’s elderly population will reside in LMICs, with expected concomitant increases in dementia cases [2]. Prevalence of dementia is relatively low in some LMICs, but other regions have a prevalence similar to or higher than that in developed countries [3]. For example, Latin America and the Caribbe- an (LAC) have the world's highest prevalence of dementia (8.5 % in subjects ≥60 years vs. 6.4 % in the U.S.) [3–5]. It is in resource-poor regions with a high prevalence of dementia that cost-effective health care targeted at vulnera- ble populations is most needed. However, dementia care is problematic, even in high-income countries, many patients with dementia remain undiagnosed and, therefore, untreated [6, 7 ]. The governments of LMICs and international health- care agencies have tended to disregard chronic conditions of the elderly, due to more immediate and widespread prob- lems of malnutrition and communicable diseases. However, the World Health Organization (WHO) recently released guidelines for increasing treatment of dementia in LMICs [8] and urged governments to consider dementia as a public health priority [9 ]. Developing effective approaches for diagnosis is the first step toward providing adequate services for dementia sufferers and their caregivers. In this article, I review strategies used to diagnose dementia in resource- poor regions, discuss the particular challenges associated with those assessments, describe some recent strategies for developing and improving diagnosis in poor countries, and consider how diagnosis of dementia might be improved in the future.