11. The Americas

  1. Hugo de Waal MD, FRCPsych, FHEA8,
  2. Constantine Lyketsos MD, MHS9,
  3. David Ames BA, MD, FRCPsych, FRANZCP10 and
  4. John O'Brien BA, BM BCh, MA, FRCPsych, MD11
  1. Pablo M. Bagnati1,
  2. Janus L. Kremer2,
  3. Fernando E. Taragano3,
  4. Ricardo F. Allegri4,
  5. Cassio M. C. Bottino5,
  6. Patricio Fuentes6 and
  7. Quincy M. Samus7

Published Online: 7 JUL 2013

DOI: 10.1002/9781118378663.ch11

Designing and Delivering Dementia Services

Designing and Delivering Dementia Services

How to Cite

Bagnati, P. M., Kremer, J. L., Taragano, F. E., Allegri, R. F., Bottino, C. M. C., Fuentes, P. and Samus, Q. M. (2013) The Americas, in Designing and Delivering Dementia Services (eds H. de Waal, C. Lyketsos, D. Ames and J. O'Brien), John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118378663.ch11

Editor Information

  1. 8

    Lead Consultant, Norfolk Dementia Care Academy, Norwich, UK

  2. 9

    Associate Postgraduate Dean, East of England Deanery, Cambridge, UK

  3. 10

    Elizabeth Plank Althouse Professor, Director of the Johns Hopkins Memory and Alzheimer's Treatment Center, Johns Hopkins Medicine, Maryland, USA

  4. 11

    Director, National Ageing Research Institute, University of Melbourne Professor of Ageing and Health, Victoria, Australia

Author Information

  1. 1

    Memory and Aging Center, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina

  2. 2

    Instituto de Neuropsiquiatría Kremer, Córdoba, Argentina

  3. 3

    Department of Neurosciences, Centro de Estudios Médicos e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina

  4. 4

    Memory and Aging Center, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina

  5. 5

    Old Age Research Group (PROTER), Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil

  6. 6

    Cognitive Neurology and Dementia Unit, Neurology Service, Hospital of Salvador and Geriatrics Section, Clinical Hospital University of Chile, Santiago, Chile

  7. 7

    Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Maryland, Baltimore, USA

Publication History

  1. Published Online: 7 JUL 2013

ISBN Information

Print ISBN: 9781119953494

Online ISBN: 9781118378663



  • dementia services;
  • Argentina;
  • national case register;
  • ReDeCar;
  • ALMA;
  • Brazil;
  • epidemiologic polarisation;
  • dementia reference centres;
  • Brazilian national dementia policies;
  • Chile


In this chapter we present an overview of dementia services and the general state of affairs regarding dementia in four countries, representing North and South America:

  • Argentina

  • Brazil

  • Chile

  • the USA

All expect increases in incidence and prevalence of dementias.

Argentina reports inequitable access to health care funding as well as a concentrated provision of specialists mainly in large cities, but also improved resources for carers. There are various partnerships and initiatives to progress research into eg biomarkers.

Brazil describes a particular diverging pattern of morbidity due to high levels of socio-economic inequality and a relatively younger age of onset in Latin America in general. It reports inadequate provision of dementia care and this is equally true with regards to postgraduate training in dementia. However, the picture overall is slowly improving, particularly through ‘dementia reference centres’ and other initiatives.

In Chile there is a comparable lack of attention to dementia care, in spite of a number of governmental health programmes. A number of professional organisations collaborate to counter this tendency and there is an expectation that current low levels of training in dementia will reverse.

The USA reports a complex, fragmented patchwork of services, providers and financing mechanisms. However, it is hoped that recent legislation will address these issues and specific national initiatives are observed to lead to improvements in practices and policy developments.