Journal of Alzheimer’s Disease 63 (2018) 1065–1073 1065

DOI 10.3233/JAD-180095
IOS Press

Prevalence of Dementia and Associated

Risk Factors: A Population-Based Study
in the Philippines
Jacqueline Domingueza , Ma. Fe de Guzmana , Macario Reandelar Jra and Thien Kieu Thi Phungb
a St. Luke’s Medical Center, QC, Metro Manila, Philippines
b Danish Dementia Research Center, Rigshospitalet, University of Copenhagen, Denmark

Handling Associate Editor: Koji Abe

Accepted 13 March 2018

Abstract.
Background: The Philippines is experiencing rapid demographic aging and with it, the dementia epidemic. Prevalence of
dementia and associated risk factors have not been studied in the Philippines.
Objectives: The study aimed to provide a reliable estimate of dementia prevalence and identify associated risk factors in the
Filipino population.
Methods: 1460 participants 60 years and older were randomly selected from the Marikina City’s senior registry. A multi-
disciplinary team (nurse, psychologist, and neurologist) administered a comprehensive assessment to the study population:
health history, neurological examination, Geriatric Depression Scale, Neuropsychiatric Inventory, Disability Assessment for
Dementia, Alzheimer’s Disease 8, and Clinical Dementia Rating Scale. The neurologist analyzed all clinical data to diagnose
dementia based on the DSM-IV criteria, Alzheimer’s Disease (AD) on the NINCDS-ADRDA criteria, vascular dementia
(VaD) on the Hachinski Ischemic Scale, cognitive impairment no dementia (CIND) on a CDR score of 0.5 and not fulfill-
ing DSM-IV criteria for dementia. Risk factors were correlated with dementia prevalence using multivariate binary logistic
regression.
Results: 1460 persons were randomly selected. 1367 agreed to participate and underwent all assessments. The response rate
was 93.6%. Dementia prevalence was found to be 10.6% (95% CI 9.0 to 12.4) with the breakdown 85.5% AD, 11.7% VaD,
and 2.7% other dementias. In this population, 82.0% of men and 70.4% of women had at least one cardiovascular risk factor
(hypertension, diabetes, dyslipidemia, smoking), which was associated with VaD prevalence but not AD.
Conclusion: The prevalence of dementia, CIND, and cardiovascular risk factors are high in the Philippines.

Keywords: Dementia, Philippines, prevalence, risk factors

INTRODUCTION began in industrialized countries, its effects are now

Starting in the 20th century, world population
aging is continuing in the 21st century. Although it
∗ Correspondence to: Jacqueline Dominguez, MD, MA, Insti-
tute of Neurosciences, St. Luke’s Medical Center, 1009 CHBC
North Tower, 279 E. Rodriguez Ave., Quezon City, 1102,
Philippines. Tel.: +63 723 0101/5009; E-mail: jcdominguez@
stlukes.com.ph.
most prominent in developing countries. In 1915,
about two-thirds of the world’s older population
lived in less developed regions. By 2050, the pro-
portion will reach 80% [1]. Furthermore, population
aging that occurred over 50–60 years in developed
nations is being compressed into 20–30 years in less
developed nations starting at a much earlier stage of
economic development. Asia is the largest continent

ISSN 1387-2877/18/$35.00 © 2018 – IOS Press and the authors. All rights reserved
1066 J. Dominguez et al. / Dementia Prevalence in the Philippines
by population in the world with its 4.4 billion people
making up 60% of the world population today (7.3
billion in 2015) [2]. The number of people aged 60
years and older in Asia is increasing rapidly, projected
to increase from 507 million in 2015 to 1.2 billion in
2050, a 250% increase [2]. In 1915, 56% of the world
population aged ≥60 years resides in Asia. In 2050,
this proportion will increase to 62% [2]. As a result,
Asia is becoming one of the oldest regions in the
world, while many of its countries are not economi-
cally prepared to cope with the political, economic,
and social consequences of population ageing.
As the incidence of dementia increases exponen-
tially after the age of 65 years old, nations in the world
is facing a global epidemic of dementia, with low and
middle-income countries (LMIC) sharing the largest
proportion, i.e., 65%. Currently, Asia has the largest
share, about half of the worldwide prevalent and inci-
dent cases of dementia [3], while the majority of its
nations (about two-thirds) are LMIC, where access to
social protection, services, support and care for peo-
ple with dementia are very limited [3]. Like many
other LMIC, the Philippines has been undergoing an
epidemiological transition caused by lifestyles and
behaviors associated with industrial and economic
development, such as increases in high fat and sugar
diets, sedentary lifestyles, and tobacco use, leading to
dramatic increase in the prevalence of obesity, hyper-
tension, diabetes, and hypercholesterolemia over the
last three decades [4–10]. These are well-established
risk factors for dementia that have not been ade-
quately addressed in the country. Because of the high
prevalence of these specific risk factors, the Filipino
population can be considered a high-risk population
for developing dementia. However, dementia is not
recognized as a major public health problem in the
Philippines. As the extent of dementia epidemic has
not been estimated in the Philippines and research
onto dementia is in general lacking, it is of paramount
important to provide knowledge about disease burden
in order to raise awareness and inform policy makers
about the necessity of social and health care reform in
dementia care. Knowledge about the attributable risks
of major risk factors to specific dementia subtypes is
key to develop intervention programs to address the
dementia epidemic in the Filipino population.
With the working hypothesis that the prevalence
of dementia is high in the Philippines, we aimed to
conduct the first population-based study to provide a
reliable estimate of dementia prevalence and associ-
ated risk factors in Filipino population 60 years and
older.
MATERIALS AND METHODS
Study design and sample size
The Marikina Memory and Aging Project was
a large population-based longitudinal study of
dementia epidemiology among community dwelling
Filipinos. This project is part of the St. Luke’s
Institute for Neurosciences database on aging and
dementia. To establish the cohort, a random sam-
ple of individuals older than 60 years old was drawn
from the senior citizen registry of Marikina City,
proportionally representing the percentages of senior
citizens residing in all 16 barangays (villages). Based
on the estimated prevalence of 5% for South East
Asia from World Alzheimer Report 2009 [11], the
minimum sample size required to achieve a max-
imum error of ± 1.5 and a confidence interval of
95% was 811 participants. Adding an estimated
20% non-response rate and loss to follow-up, the
sample size yielded a total of 1,440 participants.
Subsequently, a random sample of 1,460 partici-
pants ≥60 years old were selected from the senior
registry in the city of Marikina, which registered
17,790 senior citizens (4% of the total population
in Marikina).
Two community health workers provided by the
city government visited the selected individuals at
home and coordinated their visit to the commu-
nity research site accompanied by an informant. An
informant was defined as the person who knew the
participant well, such as a relative, a friend, a neigh-
bor, or a caregiver.
Evaluation procedures
The evaluation was carried out by a multidisci-
plinary team comprised of a nurse, a psychologist,
and a neurologist. Both the selected participant and an
informant participated in the assessments. The Uni-
fied Data Set Version 1.2 of the National Alzheimer’s
Coordinating Council [12] was used but we excluded
neuroimaging due to high costs and Unified Parkin-
son’s Disease Rating Scale (UPDRS) due to length of
time of administration. Some activities in the Func-
tional Assessment Questionnaire were not applicable
hence was replaced by the Disability Assessment in
Dementia [13].
Nurse
Demographic data and heath history: The nurse
obtained informed consent and interviewed both
 J. Dominguez et al. / Dementia Prevalence in the Philippines
the participant and the informant to collect data
about demographics and health history (smok-
ing, alcohol consumption, hypertension, diabetes,
dyslipidemia, traumatic brain injury, depression).
Alcohol abuse was defined according to UDS cod-
ing guidebook as clinically significant impairment
occurring over a 12-month period manifested in
one of the following: work, driving, social or
legal) [14].
Psychologist
The psychologist administered the following tests
to the participant:
Geriatric Depression Scale (GDS) [15]: The total
score ranges from 0 to 30 with higher score indicat-
ing more depressive symptoms. A cut-off score of 10
distinguishes between depressed and non-depressed
individuals.
Neuropsychiatric Inventory-Questionnaire (NPI-
Q) [16]: NPI-Q has a total score between 0–36,
higher scores indicating more severe behavioral dis-
turbances.
Disability Assessment for Dementia (DAD) [13]:
The DAD has 40 items with 17 related to basic self-
care and 23 to instrumental activities of daily living.
Score ranges from 0 to 40, with 40 as the best score
indicating an intact functional level.
Alzheimer’s Disease 8 (AD8) [17]: Administered
to the informant. A score of 2 or more indicates cog-
nitive impairment.
Neurologist
The neurologist performed a physical examination
including a complete neurological examination on the
participant.
Clinical Dementia Rating (CDR) [18]: The neu-
rologist rated the CDR based on interview responses
from the participants and their informants. The Sum
of Boxes score is a total score ranging from 0 to 18
based on the sum of 6 domain scores (i.e., orientation,
judgment and problem solving, memory, home and
hobbies, personal care, and community affairs) each
rated from: normal (0); questionable or very mild
dementia (0.5); mild dementia (1); moderate demen-
tia (2); and severe dementia (3). These domains are
then combined into a global CDR that ranges from 0
to 3.
Hachinski Ischemic Scale (HIS) [19]: The neu-
rologist rated the HIS, an 8-item scale, to diagnose
vascular dementia based on a score of 4 or
higher.
1067
Case ascertainment
The neurologist reviewed all the data and con-
sulted with another neurologist if necessary to reach a
consensus about dementia diagnoses. Dementia was
diagnosed based on the DSM-IV-TR criteria [20],
Alzheimer’s Disease (AD) on the NINCDS-ADRDA
criteria [21], vascular dementia (VaD) on the Hachin-
ski Ischemic Scale [19], cognitive impairment non
dementia (CIND) on a CDR score of 0.5 and not
fulfilling DSM-IV-TR criteria for dementia [22].
Risk factors
Presence or absence of medical risks factors such
as cardiovascular risk factors was recorded based on
patient’s medical history of these conditions as deter-
mined by the neurologists’ clinical judgment, which
was based on a compilation of data collected from
the participant’s self-report, informant report, medi-
cal records, use of medication, and clinical findings
during the visit.
Depression was diagnosed based on DSM-IV-TR
criteria for major depression, using results from GDS
and informant interview [20].
Quality control
The data collection forms were reviewed by the
neurologist. Data were encoded independently by the
research associate, and inconsistencies were double-
checked with the data source to ensure the data
accuracy.
Statistical analysis
Data was analyzed using SPSS Statistical Pro-
gram Version 23. Crude, age- and gender-specific
prevalence of dementia and CIND were calculated.
Age-standardized prevalence of dementia was com-
puted using the Filipino age-specific prevalence
and the Western European population structure in
2013 [2]. The age-specific prevalence of demen-
tia found in the Philippines was multiplied by the
total Western European population in 2013 in that
age group to get the corresponding total number of
people with dementia. Then, the total number of
people with dementia older than 60 years old was
divided by the total number of the Western Euro-
pean population aged 60 years and older to get the
age-standardized proportion of dementia. Frequency,
mean, and standard deviation were used to describe
1068 J. Dominguez et al. / Dementia Prevalence in the Philippines
demographic and clinical characteristics. Chi-square
test was used to determine whether there was a signif-
icant association between categorical variables, while
Fisher’s exact test was employed when the expected
observation was less than five. Independent t-test was
used to determine if there was a statistically signif-
icant difference between the means in two groups.
Significance level was set at p ≤ 0.05. Risk factors
were correlated with dementia prevalence using mul-
tivariate binary logistic regression.
Ethics
The study was approved by the St. Luke’s Institu-
tional Ethics Review Committee.
RESULTS
Data collection started in March 2011 and ended in
February 2012. The flowchart of study participants is
illustrated in Fig. 1. Only 5.1% of the selected random
sample refused to participate. Another 1.2% dropped
out and did not complete the assessments. Therefore,
the number of participants included for analysis was
1367 persons or 93.6% of the original sample (Fig. 1).
Fig. 1. Flow chart of study participants. CIND, Cognitive impairment no dementia; AD, Alzheimer’s disease; VaD, vascular dementia.
The characteristics of the study sample were
described in Table 1. The gender distribution was
29.5% male and 70.5% female. Age distribution was
equal between the two genders. The mean numbers
of school years attended for both men and women
was at 8.61 ± 3.97 but women had significantly less
education than men. The prevalence of cardiovascu-
lar risk factors is alarmingly high, with 80% of men
and 71% of women having at least one cardiovascu-
lar risk factor (smoking, alcohol abuse, hypertension,
diabetes, and dyslipidemia). Women had a slightly
higher prevalence of hypertension, dyslipidemia, and
depression than men, whereas the prevalence of
smoking and alcohol abuse was much higher in men
than in women (Table 1). It was striking that half of
the men in the study population smoked and abused
alcohol (Table 1).
In all, 145 participants were diagnosed with
dementia, yielding a crude prevalence of 10.6% (95%
CI 9.1 to 12.4). The age-standardized prevalence
of dementia was 14.2%. Based on the proportion
of citizens 60 years and older which is 6.8% and
the total population estimate of 100.98 million in
2015 [23, 24], it is estimated that 726,864 people
in the Philippines are currently living with dementia.
The breakdown of dementia subtypes were 85.5%
 J. Dominguez et al. / Dementia Prevalence in the Philippines 1069

Table 1
Characteristics of the study sample
Variables Male (n = 403) Female (n = 964) p∗∗
Age (M ± SD) 69.6 ± 6.5 70.1 ± 6.9 0.24
Education (M ± SD) 9.4 ± 3.8 8.3 ± 4.0 <0.0001
Risks Factors Present n (%) Absent n (%) Present n (%) Absent n (%) p∗
Cardiovascular riskδ (n = 1,347) 327 (82.0) 72 (18.0) 667 (71.0) 281 (29.0) <0.0001
Hypertension (n = 1,280) 194 (52.4) 176 (47.6) 539 (59.2) 371 (40.8) 0.03
Diabetes (n = 1,243) 61 (17.0) 298 (83.0) 168 (19.0) 716 (81.0) 0.41
Dyslipidemia (n = 1,062) 78 (25.7) 225 (74.3) 294 (38.7) 465 (61.3) <0.0001
Smoking history (n = 1,345) 217 (54.7) 180 (45.3) 92 (9.7) 856 (90.3) <0.0001
Alcohol abuse (n = 1,303) 163 (42.2) 223 (57.8) 74 (8.1) 843 (91.9) <0.0001
TBIδδ (n = 1,347) 10 (2.5) 389 (97.5) 20 (2.1) 928 (97.9) 0.65
Depression history (n = 1,347) 135 (33.8) 264 (66.2) 420 (44.3) 528 (55.7) <0.0001
Depression active in 2 years (n = 1,298) 120 (31.1) 266 (68.9) 390 (42.8) 522 (57.2) <0.0001
Depression episodes 2 years prior (n = 1,279) 89 (23.3) 293 (76.7) 278 (31.0) 619 (69.0) 0.01
∗ Obtained using Chi-square tests; ∗∗ Obtained using T-tests for independent samples; δ Cardiovascular risk includes presence of at least one
of following cases hypertension, diabetes, dyslipidemia, smoking history; δδ TBI means traumatic brain injury which may include TBI with
brief or extended loss of consciousness and TBI with chronic deficits or dysfunctions.

Fig. 2. Age and gender-specific dementia prevalence.

AD, 11.7% VaD, and 2.7% other dementias (Fig. 1).
The prevalence of CIND was 23.2% (317 cases). Age-
specific dementia prevalence was shown in Fig. 2,
demonstrating that it increased steeply with age.
There was no significant difference between gender-
specific prevalence for men and women in the overall
prevalence, being 11.7% and 10.2%, respectively
(z = –0.819, two-tailed p = 0.41). However, the risk of
dementia for men increased much steeper with age.
At younger age, few men than women were affected
with dementia, but the reverse held true at the higher
end of age spectrum (Table 2).
The association between demographics and health
factors and dementia prevalence was shown in
Table 3. Age was significantly associated with
dementia risk and AD but not with VaD. Gender
was not associated with dementia risk. Education was
significantly associated with reduced risk for demen-
tia. Depression, alcohol abuse and dyslipidemia were
significantly associated only with VaD (Table 3).
Sensitivity analysis for separate gender showed that
age was consistently associated with dementia and
AD (p < 0.0001) but not for VaD in both men and
women. Dyslipidemia was associated with increased
1070 J. Dominguez et al. / Dementia Prevalence in the Philippines

Table 2
Age and gender specific dementia prevalence
Groups Both Sexes Male Female 2-tailed p
Age Groups Dementia n (%) Total Dementia n (%) Total Dementia n (%) Total
60–69 years old 41 (5.9) 694 8 (3.8) 213 33 (6.9) 481 0.01
70–79 years old 75 (13.6) 550 29 (18.0) 161 46 (11.8) 389 0.05
≥80 years old 29 (23.6) 123 10 (34.5) 29 19 (20.2) 94 0.11
Total 145 (10.6) 1367 47 (11.7) 403 98 (10.2) 964 0.41

Table 3
Multivariate analysis of factors associated with dementia prevalence
Variables Dementia (n = 145) AD (n = 124) VaD (n = 17)
Exp (␤) p-value 95% CI Exp (␤) p-value 95% CI Exp (␤) p-value 95% CI
Age <0.0001 <0.0001 0.58
Age (≥80 years old) 7.84 <0.0001 (3.78–16.25) 9.24 <0.0001 (4.23–20.18) 2.04 0.57 (0.18–23.58)
Age (70–79 years old) 3.50 <0.0001 (2.03–6.02) 4.03 <0.0001 (2.12–7.35) 2.10 0.31 (0.50–8.86)
Sex (Female) 0.65 0.17 (0.35–1.20) 0.67 0.24 (0.35–1.30) 0.54 0.53 (0.08–3.74)
Education 0.94 0.05 (0.88–1.00) 0.95 0.14 (0.89–1.02) 0.92 0.37 (0.76–1.11)
Smoking History 0.87 0.68 (0.46–1.65) 1.07 0.84 (0.55–2.09) 0.27 0.23 (0.03–2.33)
Alcohol Abuse 1.83 0.07 (0.95–3.51) 1.41 0.34 (0.69–2.87) 16.30 0.01 (1.95–136.44)
Dyslipidemia 1.44 0.16 (0.86–2.41) 1.09 0.76 (0.62–1.92) 26.37 0.01 (2.73–254.40)
Hypertension 1.23 0.42 (0.75–2.01) 1.08 0.78 (0.64–1.81) 3.86 0.22 (0.44–33.71)
Diabetes 1.08 0.82 (0.58–1.99) 1.21 0.56 (0.63–2.32) 0.44 0.36 (0.08–2.52)
Depression 2 years active 0.77 0.44 (0.40–1.49) 0.87 0.70 (0.44–1.74) 0.44 0.39 (0.06–2.95)
Depression episodes 2 years prior 1.87 0.08 (0.92–3.79) 1.47 0.32 (0.69–3.13) 13.46 0.01 (1.73–104.90)
Traumatic Brain Injury 0.48 0.51 (0.05–4.28) 0.57 0.62 (0.06–5.08)
Notes: Selection procedure is Backward LR: Stepwise Algorithm; VaD, vascular dementia; AD, Alzheimer’s disease.

risk for dementia, AD, and VaD in men (p = 0.05).
For women, depression was associated with increased
VaDrisk (p = 0. 02) but not for dementia and AD.
DISCUSSION
This is the first population-based study in the
country to provide reliable estimate of dementia
prevalence and CIND. Prevalence of dementia in
the Philippines was found to be high, with a crude
prevalence of 10.6% (95% CI 9.1 to 12.4). The age-
standardized prevalence of dementia was 14.2%, the
double of the updated estimate for South East Asia in
2015 of 7.6% [3]. There was no gender-based dif-
ference in dementia prevalence between men and
women. Prevalence of dementia has been found to
be higher in women than men in some countries but
not in all [3].
The prevalence of CIND was also high at 23.2%.
A longitudinal follow-up of the cohort to determine
dementia incidence and attributable risk factors to
dementia incidence has subsequently been conducted
and data is being analyzed. Together with data from
this study, we will be able to compute a projection for
the increase of dementia prevalence in the Philippines
through to 2050. The prevalence of dementia is
projected to increase by 236% from 2015 to 2050
for South East Asia, according to World Alzheimer
Report 2015 [3].
The prevalence of cardiovascular risk factors was
alarmingly high. Hypertension was present in half
of the study population, double of the global age-
standardized prevalence of hypertension and the
current estimate for Filipino adult population over
20 years old [25, 26]. While mean blood pressure has
decreased in many parts of the world, it is increasing
in South East Asia, with low-income and middle-
income countries sharing the largest burden in the
global increase of hypertension prevalence [25]. The
high rate of smoking among men (about half) in
the study population is striking, reflecting the cur-
rent shift in smoking from high-income countries
to low-income countries [4]. Furthermore, the high
prevalence of alcohol abuse among men (about half)
is of great concern and needs to be addressed.
The prevalence of diabetes in this study population
was also the double of the global age-standardized
prevalence of diabetes and triple of estimated for Fil-
ipino adults [4, 26]. Dyslipidemia prevalence in this
population was also almost the double of the esti-
mate for Filipino adults older than 20 years old [26].
 J. Dominguez et al. / Dementia Prevalence in the Philippines
It is known that population mean cholesterol levels
have been steadily increasing in South East Asia [4].
The reason for the high prevalence of cardiovascular
risk factors found in the study sample compared to
the national estimates is most likely due to age, as
older persons have higher prevalence of chronic dis-
eases, including cardiovascular diseases. There were
differences in the risk factor profiles for men and
women, with women having higher prevalence of
dyslipidemia and hypertension, whereas about half
the men abused alcohol and smoked. These differ-
ential risk factor profiles could partly explain the
findings that the risk of dementia increased much
steeper with age among men than women (Fig. 2,
Table 2), although the overall prevalence was the
essentially the same for the two genders. Cardiovas-
cular risk factors were associated with VaD but not
with AD and dementia. Despite the high prevalence
of cardiovascular risk factors, the proportion of VaD
in this population (11.7%) was not as high as reported
in Asia [27], where the proportions of VaD vary from
20–50% of all dementia cases. However, the propor-
tion of VaD has been found to be age-dependent in
Japan, being lower (8-9%) in the age group older than
65 years old and higher (16%) in the age group 64
years and younger [28]. Furthermore, cardiovascu-
lar risk factors were only associated with increased
VaD risk and not with AD in this study population.
The possible explanations could be the high preva-
lence of stroke and high mortality rate associated with
stroke in the Philippines [29, 30]. Due to limited ser-
vices and resources, medical care for stroke patients
including acute intervention, rehabilitation, and pre-
ventive strategies addressing hypertension, diabetes,
and dyslipidemia remains inadequate [29]. There-
fore, stroke in older individuals is likely a fatal event.
This could also explain that age was not associated
with increased risk for VaD in this study popula-
tion. Furthermore, due to the lack of neuroimaging,
patients with cerebral small vessel disease(SVD)
could be misclassified as AD, and a large proportion
of mixed AD and VaD could also be missed in this
study.
This is a cross-sectional study therefore the
association found cannot firmly establish a causal
relationship. Furthermore, neuroimaging and other
investigations could not be carried out to precisely
ascertain the dementia subtypes. With the high preva-
lence of cardiovascular risk factors, it is highly likely
that there is a high proportion of cerebral SVD, a
highly prevalent finding among older Asians [31].
SVD markers could be a potential target for treatment
1071
in clinical trials to delay progression of cerebrovas-
cular disease and potentially cognitive decline in the
Philippines and Asia. The prevalence of CIND was
also found to be considerable in this study popu-
lation. Since this is a population at high risk for
developing dementia [22], they are target for pre-
ventive interventions. In order to precisely assess
the efficacy of preventive interventions on which
type of CIND, it is crucial to define whether AD,
VaD particularly subcortical SVD or mixed pathol-
ogy is present by neuroimaging at baseline [32, 33].
Subjects with high SVD burden at baseline may ben-
efit most from the intensive vascular management
program [34].
Certainly, dementia is already a major public health
problem and will be increasingly so in the years to
come. Therefore, it is critical to provide policy mak-
ers with the reliable estimate of the disease burden
to raise awareness and advocate for the develop-
ment of health care and social strategies to address
this rapidly growing dementia epidemic, including
adequately addressing the high prevalence of car-
diovascular risk factors. Cardiovascular diseases are
currently the leading cause of death in the Philip-
pines and stroke is the second [30]. At the moment,
dementia diagnosis and management in the non-acute
settings is not covered by PhilHealth, the national
health insurance program to provide universal health-
care coverage for key health issues. The patients and
their families are basically alone in their struggles.
They pay for the costs of care out of their pockets,
if they can afford. Older individuals with dementia
are usually not prioritized in the face of limited fam-
ily resources. The Philippines is experiencing high
growth rate in the past years. Therefore, it is impor-
tant to channel this economic gain into social and
health care reforms to address the major public health
problems in the country, including dementia and its
major modifiable risk factors, i.e. cardiovascular risk
factors and diseases.
ACKNOWLEDGMENTS
This study was supported by grants from the
Philippine Council for Health Research and Develop-
ment of the Department of Science and Technology
(FP09011) and St. Luke’s Medical Center (09-010),
and with the cooperation of the Office of Senior Cit-
izens Affairs of Marikina City, Philippines.
Authors’ disclosures available online (https://
www.j-alz.com/manuscript-disclosures/18-0095r1).
1072 J. Dominguez et al. / Dementia Prevalence in the Philippines
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