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Two of every three persons living with dementia reside in low- and middle-income countries (LMICs). The projected increase in global dementia rates is expected to affect LMICs disproportionately. However, the majority of global dementia care costs occur in high-income countries (HICs), with dementia research predominantly focusing on HICs. This imbalance necessitates LMIC-focused research to ensure that characterization of dementia accurately reflects the involvement and specificities of diverse populations. Development of effective preventive, diagnostic, and therapeutic approaches for dementia in LMICs requires targeted, personalized, and harmonized efforts. Our article represents timely discussions at the 2022 Symposium on Dementia and Brain Aging in LMICs that identified the foremost opportunities to advance dementia research, differential diagnosis, use of neuropsychometric tools, awareness, and treatment options. We highlight key topics discussed at the meeting and provide future recommendations to foster a more equitable landscape for dementia prevention, diagnosis, care, policy, and management in LMICs. HIGHLIGHTS: Two-thirds of persons with dementia live in LMICs, yet research and costs are skewed toward HICs. LMICs expect dementia prevalence to more than double, accompanied by socioeconomic disparities. The 2022 Symposium on Dementia in LMICs addressed advances in research, diagnosis, prevention, and policy. The Nairobi Declaration urges global action to enhance dementia outcomes in LMICs.

Background and Objectives: Spanish is the second most spoken language in the United States. Not all substance use disorder (SUD) treatment facilities provide treatment in Spanish. This study examined factors associated with SUD treatment facilities having counselors that provide treatment in Spanish. Methods: State‐level estimates of Spanish‐speaking individuals were derived from the American Community Survey 2019. SUD treatment facility characteristics were captured from the National Survey of Substance Abuse Treatment Services 2020. We examined a sample of 15,246 facilities which included 12,798 outpatient, 3554 nonhospital residential, and 1106 with both outpatient and residential programs. Binary logistic regression models were used to observe state‐level proportions of Spanish speakers and facility‐level characteristics as factors associated with a facility having counselors that provide treatment in Spanish. Results: Approximately 23.3% of facilities had counselors able to provide treatment in Spanish. Among outpatient or nonhospital residential SUD facilities, those in a state with a larger proportion of Spanish‐speaking individuals, facilities with pay assistance, facilities that accept Medicaid, and facilities that engage in community outreach had higher odds of having counselors that provide treatment in Spanish. Conclusions: Considering that less than a quarter of facilities provide treatment in Spanish, increasing the availability of linguistically appropriate and culturally responsive services for SUD is imperative. Scientific Significance: This national study is the first of its kind to examine associations between estimates of Spanish speakers and treatment facility characteristics associated with counselors that provide treatment in Spanish in outpatient and nonhospital residential SUD treatment. [ABSTRACT FROM AUTHOR]

Background: The latest Centers for Disease Control and Prevention prevalence estimate of Autism Spectrum Disorders (ASD) is 14.7 per 1,000 children aged eight years, roughly 30% higher than the prevalence reported in 2012. However, the prevalence of ASD among Hispanic children, including children in South Texas, continues to be much lower than national estimates for non-Hispanic White children. The possibility of underdiagnosis of ASD among Hispanic children remains a concern and may be attributed to a lack of culturally competent healthcare providers. To address inadequate access to healthcare among Hispanic communities, promotoras or community health worker (CHW)-based outreach has proven effective at increasing awareness on general health practices. A three-phase 'train-the-trainer' program was developed using the Developmental Milestones Promotora Training Guide as the main component. The objective of the first phase was to evaluate the use of the Training Guide to educate CHWs in South Texas on normal developmental milestones and recognize ASD warning signs. Methods: Fifty-eight CHWs from two South Texas counties attended the training. The participants completed pre- and post-test assessments, and a paired t-test was conducted to ascertain mean percent-correct responses. The outcome of interest was a significant difference within participants in their mean percent correct responses between their pre- and posttests. Results: A statistically significant difference (n=58, p<0.0000) was found between mean percent correct responses of the pretest (mean (M)= 60.49, standard deviation (SD)= 16.41) and post-test (M= 73.56, SD= 18.15). Discussion: The Promotora Training Guide is an effective tool for increasing knowledge among South Texas CHWs regarding developmental milestones and ASD warning signs. Certification and training curriculums for CHWs should include this guide to enable CHWs to help Hispanic families recognize developmental delays, thereby improving the health outcomes of affected children by allowing for earlier detection, diagnosis, and therapy. [ABSTRACT FROM AUTHOR]