Behavioral and Psychosocial Treatments of Dementia in Mexico

  • Silvia Mejía-ArangoEmail author
  • Mariana López-Ortega
  • Laura Barba-Ramírez


The increase of the elder population in Mexico has led to a growth in individuals with chronic diseases among which the dementias stand out. Approximately 800,000 people in Mexico have some form of dementia, a figure that will triple in the next 30 years. The accelerated process of aging of the population that has occurred in the past years has led to the need by the health system to prioritize the timely diagnosis of degenerative diseases including dementia, leaving the intervention in the background and oriented exclusively to the family as an instrument for the application of treatments. In a context of great social inequalities and economic constraints, the family must cope with the multiple manifestations of dementia related to the progressive deterioration of cognitive functions, within which the behavioral and psychiatric symptoms occupy a predominant place because of their negative effect on the patient’s health and on the mental health of the caregiver. The lack of access to nursing homes and related facilities, in-home registered nurses and home health aides, and other home- and community-based services in Mexico leaves the management of behavioral and psychiatric symptoms of dementia in the hands of families and caregivers who accomplish the caring process in highly disadvantaged contexts.


Behavioral Symptoms Dementia Informal Care Mexico Older Adults Psychological Symptoms 


  1. Angel, J. L., Angel, R. J., López-Ortega, M., Robledo, L. M. G., & Wallace, R. B. (2016). Institutional context of family eldercare in Mexico and the United States. Journal of Cross-Cultural Gerontology, 31(3), 327–336.CrossRefGoogle Scholar
  2. Arriagada, I. (2010). La crisis del cuidado en Chile. Revista de Ciencias Sociales, (23)27, 58–67.Google Scholar
  3. Ávila-Funes, J. A., Melano-Carranza, E., Payette, H., & Amieva, H. (2007). Síntomas depresivos como factor de riesgo de dependencia en adultos mayores. Salud Pública de México, 49(5), 367–375.CrossRefGoogle Scholar
  4. Azermai, M., Petrovic, M., Elseviers, M. M., Bourgeois, J., Van Bortel, L. M., & Vander Stichele, R. H. (2012). Systematic appraisal of dementia guidelines for the management of behavioural and psychological symptoms. Ageing Research Reviews, 11(1), 78–86.CrossRefGoogle Scholar
  5. Beinart, N., Weinman, J., Wade, D., & Brady, R. (2012). Caregiver burden and psychoeducational interventions in Alzheimer’s disease: A review. Dementia and Geriatric Cognitive Disorders extra, 2(1), 638–648.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Bennett, S., & Thomas, A. J. (2014). Depression and dementia: Cause, consequence or coincidence? Maturitas, 79, 184–190.CrossRefPubMedPubMedCentralGoogle Scholar
  7. Bojorquez-Chapela, I., Villalobos-Daniel, V. E., Manrique-Espinoza, B. S., Tellez-Rojo, M. M., & Salinas-Rodríguez, A. (2009). Depressive symptoms among poor older adults in Mexico: Prevalence and associated factors. Revista Panamericana de Salud Publica, 26(1), 70–77.PubMedPubMedCentralGoogle Scholar
  8. Byers, A. L., & Yaffe, K. (2011). Depression and risk of developing dementia. Nature Reviews Neurology, 7, 323–331.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Campbell, P., Wright, J., Oyebode, J., Job, D., Crome, P., Bentham, P., & Lendon, C. (2008). Determinants of burden in those who care for someone with dementia. International Journal of Geriatric Psychiatry, 23(10), 1078–1085.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Campos, B., Ullman, J. B., Aguilera, A., & Dunkel Schetter, C. (2014). Familism and psychological health: The intervening role of closeness and social support. Cultural Diversity and Ethnic Minority Psychology, 20(2), 191.CrossRefGoogle Scholar
  11. Cohen-Mansfield, J. (2001). Nonpharmacologic interventions for inappropriate behaviors in dementia: A review, summary, and critique. The American Journal of Geriatric Psychiatry, 9(4), 361–381.CrossRefGoogle Scholar
  12. Corsi, J. (2001). Violencia Familiar: Una Mirada interdisciplinaria sobre un grave problema social. Argentina: Paidos.Google Scholar
  13. Ferri, C. P., Ames, D., & Prince, M. (2004). Behavioral and psychological symptoms of dementia in developing countries. International Psychogeriatrics, 16(4), 441–459.CrossRefGoogle Scholar
  14. Finkel, S. I., e Silva, J. C., Cohen, G., Miller, S., & Sartorius, N. (1997). Behavioral and psychological signs and symptoms of dementia: A consensus statement on current knowledge and implications for research and treatment. International Psychogeriatrics, 8(S3), 497–500.CrossRefGoogle Scholar
  15. Frisoni, G., Rozzini, L., Gozzetti, A., Binetti, G., Zanetti, O., Bianchetti, A., & Cummings, J. (1999). Behavioral syndromes in Alzheimer’s disease: Description and correlates. Dementia and Geriatric Cognitive Disorders, 10(2), 130–138.CrossRefGoogle Scholar
  16. Gallagher-Thompson, D., Haley, W., Guy, D., Rupert, M., Argüelles, T., Zeiss, L. M., & Ory, M. (2003). Tailoring psychological interventions for ethnically diverse dementia caregivers. Clinical Psychology: Science and Practice, 10(4), 423–438.Google Scholar
  17. Gallagher-Thompson, D., Talamantes, M., Ramirez, R., & Valverde, I. (1996). Service delivery issues and recommendations for working with Mexican American family caregivers. Ethnicity and the Dementias, 137–152.Google Scholar
  18. Gauthier, S., Cummings, J., Ballard, C., Brodaty, H., Grossberg, G., Robert, P., & Lyketsos, C. (2010). Management of behavioral problems in Alzheimer’s disease. International Psychogeriatrics, 22(03), 346–372.CrossRefGoogle Scholar
  19. Gibbons, C., Creese, J., Tran, M., Brazil, K., Chambers, L., Weaver, B., & Bédard, M. (2014). The psychological and health consequences of caring for a spouse with dementia: A critical comparison of husbands and wives. Journal of Women & Aging, 26(1), 3–21.CrossRefGoogle Scholar
  20. Gonyea, J. G., López, L. M., & Velásquez, E. H. (2016). The effectiveness of a culturally sensitive cognitive behavioral group intervention for Latino Alzheimer’s caregivers. The Gerontologist, 56(2), 292–302.CrossRefPubMedPubMedCentralGoogle Scholar
  21. Gutiérrez Robledo LM, & Arrieta Cruz I (coords.) (2014). Plan de Acción Alzheimer y otras Demencias. México. 2014. México: Instituto Nacional de Geriatría/Secretaría de Salud.Google Scholar
  22. Hinton, L., Chambers, D., Velásquez, A., Gonzalez, H., & Haan, M. (2006). Dementia neuropsychiatric symptom severity, help-seeking patterns, and family caregiver unmet needs in the Sacramento Area Latino Study on Aging (SALSA). Clinical Gerontologist, 29(4), 1–15.CrossRefGoogle Scholar
  23. Hinton, L., Haan, M., Geller, S., & Mungas, D. (2003). Neuropsychiatric symptoms in Latino elders with dementia or cognitive impairment without dementia and factors that modify their association with caregiver depression. The Gerontologist, 43(5), 669–677.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Hinton, L., Tomaszewski Farias, S., & Wegelin, J. (2008). Neuropsychiatric symptoms are associated with disability in cognitively impaired Latino elderly with and without dementia: Results from the Sacramento Area Latino study on Aging. International Journal of Geriatric Psychiatry, 23(1), 102–108.CrossRefPubMedPubMedCentralGoogle Scholar
  25. INEGI. (2014). Estadísticas a propósito del día internacional de las personas de edad. Datos Nacionales. México: Instituto Nacional de Geografía y Estadística.Google Scholar
  26. INEGI. (2015). Sistema de cuentas nacionales de México. Cuenta satélite del sector salud de México 2013. Preliminar. Año base 2008. México: Instituto Nacional de Estadística y Geografía.Google Scholar
  27. Jimenez, D. E., Bartels, S. J., Cardenas, V., Dhaliwal, S. S., & Alegría, M. (2012). Cultural beliefs and mental health treatment preferences of ethnically diverse older adult consumers in primary care. The American Journal of Geriatric Psychiatry, 20(6), 533–542.CrossRefPubMedPubMedCentralGoogle Scholar
  28. Jorm, A. F. (2000). Does old age reduce the risk of anxiety and depression? A review of epidemiological studies across the adult life span. Psychological Medicine, 30(01), 11–22.CrossRefPubMedPubMedCentralGoogle Scholar
  29. Kar, N. (2009). Behavioral and psychological symptoms of dementia and their management. Indian Journal of Psychiatry, 51(5), 77.Google Scholar
  30. Livingston, G., Johnston, K., Katona, C., Paton, J., & Lyketsos, C. G. (2005). Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. American Journal of Psychiatry, 162(11), 1996–2021.CrossRefGoogle Scholar
  31. López-Ortega, M. (2014). The family household and informal old age care in Mexico. International Journal of Sociology of the Family, 40(2), 235–246.Google Scholar
  32. López-Ortega, M., & Gutiérrez-Robledo, L. M. (2015). Percepciones y valores en torno a los cuidados de las personas adultas mayores. In: Luis Miguel Gutiérrez Robledo y Liliana Giraldo (coord.) Realidades y expectativas frente a la nueva vejez. Encuesta Nacional de Envejecimiento. Ciudad de México: Instituto de Investigaciones Jurídicas, Universidad Nacional Autónoma de México, pp. 113–133.Google Scholar
  33. Lövheim, H., Sandman, P. O., Kallin, K., Karlsson, S., & Gustafson, Y. (2006). Relationship between antipsychotic drug use and behavioral and psychological symptoms of dementia in old people with cognitive impairment living in geriatric care. International Psychogeriatrics, 18(04), 713–726.CrossRefGoogle Scholar
  34. McDowell, I., Hill, G., Nilsson, T. H., & Kozma, A. (2002). Patterns and health effects of caring for people with dementia. The Gerontologist, 42(5), 643–652.CrossRefGoogle Scholar
  35. Mejia-Arango, S., & Gutierrez, L. M. (2011). Prevalence and incidence rates of dementia and cognitive impairment no dementia in the Mexican population: Data from the Mexican Health and Aging Study. Journal of Aging and Health, 23(7), 1050–1074.CrossRefPubMedPubMedCentralGoogle Scholar
  36. Mejía-Arango, S., Wong, R., & Michaels-Obregón, A. (2015). Normative and standardized data for cognitive measures in the Mexican Health and Aging Study. Salud Pública de México, 57, s90–s96.CrossRefPubMedPubMedCentralGoogle Scholar
  37. Mejia-Arango, S., & Zuniga, C. (2011). Diabetes mellitus como factor de riesgo de demencia en la población adulta mayor mexicana. Revista de Neurologia, 53(7), 397.CrossRefGoogle Scholar
  38. Mitrani, V., & Czaja, S. (2000). Family-based therapy for dementia caregivers: Clinical observations. Aging & Mental Health, 4, 200–209.CrossRefGoogle Scholar
  39. Montes de Oca, V. (1999). Diferencias de género en el sistema de apoyo a la población envejecida en México, en Papeles de Población, Centro de Investigación y Estudios Avanzados de la Población, UAEM, Nueva época Año 5, No. 19, enero-marzo, p. 149–172.Google Scholar
  40. Nigenda, G., López-Ortega, M., Matarazzo, C., & Juárez-Ramírez, C. (2007). La atención de los enfermos y discapacitados en el hogar. Retos para el sistema de salud mexicano. Salud Pública de México, 49(4), 286–294.CrossRefPubMedPubMedCentralGoogle Scholar
  41. Nobles, J. (2013). Migration and father absence: Shifting family structure in Mexico. Demography, 50(4), 1303–1314.CrossRefPubMedPubMedCentralGoogle Scholar
  42. Prince, M. (2000). Dementia in developing countries. A consensus statement from the 10/66 Dementia Research Group. International Journal of Geriatric Psychiatry, 15(1), 14–20.CrossRefPubMedPubMedCentralGoogle Scholar
  43. Prince, M. (2004). Care arrangements for people with dementia in developing countries. International Journal of Geriatric Psychiatry, 19(2), 170–177.CrossRefPubMedPubMedCentralGoogle Scholar
  44. Prince, M., Comas-Herrera, A., Knapp, M., Guerchet, M., & Karagiannidou, M. (2016). World Alzheimer report 2016. Improving healthcare for people living with dementia: Coverage, quality and costs now and in the future.Google Scholar
  45. Robles, L. & Pérez, A. C. (2012). Expectativas sobre la obligación filial: Comparación de dos generaciones en México. Revista Latinoamericana de Ciencias Sociales, Niñez y Juventud, 10(1), 527–540.Google Scholar
  46. Robles Silva, L. (2001). El fenómeno de las cuidadoras: Un efecto invisible del envejecimiento. Estudios Demográficos y Urbanos, 16(3), 61–584.CrossRefGoogle Scholar
  47. Rodríguez L, Sotolongo O, Gladys L, & Calvo M. (2012). Violencia sobre personas de la tercera edad con demencia Policlínico Cristóbal Labra Lisa.2010. Rev Haban Cienc Méd [Internet]. 11(5), 709–726.Google Scholar
  48. Ruelas González, M. G., & Salgado de Snyder, V. N. (2009). Factores asociados con el auto-reporte de maltrato en adultos mayores de México. Rev Chil Salud Publica, 13(2), 90–99.Google Scholar
  49. Savva, G. M., Zaccai, J., Matthews, F. E., Davidson, J. E., McKeith, I., & Brayne, C. (2009). Prevalence, correlates and course of behavioural and psychological symptoms of dementia in the population. The British Journal of Psychiatry, 194(3), 212–219.CrossRefPubMedPubMedCentralGoogle Scholar
  50. Sawatzky, J. E., & Fowler-Kerry, S. (2003). Impact of caregiving: Listening to the voice of informal caregivers. Journal of Psychiatric and Mental Health Nursing, 10(3), 277–286.CrossRefGoogle Scholar
  51. Schulz, R., & Sherwood, P. R. (2008). Physical and mental health effects of family caregiving. Journal of Social Work Education, 44(3), 105–113.CrossRefGoogle Scholar
  52. Smith, M., Gerdner, L. A., Hall, G. R., & Buckwalter, K. C. (2004). History, development, and future of the progressively lowered stress threshold: A conceptual model for dementia care. Journal of the American Geriatrics Society, 52(10), 1755–1760.CrossRefPubMedPubMedCentralGoogle Scholar
  53. Thiyagarajan, J., Prince, M., & Webber, M. (2014). Social support network typologies and health outcomes of older people in low and middle income countries–A 10/66 Dementia Research Group population-based study. International Review of Psychiatry, 26(4), 476–485.CrossRefGoogle Scholar
  54. Wenger, G. C. (1991). A network typology: From theory to practice. Journal of Aging Studies, 5(2), 147–162.CrossRefGoogle Scholar
  55. Wiglesworth, A., Mosqueda, L., Mulnard, R., Liao, S., Gibbs, L., & Fitzgerald, W. (2010). Screening for abuse and neglect of people with dementia. Journal of the American Geriatrics Society, 58(3), 493–500.CrossRefGoogle Scholar
  56. Wilson, R. S., Hoganson, G. M., Rajan, K. B., Barnes, L. L., De Leon, C. M., & Evans, D. A. (2010). Temporal course of depressive symptoms during the development of Alzheimer disease. Neurology, 75(1), 21–26.CrossRefPubMedPubMedCentralGoogle Scholar
  57. Wong, R., Michaels-Obregón, A., Palloni, A., Gutiérrez-Robledo, L. M., González-González, C., López-Ortega, M., … Mendoza-Alvarado, L. R. (2015). Progression of aging in Mexico: the Mexican Health and Aging Study (MHAS). Salud Pública de México, 57, S79–S89.CrossRefPubMedPubMedCentralGoogle Scholar
  58. World Health Organization. (2012). Dementia: A Public Health Priority. Washington, DC. Retrieved from
  59. Zúñiga-Santamaría, T., Sosa-Ortiz, A. L., Alonso-Vilatela, M. E., Acosta-Castillo, I., & Casas-Martínez, M. D. L. L. (2010). Dependencia y maltrato en el anciano con demencia. Persona y Bioética, 14, 1.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  • Silvia Mejía-Arango
    • 1
    Email author
  • Mariana López-Ortega
    • 2
  • Laura Barba-Ramírez
    • 3
  1. 1.El Colegio de la Frontera Norte, Department of Population StudiesTijuanaMexico
  2. 2.National Institutes of Health, Mexico, National Institute of GeriatricsCuernavacaMexico
  3. 3.National Council to Prevent Discrimination, Mexico; El Colegio de la Frontera NorteTijuanaMexico

Personalised recommendations