Introduction: Epidemiological data indicate that neurodegenerative diseases show a high prevalence with a progressive increasing trend, especially in aging populations, as is the case in rural areas. The objective of this study was to assess the quantitative impact of neurodegenerative diseases in rural areas of the Spanish-Portuguese border region and to describe the epidemiological profile of the most prevalent disorders in one of the most depopulated and aged regions of Europe. Methods: A cross-sectional descriptive study was designed to estimate the prevalence of subjects diagnosed with the most common neurodegenerative disorders: dementia (Alzheimer’s disease and other dementias), Parkinson’s disease and Parkinsonism, and multiple sclerosis in the Spanish-Portuguese cross-border border region in 2020. It includes Bragança and Guarda Districts (Portugal) and Salamanca (Castilla y León, Spain). Results: Neurodegenerative diseases accounted for 1.85% in the Spanish-Portuguese cross-border region in 2020; a total of 5,819 records were reported: 987 (prevalence, 2.51%) in Salamanca (Spain); 2,332 (prevalence, 1.87%) in Bragança; and 2,500 (prevalence, 1.66%) in Guarda. Female population suffered from them in higher proportion (2.35 vs. 1.32%). Dementia represented 1.19% (3,744), Parkinson’s disease and Parkinsonism 0.58% (1,823), and multiple sclerosis 0.08% (252). These disorders impacted older age groups. In the rural border region of Spain, 1 out of 4 cases were institutionalized. Conclusion: The findings reveal the health impact of neurodegenerative diseases in the Spanish-Portuguese cross-border region. The epidemiological data emphasize the region’s circumstances and highlight research priorities. Intervention strategies must be implemented in the region to ensure quality healthcare in rural areas.

1.
GBD 2016 Neurology Collaborators
Nichols
E
,
Alam
T
,
Bannick
MS
,
Beghi
E
,
Blake
N
.
Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
.
Lancet Neurol
.
2019
;
18
(
5
):
459
80
.
2.
GBD 2019 Diseases and Injuries Collaborators
.
Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
.
Lancet
.
2020
;
396
(
10258
):
1204
22
.
3.
World Health Organization (WHO)
Dementia
Geneva
World Health Organization: A public health priority
2012
.
4.
Fiest
KM
,
Roberts
JI
,
Maxwell
CJ
,
Hogan
DB
,
Smith
EE
,
Frolkis
A
.
The prevalence and incidence of dementia due to Alzheimer’s disease: a systematic review and meta-analysis
.
Can J Neurol Sci
.
2016
43
Suppl 1
S51
82
.
5.
Kalia
LV
,
Lang
AE
.
Parkinson’s disease
.
Lancet
.
2015
;
386
(
9996
):
896
912
.
6.
World Health Organization (WHO) [Internet]
.
World failing to address dementia challenge
2021
. Available from: https://www.who.int/news/item/02-09-2021-world-failing-to-address-dementia-challenge.
7.
Garcés
M
,
Crespo Puras
C
,
Finkel Morgenstern
L
,
Arroyo Menéndez
M
In:
Madrid
UC
,
Neuroalianza
, editors.
Estudio sobre las enfermedades neurodegenerativas en España y su impacto económico y social
Madrid
2016
.
8.
Nieto Masot
A
,
Cárdenas Alonso
G
,
Engelmo Moriche
Á
.
Spatial analysis of the rural-urban structure of the Spanish municipalities
.
Int J Geoinf
.
2020
;
9
(
4
):
213
.
9.
Alzheimer´s Disease International [Internet]
.
Dementia facts & figures: dementia statistics
. Available from: https://www.alzint.org/about/dementia-facts-figures/dementia-statistics/.
10.
GBD 2019 Dementia Forecasting Collaborators
.
Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019
.
Lancet Public Health
.
2022
;
7
(
2
):
e105
25
.
11.
Alzheimer Europe [Internet]
.
Dementia in Europe yearbook 2019: estimating the prevalence of dementia in Europe
.
Luxembourg, alzheimer Europe
.
2019
. Available from: https://www.alzheimer-europe.org/resources/publications/dementia-europe-yearbook-2019-estimating-prevalence-dementia-europe.
12.
Balestrino
R
,
Schapira
AHV
.
Parkinson disease
.
Eur J Neurol
.
2020
;
27
(
1
):
27
42
.
13.
Ferreira
JJ
,
Gonçalves
N
,
Valadas
A
,
Januário
C
,
Silva
MR
,
Nogueira
L
.
Prevalence of Parkinson’s disease: a population-based study in Portugal
.
Eur J Neurol
.
2017
;
24
(
5
):
748
50
.
14.
Santos García
D
,
Blázquez-Estrada
M
,
Calopa
M
,
Escamilla-Sevilla
F
,
Freire
E
,
García Ruiz
PJ
.
Present and future of Parkinson’s disease in Spain: Parkinson-2030 delphi Project
.
Brain Sci
.
2021
;
11
(
8
):
1027
.
15.
Sociedad Española de Neurología (Sen) [Internet]
El número de Afectados por la Enfermedad de Parkinson se Duplicará en 20 Años y se Triplicará en 2050
. Available from: https://www.sen.es/saladeprensa/pdf/Link238.pdf.
16.
Walton
C
,
King
R
,
Rechtman
L
,
Kaye
W
,
Leray
E
,
Marrie
RA
.
Rising prevalence of multiple sclerosis worldwide: insights from the Atlas of MS, third edition
.
Mult Scler
.
2020
;
26
(
14
):
1816
21
.
17.
GBD 2016 Multiple Sclerosis Collaborators
.
Global, regional, and national burden of multiple sclerosis 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
.
Lancet Neurol
.
2019
;
18
(
3
):
269
85
.
18.
MS International Federation [Internet]
.
Atlas of multiple sclerosis (MS)
. Available from: https://www.atlasofms.org/map/portugal/epidemiology/number-of-people-with-ms.
19.
Instituto Nacional de Estadística [INE] [Internet]
. Esperanza de vida al nacimiento. Indicadores de Mortalidad. 2021. Available from: https://www.ine.es/jaxiT3/Datos.htm?t=1485.
20.
Instituto Nacional de Estatística [INE] [Internet]
Esperança de vida à nascença diminuiu em todas as regiões do continente 2019-2021
.
2022
. Available from: https://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_destaques&DESTAQUESdest_boui=541021600&DESTAQUESmodo=2.
21.
Población Tarjetas Sanitarias Individuales
TIS-SACYL, 01/01/2020
. [Internet]. SACYL. Available from: https://www.saludcastillayleon.es/transparencia/es/transparencia/informacion-datos-publicos/datos-interes/poblacion-tsi.
22.
Bilhete de identidade dos Cuidados de Saúde Primários – 2020.12.29
[Internet]. Available from: https://bicsp.min-saude.pt/pt/biufs/2/20024/Pages/default.aspx.
23.
Instituto Nacional de Estatística [INE] [Internet]
Estimativas anuais da população residente no distrito de Bragança: atualizado a 14 de junho de 2019
.
2020
. Available from: INE: http://www.ine.pt.
24.
República Portuguesa -Coesão Territorial
Valorizaçao do Interior-. Ministerio para la Transición ecológica y el Reto Demográfico -Secretaría General para el reto Demográfico-. Estrategia común de desarrollo transfronterizo
.
2020
.
25.
Instituto Nacional de Estadística [INE]
. [Internet]. Índice de envejecimiento. Indicadores de Estructura de la población. 2021. Available from: https://www.ine.es/jaxiT3/Datos.htm?t=1489.
26.
Orgaz
B
,
Picado
E
,
Yurrebaso
A
,
Badía
M
.
Caracterización de la zona rural de la provincia de Salamanca. XXII Congreso Virtual Internacional de Psiquiatría
.
Psicología y salud mental. A y salud mental
. www.interpsiquis.com – del 24 mayo al 4 de junio de 2021.
27.
Instituto Nacional de Estatística [INE] [Internet]
Estimativas de população residente em Portugal 2019
.
2020
. Available from: https://www.ine.pt/ngt_server/attachfileu.jsp?look_parentBoui=438658715&att_display=n&att_download=y.
28.
De Lau
LM
,
Breteler
MM
.
Epidemiology of Parkinson’s disease
.
Lancet Neurol
.
2006
;
5
(
6
):
525
35
.
29.
National Academies of Sciences
.
Engineering, and medicine; division of behavioral and social sciences and education; board on behavioral, cognitive, and sensory sciences; committee on the decadal survey of behavioral and social science research on alzheimer’s disease and alzheimer’s disease-related dementias. 2, Prevention and Protective Factors
.
Reducing the impact of dementia in America: a decadal survey of the behavioral and social sciences
Washington (DC)
National Academies Press (US)
2021
[Internet]. https://www.ncbi.nlm.nih.gov/books/NBK574343/.
30.
Peters
R
,
Ee
N
,
Peters
J
,
Booth
A
,
Mudway
I
,
Anstey
KJ
.
Air pollution and dementia: a systematic review
.
J Alzheimers Dis
.
2019
70
s1
45
63
.
31.
OECD. Health at a glance 2017: OECD indicators
OECD Publishing
Paris
2017
. Available from: http://dx.doi.org/10.1787/health_glance-2017-en.
32.
Tola-Arribas
MA
,
Yugueros
MI
,
Garea
MJ
,
Ortega-Valín
F
,
Cerón-Fernández
A
,
Fernández-Malvido
B
.
Prevalence of dementia and subtypes in Valladolid, northwestern Spain: the DEMINVALL study
.
PLoS One
.
2013
;
8
(
10
):
e77688
.
33.
Podcasy
JL
,
Epperson
CN
.
Considering sex and gender in Alzheimer disease and other dementias
.
Dialogues Clin Neurosci
.
2016
;
18
(
4
):
437
46
.
34.
Beam
CR
,
Kaneshiro
C
,
Jang
JY
,
Reynolds
CA
,
Pedersen
NL
,
Gatz
M
.
Differences between women and men in incidence rates of dementia and alzheimer’s disease
.
J Alzheimers Dis
.
2018
;
64
(
4
):
1077
83
.
35.
Bae
JB
,
Lipnicki
DM
,
Han
JW
,
Sachdev
PS
,
Kim
TH
,
Kwak
KP
.
For Cohort Studies of Memory in an International Consortium (COSMIC). Does parity matter in women’s risk of dementia? A COSMIC collaboration cohort study
.
BMC Med
.
2020
;
18
(
1
):
210
.
36.
Martínez-Pérez
JA
,
Ortiz-García
R
,
González-Zerega
A
,
López-Gosling
I
,
Guzmán
A
,
Dragomir
E
.
Epidemiología del parkinsonismo en el Área de Salud de Guadalajara [Epidemiology of parkinsonism in the Guadalajara Health Area]
.
Semergen
.
2014
;
40
(
6
):
305
12
.
37.
García López
FJ
,
García-Merino
A
,
Alcalde-Cabero
E
,
de Pedro-Cuesta
J
.
Incidence and prevalence of multiple sclerosis in Spain: a systematic review
.
Neurologia
.
2022
22
00177
8
.
38.
Branco
M
,
Alves
I
,
Martins da Silva
A
,
Pinheiro
J
,
MJ
,
Correia
I
.
The epidemiology of multiple sclerosis in the entre Douro e Vouga region of northern Portugal: a multisource population-based study
.
BMC Neurol
.
2020
;
20
(
1
):
195
.
39.
Coyle
PK
.
What can we learn from sex differences in MS
.
J Pers Med
.
2021
;
11
(
10
):
1006
.
40.
Pinto
C
,
Geraghty
AWA
,
McLoughlin
C
,
Pagnini
F
,
Yardley
L
,
Dennison
L
.
Experiences of psychological interventions in neurodegenerative diseases: a systematic review and thematic synthesis
.
Health Psychol Rev
.
2023
;
17
(
3
):
416
38
.
41.
Aza
A
,
Gómez-Vela
M
,
Badia
M
,
Begoña Orgaz
M
,
González-Ortega
E
,
Vicario-Molina
I
.
Listening to families with a person with neurodegenerative disease talk about their quality of life: integrating quantitative and qualitative approaches
.
Health Qual Life Outcomes
.
2022
;
20
(
1
):
76
.
42.
Badia
M
,
Orgaz
MB
,
Vicario-Molina
I
,
González-Ortega
E
,
Gómez-Vela
M
,
Aza
A
.
Transcultural adaptation and psychometric properties of Family Quality of Life Survey for caregivers of people with neurodegenerative disease: a study of Spanish families who live in the rural Spain-Portugal cross-border
.
Health Qual Life Outcomes
.
2021
;
19
(
1
):
172
.
You do not currently have access to this content.