Prevalence of Dementia and Modifiable Risk Factors among Older Adults in Cuba: A Population-Based Study

Background: Cuba faces rapid population ageing, with important implications for the prevalence and burden of dementia. Objective: To estimate the prevalence of dementia and quantify the relationship with modifiable risk factors among older adults in Cuba. Methods: A single-phase, population-based catchment area survey was conducted among all residents aged ≥65 years in 13 urban and rural catchment areas in western Cuba between 2023 and 2025 using the Caribbean American Dementia and Aging Study (CADAS) protocol. Dementia was diagnosed using the 10/66 Dementia Research Group diagnostic algorithm. Results: A total of 1,509 participants aged ≥65 years were evaluated in their homes, representing a 93.8% response rate. The weighted prevalence of dementia was 8.42% (95% CI: 7.02–9.84), higher among women (10.06%) than men (6.46%) and increasing markedly with age. Physical inactivity and low educational attainment showed the largest individual association with dementia risk, with population attributable fractions (PAFs) of 15.6% (95% CI: 8.3–21.9) and 9.7% (95% CI: 2.4–16.7), respectively. Social isolation, visual impairment, uncontrolled hypertension, and traumatic brain injury also contributed to dementia risk, whereas obesity, diabetes, smoking, alcohol use, and hearing impairment showed smaller, non-significant PAFs. Overall, 32.4% (95% CI: 23–45) of dementia cases in the population were associated with modifiable risk factors using PAF estimation methods. Conclusion: Dementia represents a substantial public health burden among older adults in Cuba, with a considerable proportion of cases related to modifiable risk factors. Strengthening policies that promote equitable access to education across the course of life, support physical activity in older age, improve detection and management of cardiovascular risk factors, and expand access to sensory health services may help reduce future dementia burden.