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Introduction: Despite high dementia prevalence in Hispanic populations globally, especially Caribbean Hispanics, no study has comparatively examined the association between education and dementia among Hispanics living in the Caribbean Islands and older adults in the United States., Methods: We used data on 6107 respondents aged 65 and older in the baseline wave of the population-based and harmonized 10/66 survey from Cuba, the Dominican Republic, and Puerto Rico, collected between 2003 and 2008, and 11,032 respondents aged 65 and older from the U.S.-based Health and Retirement Study data in 2014, a total of 17,139 individuals. We estimated multivariable logistic regression models examining the association between education and dementia, adjusted for age, income, assets, and occupation. The models were estimated separately for the Caribbean population (pooled and by setting) and the U.S. population by race/ethnicity (Hispanic, Black, and White), followed by pooled models across all populations., Results: In the Caribbean population, the relative risk of dementia among low versus high educated adults was 1.45 for women (95% confidence interval [CI] 1.17, 1.74) and 1.92 (95% CI 1.35, 2.49) for men, smaller compared to those in the United States, especially among non-Hispanic Whites (women: 2.78, 95% CI 1.94, 3.61; men: 5.98, 95% CI 4.02, 7.95)., Discussion: The differential associations between education and dementia across the Caribbean and US settings may be explained by greater disparities in social conditions in the United States compared to the Caribbean, such as access to health care, healthy behaviors, and social stressors, which serve as potentially important mediators., Competing Interests: WD has provided consultation to Urban Institute, the Robert Wood Johnson Foundation, NIH, and Annual Review of Public Health. JL, IJG, AH, JW, IJV, DA, ML, and JLR have nothing to disclose., (© 2021 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.)

The SARS-CoV-2 global pandemic will disproportionately impact countries with weak economies and vulnerable populations including people with dementia. Latin American and Caribbean countries (LACs) are burdened with unstable economic development, fragile health systems, massive economic disparities, and a high prevalence of dementia. Here, we underscore the selective impact of SARS-CoV-2 on dementia among LACs, the specific strain on health systems devoted to dementia, and the subsequent effect of increasing inequalities among those with dementia in the region. Implementation of best practices for mitigation and containment faces particularly steep challenges in LACs. Based upon our consideration of these issues, we urgently call for a coordinated action plan, including the development of inexpensive mass testing and multilevel regional coordination for dementia care and related actions. Brain health diplomacy should lead to a shared and escalated response across the region, coordinating leadership, and triangulation between governments and international multilateral networks., Competing Interests: Agustin Ibanez is partially supported by grants from CONICET, FONCyT‐PICT 2017‐1818, FONCyT‐PICT 2017 1820, ANID/FONDAP/15150012, INECO Foundation, the Interamerican Development Bank (IDB), GBHI ALZ UK‐20‐639295, and the MULTI‐PARTNER CONSORTIUM TO EXPAND DEMENTIA RESEARCH IN LATIN AMERICA (ReDLat, supported by National Institutes of Health, National Institutes of Aging [R01 AG057234], Alzheimer's Association [SG‐20‐725707], Tau Consortium, and Global Brain Health Institute). Fabricio Ferreira de Oliveira has contributed by way of a grant from FAPESP ‐ The State of São Paulo Research Foundation (grant #2015/10109‐5). Alzheimer's Society Canada and the Weston Brain Institute (to FGF), National Institute for Translational Neuroscience (INNT/Brazil) (to FGF), the Brazilian funding agencies Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) (to FGF). Elisa De Paula França Resende received funding from the Alzheimer's Association. Alzheimer's Association Research Grant 2018‐AARG‐591107 and REDI170583 (CDA). María Isabel Behrens is supported by grants from FONDECYT (Fondo de Desarrollo Científico y Tecnológico) Grant 1190958, FONDEF (Fondo de Fomento al Desarrollo Científico y Tecnológico Grant ID19I10302, and URedes URC‐036/17. Andrea Slachevsky is partially supported by grants from ANID/FONDAP/15150012, ANID / Fondecyt/ 1141279. Kenneth S. Kosik has support from the Alzheimer's Association and Tau Consortium. The contents of this publication are solely the responsibility of the authors and do not represent the official views of these Institutions. The other authors declare no conflicts of interest., (© 2020 The Authors. Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals, Inc. on behalf of Alzheimer's Association.)