ABSTRACT Background: Traffic accidents (TA) are a global problem with mortality of 1.25 million each year. The objective of this study was to compare adjusted mortality rates (AMR) by AT of Colombia, with Spain and the United States (US). The selection is justified because Colombia is a country with less development in road safety, Spain a nation that has adhered to European guidelines and US for having little adherence to international guidelines. Methods: A descriptive cross-sectional study was carried out for five-year periods, by calculating the AMRs by the direct method of standardization according to sex and age groups, as well as the adjustment of the motorization index. The mean values, the 95% confidence interval for each country and the relative change between the periods studied were calculated. Results: The AMR of periods P1 and P2 in all countries decreased significantly (p <0.005). In periods P2 and P3 also decreased significantly in Spain, by 52.0% (p = 0.010), and in the US, by 23.6% p = 0.001), while in Colombia the difference of 4.0% it was not significant (p = 0.724). Spain stood out for the reduction in mortality (P1-P3), by 69.0%. Conclusions: Colombia presented a less favorable evolution of mortality due to AT than Spain and the US. Men aged 15 to 44, motorcyclists and cyclists were the most committed. The TAs are a public health problem that Colombia has raised and must adapt to its reality those successful measures in other countries.

RESUMEN Fundamentos: Los accidentes de tráfico (AT) son un problema mundial con mortalidad de 1,25 millones cada año. El objetivo de este estudio fue comparar tasas ajustadas de mortalidad (TAM) por AT de Colombia, con España y Estados Unidos (EEUU). La selección se justifica por ser Colombia un país con menor desarrollo en seguridad vial, España una nación que se ha adherido a directrices Europeas y EEUU por tener poca adherencia a directrices internacionales. Métodos: Se realizó un estudio descriptivo de corte transversal por quinquenios, mediante el cálculo de las TAM por el método directo de estandarización según sexo y grupos de edad, así como el ajuste del índice de motorización. Se calcularon los valores medios, el intervalo de confianza al 95% por cada país y el cambio relativo entre los períodos estudiados. Resultados: Las TAM de los períodos P1 y P2 en todos los países disminuyeron significativamente (p<0.005). En los períodos P2 y P3 también disminuyeron significativamente en España, en un 52,0% (p=0,010), y en EU, en un 23,6% p=0,001), mientras que en Colombia la diferencia de 4,0% no fue significativa (p=0,724). Destacó España por la reducción de su mortalidad (P1-P3), en un 69.0%. Conclusiones: Colombia presentó una evolución menos favorable de mortalidad por AT que España y EEUU. Los hombres de 15 a 44 años, motociclistas y ciclistas fueron los más comprometidos. Los AT son un problema de salud pública que tiene planteado Colombia y debe adaptar a su realidad aquellas medidas exitosas en otros países.

ABSTRACT Background: Traffic accidents (TA) are a global problem with mortality of 1.25 million each year. The objective of this study was to compare adjusted mortality rates (AMR) by AT of Colombia, with Spain and the United States (US). The selection is justified because Colombia is a country with less development in road safety, Spain a nation that has adhered to European guidelines and US for having little adherence to international guidelines. Methods: A descriptive cross-sectional study was carried out for five-year periods, by calculating the AMRs by the direct method of standardization according to sex and age groups, as well as the adjustment of the motorization index. The mean values, the 95% confidence interval for each country and the relative change between the periods studied were calculated. Results: The AMR of periods P1 and P2 in all countries decreased significantly (p <0.005). In periods P2 and P3 also decreased significantly in Spain, by 52.0% (p = 0.010), and in the US, by 23.6% p = 0.001), while in Colombia the difference of 4.0% it was not significant (p = 0.724). Spain stood out for the reduction in mortality (P1-P3), by 69.0%. Conclusions: Colombia presented a less favorable evolution of mortality due to AT than Spain and the US. Men aged 15 to 44, motorcyclists and cyclists were the most committed. The TAs are a public health problem that Colombia has raised and must adapt to its reality those successful measures in other countries.

RESUMEN Fundamentos: Los accidentes de tráfico (AT) son un problema mundial con mortalidad de 1,25 millones cada año. El objetivo de este estudio fue comparar tasas ajustadas de mortalidad (TAM) por AT de Colombia, con España y Estados Unidos (EEUU). La selección se justifica por ser Colombia un país con menor desarrollo en seguridad vial, España una nación que se ha adherido a directrices Europeas y EEUU por tener poca adherencia a directrices internacionales. Métodos: Se realizó un estudio descriptivo de corte transversal por quinquenios, mediante el cálculo de las TAM por el método directo de estandarización según sexo y grupos de edad, así como el ajuste del índice de motorización. Se calcularon los valores medios, el intervalo de confianza al 95% por cada país y el cambio relativo entre los períodos estudiados. Resultados: Las TAM de los períodos P1 y P2 en todos los países disminuyeron significativamente (p<0.005). En los períodos P2 y P3 también disminuyeron significativamente en España, en un 52,0% (p=0,010), y en EU, en un 23,6% p=0,001), mientras que en Colombia la diferencia de 4,0% no fue significativa (p=0,724). Destacó España por la reducción de su mortalidad (P1-P3), en un 69.0%. Conclusiones: Colombia presentó una evolución menos favorable de mortalidad por AT que España y EEUU. Los hombres de 15 a 44 años, motociclistas y ciclistas fueron los más comprometidos. Los AT son un problema de salud pública que tiene planteado Colombia y debe adaptar a su realidad aquellas medidas exitosas en otros países.

Com o aumento gradual da expectativa de vida das pessoas, devido aos progressos científico e de saúde pública a serviço da sociedade, a prevalência de demência tem aumentado a taxas bastante divergentes em todo o mundo. Atualmente, as taxas de prevalência variam entre 5% e 7% (6,4% em os EUA até 8,5% na América Latina) em indivíduos com idade superior a 60 anos. Prevalência mais baixa (2,1%) foi relatada na África sub-saariana, provavelmente devido a mortalidade seletiva abaixo dos 60 anos de idade. Ao contrário, uma alta prevalência de demência (23,6% de demência em pessoas ≥60 anos) foi observada na cidade de Neiva, no sul da Colômbia. Acreditamos que essa taxa alta pode ser explicada pela presença de vários fatores de risco, como: baixa escolaridade, níveis socio-económicos mais baixos, doenças crônicas, inclusão de instituições geriátricas, entre outros, e outros possíveis fatores desconhecidos.

With the gradual increase in the life expectancy of the population due to scientific progress and public health at the service of society, the prevalence of dementia has been increasing at different rates worldwide. Currently, the prevalence rates range between 5% and 7% (6.4% in the U.S. and up to 8.5 % in Latin America) in subjects older than 60 years. The lowest prevalence rate (2.1%) has been reported from sub-Saharan Africa, probably due to selective mortality under 60 years of age. By contrast, a very high prevalence of dementia (23.6% dementia in individuals ≥60 years) was observed in the city of Neiva, Southern Colombia. We believe that this high rate could be explained by the presence of several risk factors such as very low schooling, low socio-economic strata, chronic diseases, the inclusion of geriatric homes among others, and additional unknown factors.