BACKGROUND
Brazil enacted Law 14,878/2024 — a landmark National
Dementia Policy mandating:
• Universal early diagnosis & care access
• Mandatory professional training in dementia signs
• Formal caregiver support & psychosocial programs
• Unified Health System integration of dementia services
Yet legal mandates clash with a reality of systemic
collapse: fewer than 0.2% of estimated cases reach
clinical records — the "Invisibility Gap."
METHODS
• Nationwide geospatial & workforce analysis
• IBGE Census 2022 · DATASUS/SIH 2023 · CFM/CNES 2024
• ELSI-Brasil/Lancet 2023 × MS Relatório Nacional 2024
• "Invisibility Gap" = estimated prevalence vs. recorded
interactions
• Specialist density mapped across all 26 states + 5 macroregions
• Economic impact analysis: diagnostic delay cost framework
CONCLUSION
Law 14,878/2024 cannot be operationalized through analog
infrastructure alone.
A scalable AI-driven triage framework is the primary
architecture to bridge the Invisibility Gap — transforming
paper rights into real-world clinical access for 1.76M
Brazilians.
A replicable blueprint for high-demand, low-resource setÝngs
globally — where neuroengineering must democratize access
where workforce cannot.

RESULTS
LO1 Analyzing Barriers to Early Diagnosis in Low-Resource Public Health Systems
1.76M
Estimated dementia
cases in Brazil
2,053
Annual SUS (Unified Health
System) hospitalizations (2023)
>99.8%
Patients never
reach a specialist
<0.2%
Appearing in
clinical records
SUS Annual
Records
Estimated
Cases
0 200000 400000 600000 800000 1000000 1200000 1400000 1600000 1800000 2000000
2,053
1,760,000
The Invisibility Gap: Estimated vs. Recorded (Brazil) Workforce Collapse
3,167 Geriatricians in Brazil
1 : 10,104 elderly ratio
6,776 Neurologists in Brazil
1 : 4,722 elderly ratio
 CFM 2024: At current training rates, closing Brazil's geriatrician gap would
require 165+ years — rendering the Law obsolete upon enactment.
LO2 Evaluating AI Algorithms for Cognitive Triage Automation & Screening Accuracy
01
Primary Care Screening
Digital cognitive battery
administered via tablet or mobile
at UBS primary health posts —
accessible regardless of specialist
availability.
02
AI Triage Engine
ML model analyzes cognitive
patterns, flags high-risk individuals
for specialist referral, reducing
unnecessary specialist load by
~70%.
03
Specialist Optimization
Only AI-flagged patients reach
neurologist or geriatrician—
effective physician-to-patient ratio
brought within WHO standards —
multiplier effect.
LO3 Demonstrating How Neuroengineering Democratizes Neurological Access in Developing Economies
Austria (best)
UK
USA
WHO Ref.
Brazil
0 5 10 15 20 25
22
9
4
3
1
Geriatricians per 100k Elderly — Global Comparison
Region Specialists Access Status Kairos Role
Southeast
(SP/RJ/MG/ES)
55.4% Moderate
(3–6mo wait)
High-Volume
Triage
South (RS/SC/PR) 16.7% Limited Access Flow Optimization
Northeast (9 states) 14.5% Severe Shortage Primary Solution
Center-West
(DF/GO/MT/MS)
7.5% Capital
Dependence
Telemedicine
Assisted
North (AM/PA/AC...) 5.9% Medical Desert Urgent
Humanitarian
BARRIERS TO IMPLEMENTATION
Structural
• No national diagnostic registry or triage protocol
• 55.4% of all specialists concentrated in the Southeast
• 165+ years to close the geriatrician gap via training
alone
• Clinical
•
• Poor dementia literacy among primary care teams
• Late-stage diagnosis culture — no triage pathway
• Social
•
• Absent caregiver support infrastructure in SUS
• Digital exclusion in elderly and rural populations
• Family impoverishment (100% out-of-pocket costs)
ECONOMIC IMPACT
High-Income Countries
Main cost: long-term care & biotech therapies
Challenge: over-utilization of expensive imaging
Brazil (Current)
Main cost: emergency hospitalizations + drug litigation
Patient navigates 5+ specialists before diagnosis
R$10,000+ monoclonal therapies prescribed at latestage
— therapeutic window already closed. High cost,
zero clinical return.
KEY REFERENCES
• IBGE Censo 2022 · DATASUS/SIH 2023
• CFM/Câmara 2024 — Geriatrician density data
• MS/Unifesp Relatório Nacional Demência 2024
• ELSI-Brasil, Lancet Regional Health (2023)
• Law 14,878/2024 — Brazil National Dementia Policy
• WHO Global Action Plan on Dementia 2017–2025
• Jaeger et al., Dement Neuropsychol 2021
• Owen (AAIC 2025) · Cornacchia (WCS 2025) · Ismail
(AAIC 2025)
Where neuroscience leaves the laboratory to change the journey of care.