An epidemiological study of dementia under the aegis of mental health program, Maharashtra, Pune chapter

Abstract

Background:There has been an exponential growth in the number of elderly population in India. This study aims to determine the prevalence of dementia in an urban center of Pune and to evaluate the corresponding socio-demographic correlates along with psychiatric morbidity in the study sample.Materials and Methods:The study population in Pune and Kirkee cantonments was selected based on 2001 census data. The number of people over 65 years numbered 6721 and 2145 of them were randomly selected for a door-to-door survey. They were initially administered household questionnaire and then subjected to a screening tool. Each participant underwent a brief mental state examination and data was collected on the basis of a structured proforma. Patients underwent a detailed cognitive profile using subtests from CSI-D (community screening instrument – dementia), which included a Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) word list, word fluency and delayed recall. Information pertaining to socio-demographic factors in participants and caregivers, caregiver-burden and behavioral and psychological symptoms in participants too were collected from the questionnaire. Radio imaging investigation was also carried out to quantify the deficit. Statistical Package for the Social Sciences (SPSS) software was used to compute the results.Results:Findings revealed that prevalence of dementia in the sample population of elderly aged above 65 years was 4.1%. Socio-demographic factors which conferred a statistically higher risk for dementia were identified to be older age, low socio-economic status, low level of education, presence of family history, whereas, marriage was found to be protective. Burden of care was associated with caring for elderly with dementia with increasing severity of dementia. Patients with dementia performed poorly on cognitive test battery. Social network had a protective effect in respect with severity of dementia. On magnetic resonance imaging (MRI) majority of cases of Alzheimer’s Dementia (AD) and Vascular Dementia (VaD) were noted to have both gray and white matter involvement.Conclusion:Poor awareness is a key public-health problem. Society plays an important role in the ageing process. The withdrawal of the elderly from the previous societal roles,reduction in all types of interactions i.e. shift of attention from outer world to the inner world, reduction in the power and prestige of the elderly enhance aging process. Aging in Indian culture though a disability is much stressful today in Indian culture as in others.

Knowledge and attitudes of undergraduate nursing students toward dementia: An Indian perspective

“…13 This instrument consists of 20 items with 7-point Likert scale that ranged from 'strongly disagree' to 'strongly agree' to reveal nursing students' attitudes toward dementia in two sub-domains namely "dementia knowledge' ( items 3,7,10,11,12,14,15,18,19,20) and "social comfort" (items 1,2,4,5,6,8,9,13,16,17) with good psychometric properties (Cronbach's alpha 0.83-0.85). Points ranging from 1 to 7 were given to each response such that the more positive the response, the higher the score.…”

Dementia among older patients attending National Institute of Mental Health (NIMH), Dhaka, Bangladesh

“…A community based survey in Pune, India yielded a prevalence rate 4.1%. 12 A study in a rural community in Kerala showed a prevalence of 33.9 per 1000 in people aged 60 years and above. 13 Compared to this study, a western study showed a higher prevalence rate (9.8%).…”

Influence of education on cognitive function in the elderly population of Pune city, Maharashtra, India

“…They showed a positive correlation between low levels of education with an increased incidence of dementia. 14 Data from the Assets and Health Dynamics of the Oldest Old (AHEAD) study in the U.S. showed a relationship between higher education and better maintenance of cognitive function and indicated that those with low levels of education were more likely to become cognitively impaired. 15 A recent study in New York found that lower educational level was associated with a higher risk of dementia.…”