Prevalence of Dementia in an Urban Indian Population

Abstract

This article reports the findings of a 3-year epidemiological survey for dementia in an urban community-resident population in Mumbai (Bombay), India, wherein the prevalence of all types of dementia was determined. Method: The study was conducted in three stages. Stage 1: From a potential pool of 30,000 subjects aged 40 years or more, 24,488 (male = 11,875; female = 12,613) persons completed self-report or interviewer-rated protocols based on the Sandoz Clinical Assessment Geriatric Scale, but 5,512 (18.37%) persons refused to participate. Scores on the protocol had a possible range from 0 through 34. Stage 2: Persons with a score +2SD above the mean were selected in this stage where the persons were screened for cognitive functioning using a modified and translated version of the Mini-Mental State Examination. Individuals who scored below the 5th percentile were included in Stage 3 and underwent a detailed neurological, psychiatric, and neuropsychological evaluation as well as hematological, radiological, electrocardiographic, and electroencephalographic investigations. Diagnoses were made jointly by a neurologist, psychiatrist, and psychologist using the DSM-IV diagnostic criteria. Subjects were also rated on the Clinical Dementia Rating (CDR) scale and assessed for activities of daily living. Results: One hundred five subjects with dementia (CDR ≥ 0.5) were identified in this population of 24,488 persons. The prevalence rate for dementia in those aged 40 years and more was 0.43% and for persons aged 65 and above was 2.44%. Seventy-eight individuals had a CDR of ≥ 1 yielding an overall prevalence rate of 0.32%, and a prevalence rate of 1.81% for those aged 65 years and older. The overall prevalence rate for Alzheimer's disease (AD) in the population was 0.25%, and 1.5% for those aged 65 years and above. AD (n = 62;65%) was the most common cause of dementia followed by vascular dementia (n = 23;22%). There were more women (n = 38) than men (n = 24) in the AD group. Increasing age was associated with a higher prevalence of the dementia syndrome in general as well as AD specifically. Conclusion: In the population surveyed, the prevalence of AD and other dementias is less than that reported from developed countries but similar to results of other studies in India. Prevalence of the dementia syndrome increased with age and was not related to gender. AD was the most common dementia and the prevalence was higher in women than in men. Results are discussed with respect to shorter life expectancy, relocation of affected persons, and differences in the risk factors as compared to developed countries.

An exploratory study on the prevalence of early dementia among geriatric population in a rural area of district Jammu

“…9 Similarly studies conducted in semiurban population of Srilanka and Mumbai among geriatric population in semiurban areas also observed lower prevalence of 3.98% and 2.44% respectively which could be attributed to better health care delivery mechanisms and literacy rates. 10,11 In the current study prevalence of dementia was more among females which is in tune with the findings of Vas et al, Raina SK, Razdan S and de silva HA. 6,7,10,11 These findings were contradictory to the findings of Chandra V et al who did not report any association between gender and prevalence.…”

“…10,11 In the current study prevalence of dementia was more among females which is in tune with the findings of Vas et al, Raina SK, Razdan S and de silva HA. 6,7,10,11 These findings were contradictory to the findings of Chandra V et al who did not report any association between gender and prevalence. 5 Our findings could be due to the fact that women tend to live longer than men and there are more instances of social isolation among elderly women.…”

Nursing Students' Intentions to Work in Dementia Care: Influence of Age, Ageism, and Perceived Barriers

“…These differences are mainly accounted for by early life mortality and there is little evidence that YOD is more common in LMIC. Three prevalence studies from India included participants aged less than 65 years, and prevalences of YOD were as low as those seen in high-income population-based surveys: 328 / 100 000 (60-64 years) in Kerala (24), 249 / 100 000 in Ballabgarh (55-64 years) (18), and 63 / 100 000 (50-59 years) and 280 / 100 000 (60-64 years) in Mumbai (30). However, this statement must be qualified given the likely impact of the HIV epidemic which is concentrated among younger people in low-income countries, particularly in southern and eastern Africa.…”

Mini-Mental State Examination norms in a community-dwelling sample of elderly with low schooling in Brazil

“…This procedure reduces the number of false-negatives in samples with more schooling and the number of false-positives in the less educated, especially the illiterate 4,2,5 . Following the same procedure, several studies have attempted to present MMSE cutoffs adjusted to education in the Brazilian el- derly population 7,8 , as well as in other developing countries 4,5,9,10 .…”