Subtypes of Dementia: A Study from a Memory Clinic in India

Abstract

Background: The clinical syndrome of dementia consists of several subtypes that are distinct in their etiology, clinical profile, management, and outcome. Limited specialized services are available for dementia patients in India. We report the profile of dementia subtypes from a clinic-based dementia registry in India. Methods: Consecutive dementia patients were investigated with clinical evaluation, neuropsychological tests modified for local use, and brain imaging. Results: In 347 consecutive dementia patients, Alzheimer’s disease was the most common subtype of dementia (38.3%), followed by a high proportion of vascular dementia (25.4%). Frontotemporal dementia syndromes were not uncommon (18.7%). Dementia with Lewy bodies was encountered in 8.9% of the patients, and mixed dementia was found in 8.6%. The mean age of the group at presentation was 66.3 years, nearly a decade younger than in developed countries. The proportion of patients with early-onset dementia was high (49.9%). Conclusions: Our results demonstrate that the clinical profiles of dementia subtypes in a clinic population are influenced by the population’s demographic profile, cardiovascular risk factor burden, sociocultural attitudes about cognitive impairment, and possibly genetic factors.

Differences in Drug Therapy between Dementia Disorders in the Swedish Dementia Registry: A Nationwide Study of over 7,000 Patients

“…However, to our knowledge, there is no other database in the world with a higher number of patients with different diagnosed dementia disorders. The prevalence of DLB and FTD was in a similar range as reported in previous studies [3,32,33,34]. However, 10% of the dementia patients were diagnosed with unspecified dementia.…”

“…The diagnosis of unspecified dementia (International Classification of Diseases, ICD-10 code F03) is based on a cognitive disorder with dementia but with unknown aetiology, or that the investigations aimed to determine aetiology were not performed. There is limited research on comparisons between all different dementia disorders [5], maybe due to lack of sufficiently large databases.…”

Mild Cognitive Impairment: Clinical and Imaging Profile in a Memory Clinic Setting in India

“…One third had vascular aetiology, reflecting the high prevalence of cardiovascular disease in India [20 ]and consistent with studies that have demonstrated the association between vascular disease and cognitive impairment [40]. Vitamin B 12 deficiency was an important reversible cause of cognitive dysfunction, a reflection of the frequent occurrence of vitamin B 12 deficiency-related dementia in India [41].…”

“…Patient age, gender, educational status in years, occupational status as classified by the National Classification of Occupations - 2004 [23], history of stroke and the presence of vascular risk factors were recorded for all subjects according to a structured protocol [20]. All participants were evaluated using the Mini-Mental State Examination (MMSE) [24], Addenbrooke's Cognitive Examination-Revised (ACE-R), adapted and translated into Telugu and Hindi [20,25],and the Clinical Dementia Rating Scale (CDR) [26]. Depression and anxiety were scored using the Hospital Anxiety and Depression Scale (HADS) [27].…”

“…Furthermore, a study from Brazil reported an incidence of 13.2 per 1,000 persons per year for MCI [19]. Reasons for the smaller number of clinic-based studies include a low awareness about cognitive disorders and few specialised centres available for their diagnosis and management [14,17,20]. …”