Characterizing Cognitive Deficits and Dementia in an Aging Urban Population in India

Abstract

Rapid rise in the population of older adults in India will lead to the need for increased health care services related to diagnosis, management, and long-term care for those with dementia and cognitive impairment. A direct approach for service provision through memory clinics can be an effective, successful, and sustaining means of delivering specialized health care services. We have established a memory clinic in Mumbai, India by employing the diverse clinical skills available in Indian academic institutions, diagnostic and research expertise of clinicians and psychologists, and the support of the U.S. National Institutes of Health. Our project involved recruitment of patients, clinical and neuropsychological assessment, and standardized diagnostic procedures, demonstrating the feasibility of using research methods to develop a memory clinic. In this paper, we describe the development of a community-based memory clinic in urban India, including linguistic and cultural factors and present detailed results, including diagnostic characterization, on 194 subjects with various stages of cognitive deficits. Our findings support the feasibility of developing a memory clinic in a public hospital and successful use of research diagnostic criteria to categorize cognitive deficits observed in this population, which may be used to inform the development of other such clinics.

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

“…The cognitive profile of our MCI cohort is consistent with previous studies [2,3,46,47,48]. A few individuals (13.7%) with memory complaints had only SMI, and nearly a quarter of subjects were detected to have non-amnestic MCI.…”

“…A few individuals (13.7%) with memory complaints had only SMI, and nearly a quarter of subjects were detected to have non-amnestic MCI. The majority of amnestic MCI subjects had impairment in more than one cognitive domain (70.0%), and pure amnestic MCI was not so common in concurrence with previous studies [2,3,46,47,48,49]. …”

Alzheimer's disease with cerebrovascular disease: current status in the Asia–Pacific region

“…The prevalence of dementia in India ranges from 2.4% to 4.9% and community‐ and clinic‐based studies have shown that AD is the most common type of dementia (38.3–48.7%) followed by VaD (22.0–25.4%); AD+CVD has been found in 8.6–15.0% of patients . In a regional survey in Sri Lanka, the prevalence of dementia was 3.98% (95% CI 2.6–5.7%) .…”

Dementia: Indian scenario

“…In the clinic-based study, out of 194 referral cases with cognitive dysfunction, 65.5% cases had dementia based on clinical, neuropsychological, and imaging evidences and about 22.14% cases had MCI. [18] Epidemiology Global picture The World Health Organization (WHO) predicts that by 2025, about 75% of the estimated 1.2 billion people aged 60 years and older will reside in developing countries. [3] It is estimated that the number of people living with dementia will almost double every 20 years to 42.3 million in 2020 and 81.1 million in 2040.…”