Is Dementia Differentially Distributed? A Study on the Prevalence of Dementia in Migrant, Urban, Rural, and Tribal Elderly Population of Himalayan Region in Northern India

Abstract

Background:Throughout the world, a large number of surveys have been carried out to find the prevalence of dementia with variable results.Aims:This study was to generate data on the prevalence of dementia and to generate a hypothesis on the differential distribution across populations.Materials and Methods:Four settings identified for the purpose of this study included a migrant, urban, rural, and tribal. The study was conducted in two phases: 1) A screening phase and 2) a clinical phase, on 2,000 individuals above 60 years of age. To complete the required sample of 2,000 elderly individuals, 500 individuals were approached from each site. Nobody refused to participate.Results:A total of 32/2,000 (1.6%) elderly individuals were classified as demented. No case of dementia was reported from tribal population. A look at sex differential reveals that majority (21/32; 66%) of individuals identified as demented were females. As age advanced scores on cognitive screen decreased with elders above 80 years of age showing lowest scores. Out of 32, 18 (56%) of patients classified as demented were more than 80 years of age.Conclusion:The findings of this study are in agreement with previous studies which point towards differential distribution of dementia across populations.

Screening for Dementia in Older Adults: Comparison of Mini-Mental State Examination, Mini-Cog, Clock Drawing Test and AD8

“…The prevalence of Zhejiang province in our study was 13%, higher than the national survey conducted among Chinese people aged 65 and older (5.14%) [2, 26]. In the investigation, we also found that few of the dementia patients were treated regularly with anti-dementia drugs, and none of them received cognitive rehabilitation therapies.…”

Place of Residence and Cognitive Function among the Adult Population in India

“…There are limited studies evaluating the influence of within-country migration (i.e., change of residential status). Only 2 studies based on small, regional samples compared the prevalence of cognitive impairment between rural residents, urban residents, and migrants [7, 8]. The results from these two studies were inconclusive – one study showed a higher prevalence of cognitive impairment in urban than in rural and migrant populations [8], while the other showed no statistically significant differences in the prevalence of cognitive impairment among the 3 groups [7].…”

“…However, the differences in cognition were not fully explained by sex and geographic location. Other factors, such as within-country migration, could impact later-life cognitive function [7-9]. …”

“…Only 2 studies based on small, regional samples compared the prevalence of cognitive impairment between rural residents, urban residents, and migrants [7, 8]. The results from these two studies were inconclusive – one study showed a higher prevalence of cognitive impairment in urban than in rural and migrant populations [8], while the other showed no statistically significant differences in the prevalence of cognitive impairment among the 3 groups [7]. Since migration happens in various patterns, it is essential to comprehensively examine migration patterns beyond more commonly examined rural-to-urban pattern on cognitive function using a more comprehensive examination of cognitive function, as well as using a large and nationally representative sample.…”

Use of international HIV dementia scale in assessment of neurocognition

“…A literature review on estimating the prevalence of dementia in different settings reveals that, the studies are generally conducted using a two phase strategy: (1) A screening phase and (2) a clinical phase. [3][4][5] The screening is generally conducted by using a screener like the MMSE or its modified versions and identifying suspects for clinical evaluation. The authors could have similarly identified suspects for clinical evaluation (for dementia), after administering the IHDS as a screening tool.…”