Risk of Dementia in Nepal: A Cross-Sectional Survey in Mountainous, Hilly, and Lowland Regions

Abstract

Introduction Globally dementia is a growing public health problem, with over 135,000 people in Nepal living with dementia. Nepal lacks national and community-based data on dementia prevalence. This study aims to determine the dementia risk in Nepal and assess the effects of age, sex, and geographical location on disease prevalence. It also intends to inform policy makers about the burden of dementia, prompting them to plan and prepare appropriate health and social care services for individuals affected by dementia. Methods A cross-sectional survey with total 1152 individuals (933 older people, aged 60 and over and 219 carers of 60 years and older people) was conducted to determine the prevalence of dementia risk in three geographical regions of Nepal. The Rowland Universal Dementia Assessment Scale (RUDAS) and Memory First Aid Informant Questionnaire adapted from Community Screening Interview for Dementia (CSI-D) for informant were used to measure cognitive impairment. The study evaluated the overall prevalence of cognitive impairment or risk of dementia and subgroups by region, age group, and sex. Chi-squared tests and multiple logistic regression analyses were conducted to assess the effects. Results For the RUDAS test, 53.7% (501) participants had cognitive impairment, with slightly higher rates in women (56.5%) than men (51.7%). For the Memory First Aid Informant Questionnaire/CSI-D for informant, 155 participants had cognitive impairment at a rate of 70.8%, with slightly higher rates in men. Cognitive impairment prevalence increases with age and region, with hilly and mountainous areas and low-lying regions having a greater geographic effect. Conclusions There is high risk of dementia in Nepal. The risk is influenced by age and geographical regions, necessitating early diagnosis and tailored interventions for older people and who are residing in higher altitude areas. National-level studies and exploration of factors affecting early dementia diagnosis are needed.