AN EPIDEMIOLOGIC-STUDY OF DEMENTIA IN A RURAL-COMMUNITY IN KERALA, INDIA

Background. This community-based epidemiologic study of dementia in a rural population in India investigated the prevalence of various demen ting disorders in the community, psychosocial correlates of the morbid ity, and assessment of the risk factors associated with dementia. Meth od. A door to door survey was conducted to identify elderly people age d 60 and above. A total of 2067 elderly persons were then screened wit h a vernacular adaptation of the MMSE. All those who scored 23 and bel ow had a detailed neuropsychological evaluation by CAMDEX-Section B, a nd the care-givers of the people with confirmed cognitive impairment w ere interviewed using CAMDEX-Section H to confirm the history of deter ioration or impairment in social or personal functioning. In the third phase the subjects with confirmed cognitive impairment were evaluated at home as to whether they satisfied the DSM-III-R criteria for demen tia. Subcategorisation of dementia was done based on ICD-10 diagnostic criteria. Five per cent of those whose screening was negative were ra ndomly selected and evaluated during each stage. Results. Sixty-six ca ses of dementia were identified from 2067 persons aged 60 and above, a prevalence rate of 31.9 per thousand. After correction this rate was 33.9 per thousand. Fifty-eight per cent of the dementia cases were dia gnosed as vascular dementia and 41% satisfied the criteria for ICD-10 dementia in Alzheimer's disease. There were more women in the Alzheime r's disease group; smoking and hypertension were associated with vascu lar dementia while a family history of dementia was more likely in the Alzheimer's group. Conclusion. Dementia is an important cause of morb idity in the geriatric population in this community, where families ta ke responsibility for the care of relatives with dementia.