Public Health

The much-needed studies on local epidemiological and psychosocial burden of dementia and disability among elderly is lacking in Nepal which are needed for planning and policy making. Thus, this community-based study was conducted to screen Dementia, Functional impairment and Disability among community residing elderly people.

This was a one-stage house to house cross-sectional epidemiological survey of all individuals aged ≥60 years in two wards of Dharan Sub Metropolitan City, Nepal. Measures used were Informant Questionnaire on Cognitive Decline (IQCODE) and Brief Community Screening Instrument for dementia (CSI-D), Everyday Ability Scale (EASI) and Barthel Index. Data were collected by trained nurses from December 2021 to March 2022 using Kobo toolbox software and analyzed using SPSS-16. Ethical clearance was obtained from the Nepal Health Research Council.

A total of 1009 (588 females) were enrolled in the study. Dementia was prevalent in 8.8% and 10.7% by Brief-CSID and IQ-CODE respectively. The bivariate analysis showed dementia was more frequent in ≥75 age group (OR 2.8[95% CI 1.9- 4.5]; p <0.001), having physical illness (OR 2.3[95%CI 1.3-3.9]; p = 0.003), having hearing impairment (OR 1.9[95%CI 1.2-3.0]; p = 0.004), and visual impairment (OR 1.9[95%CI 1.0-3.2]; p = 0.023). Multivariate logistic regression analysis revealed dementia by Brief CSID was associated with ≥75 age group (AOR 2.296[1.418-3.719], p = 0.001) and people using some form of mobility aids (AOR=2.022[1.19-3.435], p = 0.009). Similarly, dementia by IQCODE was associated with illiterate groups (p = 0.02) and homemaker by occupation (p = 0.02). Functional impairment (EASI score ≥5) was present in 4.9%, and 19.5% had moderate disability by Barthel index.

The study showed the prevalence of dementia among people aged ≥60 years old is high and associated with the number of risk factors. Physical illness and sensory impairments may be a modifiable risk factor in this population.