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The association between common physical impairments and dementia in low and middle income countries, and, among people with dementia, their association with cognitive function and disability. A 10/66 Dementia Research Group population‐based study
Author(s) -
Prince Martin,
Acosta Daisy,
Ferri Cleusa P,
Guerra Mariella,
Huang Yueqin,
Jacob KS,
Jotheeswaran AT,
Liu Zhaorui,
Rodriguez Juan J. Llibre,
Salas Aquiles,
Sosa Ana Luisa,
Williams Joseph D.
Publication year - 2011
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2558
Subject(s) - dementia , comorbidity , population , medicine , malnutrition , visual impairment , gerontology , cognition , psychiatry , psychology , disease , environmental health , pathology
Objective Chronic physical comorbidity is common in dementia. However, there is an absence of evidence to support good practice guidelines for attention to these problems. We aimed to study the extent of this comorbidity and its impact on cognitive function and disability in population‐based studies in low and middle income countries, where chronic diseases and impairments are likely to be both common and undertreated. Methods A multicentre cross‐sectional survey of all over 65 year old residents ( n = 15 022) in 11 catchment areas in China, India, Cuba, Dominican Republic, Venezuela, Mexico and Peru. We estimated the prevalence of pain, incontinence, hearing and visual impairments, mobility impairment and undernutrition according to the presence of dementia and its severity, and, among those with dementia, the independent contribution of these impairments to cognitive function and disability, adjusting for age, gender, education and dementia severity. Results Incontinence, hearing impairment, mobility impairment and undernutrition were consistently linearly associated with the presence of dementia and its severity across regions. Among people with dementia, incontinence, hearing impairment and mobility impairment were independently associated with disability in all regions while the contributions of pain, visual impairment and undernutrition were inconsistent. Only hearing impairment made a notable independent contribution to cognitive impairment. Conclusions There is an urgent need for clinical trials of the feasibility, efficacy and cost‐effectiveness of regular physical health checks and remediation of identified pathologies, given the considerable comorbidity identified in our population based studies, and the strong evidence for independent impact upon functioning. Copyright © 2010 John Wiley & Sons, Ltd.