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Low prevalence of dementia in South India

This study seeks to better understand why previous research carried out by the 10/66 Dementia Research Group by Professor Martin Prince showed a significantly lower prevalence of dementia in south India than in developed countries. It will investigate whether cultural attitudes towards roles of older people and extensive family support account for the low level of prevalence seen in the previous research.

The extended family structure where younger people honour and respect older people means the effects of cognitive decline may not always be apparent. Any changes may be considered normal for age and not relevant or worthy of report. In south India, younger family members routinely undertake shopping, cooking, cleaning and managing finances for older relatives and may find it difficult to acknowledge signs of decline.

If cultural factors impact on the reporting of dementia, the true prevalence in south India may be closer to that of developed countries. This would have important implications for planning culturally appropriate health and social care for older people. and for future allocation of resources.

Approximately 120 people who participated in the previous study of dementia carried out by the 10/66 Group will be followed up two or three years after the initial contact. The original survey was carried out in collaboration with the Voluntary Health Services in the town of Chennai. The Chennai survey involved 1,000 people aged over 65 year who were interviewed between 2004 and 2006. The assessments used for dementia diagnosis have been developed and validated by the 10/66 Group to enable valid comparisons of the prevalence and impact of dementia to be made across different regions and cultures.

In this study, researchers will re-contact all those who were diagnosed with dementia and all those who had cognitive impairment with no evidence of dementia. Interviews will take place in participants’ homes and a close relative will also be asked for information. These follow-ups will include cognitive tests and neurological examination as well as interviews and group discussions with family members to measure the economic and practical impact of caring and to find out about their attitudes towards older people.

The research is being carried out by A.T Jotheeswaran under the supervision of Professor Martin Prince and Dr E.S Krishnamoorthy at the VHS Medical Centre in Taramani, Chennai.

The research is funded by the Wellcome Trust.

Voluntary Health Services, Chennai

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