A preliminary survey of dementia amongst geriatric patients admitted to a single medical unit at the Teaching Hospital Jaffna (THJ), Sri Lanka using a locally validated scale - the concise cognitive assessment scale (CONCOG)

Abstract

Testing cognition is the background to dementia assessment. Most available assessment batteries are not developed or validated in developing countries. The Concise Cognitive test (CONCOG) validated in an elderly urban Sri Lankan population tested orientation to time, naming, registering 4 words, copying, verbal fluency and recall of the 4 words using native vernacular, creating a culturally acceptable and contextualized assessment tool. Patients above the age of 60 years admitted to the professorial medical unit of THJ were screened after excluding confounding factors (delirium, sepsis, chronic illness, degenerative neurological diseases) which would have affected the test results. Patients who consented voluntarily were screened using the CONCOG test. A convenient sampling method was used. The severity was decided based on the score (20 - 23 mild dementia, 13 – 19 moderate dementia and 12 or less severe dementia) Of 1001 patients screened (mean age 73.29±5.8 years; 522 or 52.1% males; 479 or 47.9% females) 675 (67.43%) had cognitive impairment. Of those with cognitive impairment mean age was 75.41±5.69, 329(48.7%) males and 346(51.3%) females. 293/675(43.41%) had mild dementia (mean age 71.8±3.66; 47.1% males). 325/675 (48.15%) had moderate dementia (mean age 77.46±4.93; 49.5% males). 57/675 (8.44%) had severe dementia (mean age 82.3±6.23; 52.6% males). Of the 1001 screened only 326(32.57%) had no evidence of dementia. In Conclusion 91.7% of subjects with cognitive impairment had mild and moderate dementia which responds to cognitive rehabilitation and medication. Early detection should be encouraged. A larger population based screening should be carried out to conform the above findings.