Abstract
BackgroundSoutheast Asia represents 10% of the global population, yet little is known about regional clinical characteristics of dementia and risk factors for dementia progression. This study aims to describe the clinico-demographic profiles of dementia in Southeast Asia and investigate the association of onset-type, education, and cerebrovascular disease (CVD) on dementia progression in a real-world clinic setting.MethodsIn this longitudinal study, participants were consecutive series of 1606 patients with dementia from 2010 to 2019 from a tertiary memory clinic from Singapore. The frequency of dementia subtypes stratified into young-onset (YOD; <65 years age-at-onset) and late-onset dementia (LOD; ≥65 years age-at-onset) was studied. Association of onset-type (YOD or LOD), years of lifespan education, and CVD on the trajectory of cognition was evaluated using linear mixed models. The time to significant cognitive decline was investigated using Kaplan-Meier analysis.ResultsDementia of the Alzheimer’s type (DAT) was the most common diagnosis (59.8%), followed by vascular dementia (14.9%) and frontotemporal dementia (11.1%). YOD patients accounted for 28.5% of all dementia patients. Patients with higher lifespan education had a steeper decline in global cognition (p<0.001), with this finding being more pronounced in YOD (p=0.0006). Older patients with a moderate-to-severe burden of CVD demonstrated a trend for a faster decline in global cognition compared to those with a mild burden.ConclusionsThere is a high frequency of YOD with DAT being most common in our Southeast Asian memory clinic cohort. YOD patients with higher lifespan education and LOD patients with moderate-to-severe CVD experience a steep decline in cognition.
Highlights
Southeast Asia represents 10% of the global population, yet little is known about regional clinical char‐ acteristics of dementia and risk factors for dementia progression
vascular dementia (VaD) was diagnosed based on the NINDS-AIREN criteria [24], frontotemporal dementia (FTD) was diagnosed based on the Raskovsky criteria [25], PDD was diagnosed based on the MDS task force criteria [26, 27], while dementia with Lewy body (DLB) was diagnosed based on the McKeith criteria [28, 29]
In a Southeast Asian memory clinic cohort with data spanning a decade, we found a trend towards increasing yearly incidence of both youngonset dementia (YOD) and late-onset dementia (LOD)
Summary
Southeast Asia represents 10% of the global population, yet little is known about regional clinical char‐ acteristics of dementia and risk factors for dementia progression. This study aims to describe the clinico-demographic profiles of dementia in Southeast Asia and investigate the association of onset-type, education, and cerebrovascular disease (CVD) on dementia progression in a real-world clinic setting. Longitudinal studies in Asia have largely focussed on older populations [10] and cognitive changes in non-dementia participants [11]. Cognitive trajectories in youngonset dementia (YOD) have not been compared with late-onset dementia (LOD) counterparts in Asia [12,13,14]. The prevalence of dementia sub-types remains to be elucidated in Southeast Asia
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