Determinants of early diagnosis of cognitive impairment in older Indian adults

Abstract

AbstractBackgroundDiagnosis of cognitive impairment at an early stage is vital to the management of dementia like Alzheimer’s disease. Recent studies have proved that multi‐modal non‐pharmacological therapy does decrease the progression of cognitive decline in patients with subjective cognitive decline (SCD) and mild cognitive impairment (MCI). In this study, we evaluated the determinants of presentation at an early stage of cognitive impairment, to our memory clinic.MethodPatients presenting with cognitive impairment were evaluated in our memory clinic. After reversible causes and depression were ruled out, patients were classified as those with early disease (SCD and MCI) or major neurocognitive decline (MNCD). A retrospective analysis of the data was done to evaluate the association of baseline characteristics (age, sex, education, region, occupation and cardiovascular diseases) with the stage of presentation of cognitive decline.ResultData of 415 patients, evaluated from 2017 to 2019, was analyzed. Reversible causes were identified in 29.2 % of the patients, including 24.1% with depression. SCD, MCI and MNCD were identified in 29.6%, 16.4%, and 24.8%, respectively. Demographic factors like male sex (p value < 0.001), higher education (p value < 0.001) and occupational skill (p value = 0.006), were significantly associated with early presentation to the memory clinic.ConclusionIn this study, we observed 65% of the patient presented at an early stage of cognitive decline (SCD and MCI). With development of possible disease modifying agents in near future, this can be an important stage of intervention. Female patients with lower educational and occupational status, associated with late presentation, can be an important target for screening.