Abstract

BackgroundTrinidad is an island that not only has a population at high vascular risk but also one that is in epidemiological transition with high dementia prevalence. The aim of the study was to investigate modifiable risk factors associated with dementia in middle-old (75–84 years) individuals.MethodsAs part of a large national community survey of dementia prevalence in Trinidad, 811 people aged 75–84 years were evaluated for dementia using the 10/66 short algorithm. Demographic data collected included information on age, gender, ethnicity, religion, education, occupation, living accommodation, smoking, alcohol consumption, self-reported medical conditions, impairments and ability to do instrumental activities of daily living (IADL). Data were analysed using multivariable logistic regression models.ResultsOf the 811 participants, nearly 55% were female. The mean age was 78.8 (SD = 2.8) years and dementia was present in 198 (24.4%). Having less than ten years of education, being an agricultural worker, skilled labourer or housewife and having more than four co-morbidities were significantly associated with dementia. The odds ratio for dementia for those having self-reported stroke was 4.93 (95% CI [2.64–9.23]) and for diabetes was 1.76 (95% CI [1.17–2.65]) adjusting for age, age2, gender, ethnicity, religion, education and occupation. Impairment in eyesight, hearing, climbing stairs, and walking were also more common in the group with dementia. Ability to perform IADLs was linked with dementia. Individuals with dementia were more likely to be unable to perform any of the eight IADLs. Those who did not exercise at all (OR 6.95, 95% CI [2.02–23.90]) and those who did low exercise (OR 1.83, 95% CI [1.07–3.13]) compared to those who did moderate to high exercise were also more likely to have dementia.ConclusionIn the middle-old population in Trinidad having diabetes and stroke, low IADL score, and no exercise were more common in people with dementia.

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