One Minute Early Dementia Screening Test for Indigent Countryside Indian Population: A Community Based Study

Abstract

AbstractBackgroundWith the ageing of our populations there are increasing numbers of older adults with memory complaints and possible dementia. A new case of dementia in some form is diagnosed every 70 seconds according to the 2010 Alzheimer’s Disease Facts and Figures; moreover countryside population especially indigent population mostly remain undiagnosed. Hence to develop an easy to use dementia detection system has become an international priority for improving care of patients with prevalent neuropsychiatric disorders of later life.Method242 patients were enrolled justifying predesigned inclusion and exclusion criteria after approval from Institutional Ethics Committee. One minute dementia test was administered to them. The 1 minute dementia test is screening tool that had 4 components, testing immediate & delayed recall, orientation, and visuo‐spatial cognition. The Clock Drawing Test (CDT) component of this tool allows clinicians to administer this test among illiterate population and quickly assess numerous cognitive domains. A cutoff score of < 12 was considered abnormal. Receiver operating characteristic, partial correlation and logistic regression analyses were employed for evaluation.ResultIn this study, majority of subjects were greater than 65 years of age. Males accounted for 68% (n = 164) and females for 34% (n = 78). Mean age of the study population was 59.7 ± 13.46 years. A statistically significant decline in cognitive domain were noted in relation to patient education (p<0.001), locality predominantly rural based uneducated population (p<0.001) as well as increasing age (p<0.01) however, no statistically significant correlation (p>0.05) was observed in relation to patient’s sex. Delayed word recall was the most frequently impaired parameter (92.5%; n = 224) followed by visuo‐spatial cognition (82%; n = 198).Immediate recall (4.9%; n = 12) was minimally effected. CDT was abnormal among 69% (n = 168) patientsConclusionIn the present study 87% (n = 210) of the patients had abnormal test. Delayed word recall was the earliest domain to get impaired followed by visuo‐spatial cognition. A cutoff score of < 12 best correlated with risk of detecting dementia. Thus, 1 minute dementia test can be a useful screening tool for detecting dementia in outdoor basis patients though larger studies are required to validate its clinical implications.