The association between common physical impairments and dementia in low and middle income countries, and, among people with dementia, their association with cognitive function and disability. A 10/66 Dementia Research Group population-based study

• Published in: International journal of geriatric psychiatry Vol. 26; no. 5; pp. 511 - 519
• Main Authors: Prince, Martin, Acosta, Daisy, Ferri, Cleusa P, Guerra, Mariella, Huang, Yueqin, Jacob, KS, Jotheeswaran, AT, Liu, Zhaorui, Rodriguez, Juan J. Llibre, Salas, Aquiles, Sosa, Ana Luisa, Williams, Joseph D.
• Format: Journal Article
• Language: English
• Published: Hove Blackwell Publishing Ltd 01.05.2011; Psychology Press; Wiley Subscription Services, Inc
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Cognition - physiology; Cognitive ability; Comorbidity; Cross-Sectional Studies; Dementia; Dementia - epidemiology; Dementia - physiopathology; Developing Countries - statistics & numerical data; Disabled Persons - statistics & numerical data; Female; Fundamental and applied biological sciences. Psychology; General aspects; Geriatric psychiatry; Geriatric psychology; Geriatrics; hearing disorders; Hearing loss; Humans; Low income groups; Male; Medical sciences; nutrition disorders; Older people; Psychoanalysis; Psychology. Psychoanalysis. Psychiatry; Psychopathology; Psychopathology. Psychiatry; Regression Analysis; Socioeconomic Factors; Studies; Urinary incontinence; vision disorders; Dominican Republic; Cuba; Venezuela; China; India; Vision disorder; Developing countries; Auditory disorder; Developmental disorder; Cognition; nutrition disorders; Mental retardation; vision disorders; Voiding dysfunction; Scientific research; Population-based survey; ENT disease; Degenerative disease; hearing disorders; Public health; Human; Urinary system disease; Nutrition disorder; Urinary tract disease; Statistical study; Urinary incontinence; Eye disease; Concomitant disease; Gerontology; comorbidity; Polypathology; Intellectual deficiency; Bladder disease; Economic aspect; Elderly; Psychiatry; Dementia; Geriatrics
• ISSN: 0885-6230; 1099-1166; 1099-1166
• DOI: 10.1002/gps.2558

ObjectiveChronic physical comorbidity is common in dementia. However, there is an absence of evidence to support good practice guidelines for attention to these problems. We aimed to study the extent of this comorbidity and its impact on cognitive function and disability in population‐based studies in low and middle income countries, where chronic diseases and impairments are likely to be both common and undertreated. MethodsA multicentre cross‐sectional survey of all over 65 year old residents (n = 15 022) in 11 catchment areas in China, India, Cuba, Dominican Republic, Venezuela, Mexico and Peru. We estimated the prevalence of pain, incontinence, hearing and visual impairments, mobility impairment and undernutrition according to the presence of dementia and its severity, and, among those with dementia, the independent contribution of these impairments to cognitive function and disability, adjusting for age, gender, education and dementia severity. ResultsIncontinence, hearing impairment, mobility impairment and undernutrition were consistently linearly associated with the presence of dementia and its severity across regions. Among people with dementia, incontinence, hearing impairment and mobility impairment were independently associated with disability in all regions while the contributions of pain, visual impairment and undernutrition were inconsistent. Only hearing impairment made a notable independent contribution to cognitive impairment. ConclusionsThere is an urgent need for clinical trials of the feasibility, efficacy and cost‐effectiveness of regular physical health checks and remediation of identified pathologies, given the considerable comorbidity identified in our population based studies, and the strong evidence for independent impact upon functioning. Copyright © 2010 John Wiley & Sons, Ltd.