Browsing by Author "Mathew, Robert"

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    Dementia in Kerala, South India: prevalence and influence of age, education and gender
    (INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, 2010)
    Background: Data on the prevalence of dementia in India with a large and aging population is scant. We studied prevalence of AD and dementia in Kerala, South India, and effects of age, education and gender on it.Methods: 2-phase survey on 2466 individuals aged > 55 years living in community. Men constituted 41%, <75 years age in 76.9% and education > 4 years in 69.6%. Screening (Phase I) using the instrumental activity of daily living scale for the elderly (IADL-E) and the Addenbrooke's cognition examination (ACE). Diagnostic-assessment (Phase II) was in 532 screen-positives and 247 (10%) screen-negatives.Results: 93 (3.77%) > 55 years and 81(4.86%) > 65 years of age had dementia. Age adjusted (against US-population in 2000) dementia (and AD) rates were 4.86% (1.91%) in age > 55 years and 6.44% (3.56%) in > 65 years. Odds for dementia (and AD) were high with increasing-age 5.89 (15.33) in 75-84, 13.23 (25.92) > 85 years, and in women 1.62 (2.95); and low 0.27 (0.16) if education was > 9 years. Age and low education increased dementia. Age and female gender increased AD.Conclusion: Prevalence of dementia and AD is higher than any reported from the subcontinent suggesting that dementia in Kerala in South India is not uncommon. Increasing age increased dementia and AD. Low-education is associated with dementia and female-gender with AD. Copyright (C) 2009 John Wiley & Sons, Ltd.
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    Mini mental state examination and the Addenbrooke's cognitive examination: Effect of education and norms for a multicultural population
    (NEUROLOGY INDIA, 2007)
    Objective: To derive population norms on the Malayalam adaptation of Addenbrooke's Cognitive Examination (M ACE) and the inclusive Malayalam mini mental state examination (M-MMSE).Materials and Methods: Education-stratified norms were obtained on randomly selected cognitively unimpaired community elders (n = 519).Results: Valid data on norms was available on 4813 subjects (age 68.5 +/- 7.1 and education 7.9 +/- 5.4). Education and age, but not gender had a significant effect on both MACE and M-MMSE. When compared to the effect of age, the effect of education was sevenfold more on the M-ACE and ninefold more on the M-MMSE. The mean composite score on the M-ACE (and the M-MMSE) was 42.8 +/- 9.8 (14.9 +/- 3.1) for those with 0 (n = 72), 55.9 +/- 12.5 (19.7 +/- 4.1) with 1- 4 (n = 96), 62.6 +/- 11.4 (21.9 +/- 3.7) with 5-8 (n = 81), 77 +/- 10.2 (25.7 +/- 2.4) with 9-12 (n = 136) and 83.4 +/- 7.2 (26.7 +/- 1.6) with > 12 (n = 103) years of formal education.Conclusions: Education has the most potent effect on performance on both M-ACE and M-MMSE in the Indian cohort. Education-stratified scores on the M-ACE and the M-MMSE, will provide a more appropriate means of establishing the cognitive status of patients. It is also our feeling that these cut-off scores will be useful across India.