Health status and risk factors for dementia in the middle old in Trinidad: Findings from a nationally representative survey

ABSTRACT

Objective: To investigate self-reported health status and risk factors for dementia in middle old (75-84 years) individuals. Design and Methodology: This study used the validated 10/66 door- to-door interview protocols. All individuals (836 persons) 75-84 years old were approached. The modified 10/66 dementia algorithm produced output in 811 (97%). Dementia diagnosis was made according to 10/66 criteria from (1) cognitive tests, the Community Screening Instrument for Dementia (CSI'D), (2) EURO-D depression scale (3) informant interview. Demographic data included information on accommodation, social network, level of impairment and instrumental activities of daily living. Data were analyzed using multilevel logistic regression models. Results: Of the 811 participants, 55% were females. The mean age was 78.9±6.3 years and dementia was present in 198 (24.4%). High level of education, professional employment and having no comorbidities were significant protective factors. In multivariate analyses those with stroke were nearly 5 times more likely (OR=4.81, 95% CI 2.72, 8.53) to have dementia, and those with diabetes were 2.5 times (OR=2.55; 95% CI 1.71-3.78) more likely to have dementia than those without these comorbities. Impairment in climbing stairs walking and sight was more common in the dementia group than the non-demented. Individuals with dementia were more likely to be unable to perform all seven instrumental activities of daily living (IADL) and were less active compared with their non-demented counterparts. Conclusion: In the middle old population in Trinidad having diabetes and stroke with varying levels of impairment as well as a sedentary lifestyle puts an individual at increased risk of dementia.