INTRODUCTION:

Dementia is a syndrome in which there is deterioration in cognitive function beyond what might be expected from the usual consequences of biological ageing¹. Although dementia mainly affects older people, it is not an inevitable consequence of ageing. Currently more than 55 million people live with dementia worldwide, and there are nearly 10 million new cases every year².

Dementia results from a variety of diseases and injuries that primarily or secondarily affect the brain. Alzheimer’s disease is the most common form of dementia and may contribute to 60-70% of cases³. Dementia is currently the seventh leading cause of death among all diseases and one of the major causes of disability and dependency among older people globally⁴. Dementia has physical, psychological, social and economic impacts, not only for people living with dementia, but also for their careers, families and society at large.

Dementia is currently the seventh leading cause of death among all diseases and one of the major causes of disability and dependency among older people worldwide⁵. Dementia has physical, psychological, social and economic impacts, not only for people living with dementia, but also for their careers, families and society at large. There is often a lack of awareness and understanding of dementia, resulting in stigmatization and barriers to diagnosis and care.

The study is important in this scenario because it helps in making the community aware about the risk factors of dementia. It has become obvious that the number of normal elderly Indians and those with dementia requiring special health care are increasing exponentially. The average life expectancy has now increased to over 60 years, moving into decades where Alzheimer’s disease and multi-infarct vascular dementia take the maximum toll.

The estimated population of demented elderly in India is 3.7 million. A two-fold increase in dementia prevalence to 7.6 million by 2030 is estimated, making dementia a very important national health problem⁶. Indian studies have reported the prevalence of dementia amongst the elderly range from 0.8 to 5.546% in rural areas and 0.9 to 4.86% in urban areas and the variation is probably related to methodological differences⁷.

STATEMENT OF THE PROBLEM:

A cross sectional study to assess the magnitude and risk factors of dementia among elderly residing in Ernakulam district, Kerala.

OBJECTIVES:

1. To estimate the magnitude of dementia among elderly.

2. To determine the factors associated with dementia among elderly.

3. To determine the association of magnitude of dementia with selected demographic variables and risk factors.

OPERATIONAL DEFINITIONS:

Magnitude:

Magnitude refers to the proportion of people diagnosed by dementia in elderly which will be assessed by Hasegawa’s Dementia Scale – Revised.

Risk factors:

Risk factors refer to the agents which can lead to dementia in elderly which will be assessed by self structured questionnaire.

Dementia:

Dementia refers to a disorder of brain which affects the normal thinking and memory in elderly.

Elderly:

Elderly refers to people in the age group of 60 years and above residing in Aikaranad Grama Panchayath.

ASSUMPTIONS:

Risk factors of dementia may vary with individual.

HYPOTHESES:

H₀₁: There is no significant association of magnitude of dementia with selected demographic variables and risk factors among elderly.

H_A1: There is significant association of magnitude of dementia with selected demographic variables and risk factors among elderly.

MATERIALS AND METHODS:

Study Design:

Our research is a cross-sectional quantitative study to assess the magnitude and risk factors of dementia among elderly.

Study Population:

The population of the study was elderly above 60 years of age residing in Aikaranad Gramapanchayat, Ernakulam district, Kerala.

Sample and Settings:

The total number of 384 samples were selected through non-probability convenience sampling technique. The study was conducted among elderly residing in Aikaranad Gramapanchayat, Ernakulam district, Kerala.

Tools and Techniques:

A structured tool was prepared with the help of journals, textbooks and after an extensive review of literature. Tool 1; Section A - Socio-demographic Proforma, Section B - Checklist to determine the risk factors of dementia and Tool 2 - Hasegawa’s Dementia Scale – Revised.

Tool:

It is a testing device for measuring a given event, such as a questionnaire, an interview or a set of guidelines or checklist for observation.

Description of Tool:

Tool 1: Structured tool to assess risk Factors of Dementia:

Section A: Socio-demographic performa

Socio-demographic variables consist of age, gender, educational status, occupation, religion, marital status, monthly income, area of residence and type of family.

Section B: Clinical Profile

Clinical profile consists of risk factors of dementia (Stroke, dyslipidemia, diabetes, heart disease, hypertension, traumatic brain injury, depression, substance use, sleep disturbances, family history and exercise).

Tool 2: Hasegawa’s Dementia Scale- Revised

Hasegawa’s Dementia Scale- Revised is a standardized questionnaire to assess the magnitude of dementia among elderly. It helps to measure cognitive function accurately, both cooperation by the subjects and skill of the examiner are necessary. The questionnaire consists of 9 questions to assess the magnitude of dementia; the maximum score is 30 and minimum score is 0.

RESULTS:

The major findings of the study were presented under the following sessions:

Section 1: Magnitude of dementia.

Section 2: Frequency and percentage distribution of socio-demographic variables of dementia.

Section 3: Frequency and percentage distribution of risk factors of dementia.

Section 4: Association of magnitude of dementia with selected demographic variables.

Section 5: Association of magnitude of dementia with risk factors of dementia.

Section 1: Magnitude of dementia:

In this study among 384 elderly people 25.52% has mild dementia, 0.52% has moderate dementia and 3.91% has severe dementia.

Section 2: Frequency and percentage distribution of socio-demographic variables of dementia:

In this study, majority of the subjects, 34.4% were in the age group of 71-80 years. Among the subjects, 67.45% were males. Data regarding the educational status of the subjects showed 53.91% were in high school education status, 50.52% were employed as coolie workers, 71.61% were married and 58.85% have a monthly income of Rs. 5,001-20,000. Majority of the subjects, 70.05% resides in rural area and 63.02% belongs to nuclear family.

Section 3: Frequency and percentage distribution of risk factors of dementia:

In this study, among 384 study subjects 76.04% have hypertension, 60.08% have diabetes mellitus and 51.04% had history of stroke. Majority of the subjects, 96.88% were non smokers, 98.96% has not reported head injury. Majority of the subjects 58.33% do not have cholesterol, 17.19% had heart disease, 1.04% had head injury, 7.81% had family history of dementia, 95.31% have no sleep disturbances and 74.22% do not perform regular exercise.

Section 4: Association of magnitude of dementia with selected demographic variables:

· In this study we have performed Chi square test to determine the association of magnitude of dementia with selected demographic variables.

· It was found that there is no significant association between magnitude of dementia with selected demographic variables; age, gender, education, marital status, monthly income, occupation, religion, area of residence and type of family.

· Therefore, null hypothesis H₀₁ was accepted

Section 5: Association of magnitude of dementia with risk factors of dementia:

· In this study we have performed Chi square test to determine the association of magnitude of dementia with risk factors of dementia.

· It was found that there was a significant association between head injury with magnitude of dementia.

· Therefore, alternative hypothesis H_A1 was accepted.

In this study among 384 elderly people 25.52% has mild dementia, 0.52% has moderate dementia and 3.91% has severe dementia. Majority of the subjects, 34.4% were in the age group of 71-80 years. Among the subjects, 67.45% were males. Data regarding the educational status of the subjects showed 53.91% were in high school education status, 50.52% were employed as coolie workers, 71.61% were married and 58.85% have a monthly income of Rs. 5,001-20,000. Majority of the subjects, 70.05% resides in rural area and 63.02% belongs to nuclear family.

Among 384 study subjects 76.04% have hypertension, 60.08% have diabetes mellitus and 51.04% had history of stroke. Majority of the subjects, 96.88% were non smokers, 98.96% has not reported head injury. Majority of the subjects 58.33% do not have cholesterol, 17.19% had heart disease, 1.04% had head injury, 7.81% had family history of dementia, 95.31% have no sleep disturbances and 74.22% do not perform regular exercise. It is found that here is no significant association between magnitude of dementia with selected demographic variables; age, gender, education, marital status, monthly income, occupation, religion, area of residence and type of family. It was found that there was a significant association between head injury with magnitude of dementia.

DISCUSSION:

The present study reflected that the magnitude of dementia increases with age. Among 384 elderly people aged above 60 years, 115 subjects shows dementia which can be classified as mild (25.52%), moderate (0.52%) and severe (3.91%) dementia. The highest incidence of dementia is among the age category between 71-80. The factors associated with dementia are more with individuals who have suffered from head injury. Nowadays so many elderly people are diagnosed with dementia, so specific screening programs should be conducted both in rural and urban areas which will help in early diagnosis and treatment. and also, awareness classes and training programs can be conducted for the family members for giving adequate care to the patients.

NURSING IMPLICATION:

Findings of the present study have several implication in nursing practice, nursing administration, nursing education and nursing research.

Nursing Practice:

· Community Health Nursing professional can conduct screening programs of dementia in rural and urban settings.

· Community Health Nursing professional can conduct awareness programme in community setting.

Nursing Education:

· Nursing students can be sensitized about the signs and symptoms of dementia and diagnostic measures of dementia.

· Addition of information regarding dementia in preventive and social dementia.

Nursing Administration:

· The nurse administrator can provide comprehensive information about dementia and support the patients and educate the relatives about management of those patients.

Nursing Research:

· The study can motivate the nurse researcher for the further research.

· The study findings can be used as a review of literature for further study.

RECOMMENDATIONS:

In the light of present study, the following recommendations were put forward.

· Awareness programs can be conducted for the family members about the home management of patients.

· Periodic training programs can be conducted for the patients with dementia which helps in improving their memory.

REFERENCES:

1. World Health Organization, Global Dementia Observatory 2020 Available from: [ Last cited on 15 Mar 2023].

2. Shaji KS, Jithu VP, Jyothi KS. Indian research on aging and dementia. Indian J Psychiatry. 2010 Jan; 52(Suppl 1): S148-52. doi: 10.4103/0019- 5545.69227. PMID: 21836672; PMCID: PMC3146224.

3. Arvanitakis Z, Shah RC, Bennett DA. Diagnosis and Management of Dementia: Review. JAMA. 2019 Oct 22; 322(16):1589-1599. doi: 10.1001/jama.2019.4782. PMID: 31638686; PMCID: PMC7462122.

4. Livingston G, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet. 2020; doi:10.1016/S0140-6736(20)30367-6

5. Purandare N. Prevention of dementia: Role of vascular risk factors and cerebral emboli. Indian J Psychiatry. 2009 Jan; 51 Suppl 1(Suppl1): S39-43. PMID: 21416015; PMCID: PMC3038539.

6. Krishnamoorthy, Ennapadam; Vivek, Misra & VG, Srivatsa. (2015). Dementia in India.

7. Nulkar A, Paralikar V, Juvekar S. Dementia in India–a call for action. Journal of Global Health Reports. 2019 Dec 1.

8. Chandra V, Ganguli M, Pandav R, Johnston J, Belle S, DeKosky ST. Prevalence of Alzheimer's disease and other dementias in rural India: the Indo-US study. Neurology. 1998 Oct 1; 51(4): 1000-1008.

Received on 20.08.2025 Revised on 12.09.2025

Accepted on 03.10.2025 Published on 03.11.2025

Available online from November 15, 2025

A and V Pub Int. J. of Nursing and Med. Res. 2025; 4(4):201-204.

DOI: 10.52711/ijnmr.2025.37

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.