About 3.4 crore older Indians living with mild cognitive impairment, affecting daily lives: Study

NEW DELHI: In India, an estimated 3.4 crore older adults, aged 60 years and above, are living with mild cognitive impairment, affecting their daily lives and activities in some manner, new research has found.

It estimated that 2.4 crore and almost 1 crore older adults are living with mild and major neurocognitive disorders,  respectively, impairing faculties like memory, attention, executive function and language, and signifying potential dementia.

Using survey data from nationally representative sample of adults in India, researchers found a higher prevalence of these disorders in the older ones (over 80 years old) and in those with lower levels of education. Prevalence in women and men was found to be comparable and almost equal.

The team also found the prevalence to be higher in rural-living older adults than urban ones, and more in the illiterate than the literate. About 13.4 crore adults in India are estimated to be aged 60 years and above, and are projected to constitute 20 per cent of the population by 2050, they said.

For the study, the international team of researchers, led by Johns Hopkins University, US, and including those at St. John's Medical College, Bengaluru, Karnataka, recruited almost 4,100 participants residing in 18 geographically and linguistically diverse states such as Jammu & Kashmir, Punjab, Delhi, West Bengal, Maharashtra, Karnataka, Tamil Nadu, among others. The majority of the group was aged 60-79 years.

This study is called the LASI-DAD, Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India, and the participants were recruited from the main LASI. They collectively represented 91 per cent of the population, the researchers said in their study published in the journal PLoS ONE.

"We are aware of no previous Indian population-representative estimates of mild cognitive impairment, a group which will be increasingly important in coming years to identify for potential therapeutic treatment," the authors wrote.

For their analysis, the researchers relied on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a widely recognised clinical diagnostic authority. It recognises that dementia typically involves cognitive decline severe enough to interfere with one's daily functioning, they explained.

The DSM-5 diagnostic criteria for neurocognitive disorder entails documentation of cognitive decline and assessing how independent an individual performs their everyday activities. The criteria also describes exclusionary conditions, based on which the researchers excluded participants with active delirium, schizophrenia, history of stroke, and major depression, all of which were ascertained through interviews.

Upon analysing all the data, the researchers found that the population prevalence of DSM-5 mild and major neurocognitive disorder was 17.6 per cent and 7.2 per cent, respectively.

They also found that the prevalence of major neurocognitive disorder was greater with older ages - from about 4 per cent among those aged 60-64 years to 15.2 per cent among those aged over 80 years.

Among the participant sample, the team found that 12 per cent reported severe loss in at least one ADL (activities of daily living) and 8.5 per cent reported impairment in any IADL (instrumental activities of daily living).

Major neurocognitive disorder was more prevalent among illiterate (9.3 per cent) than literate (5 per cent) and rural (10.3 per cent) than urban (4.9 per cent) participants, they found.

"These findings, coupled with a growing number of older adults in the coming decades in India, have important implications for society, public health, and families," the researchers wrote.