Epidemiological study of dementia after retirement

ABSTRACT

To determine prevalence of dementia and its subtypes among governmental retired employee [above 60 years old] attending Zagazig health insurance out patient clinic, Sharkia governorate, Egypt. A three phase study was carried out to screen 1800 subjects aged 60 years and above. During phase I all subjects were administrated standardized Mini-Mental state Examination [SMMSE]. In phase II, all screened positive subjects were subjected to complete history taking, clinical examination, Neuropsychiatric scales [Blessed Dementia scale, Clinical Dementia Rating scale and geriatric depression scale]. We diagnosed dementia only in 66 subjects [depending on DSM IV diagnostic criteria] yielding a crude prevalence rate of dementia of 3.66%. From the remaining screened negative subjects we selected 30 age and sex matched controls. To complete and further diagnose dementia subtypes, patients were subjected to some laboratory tests, EEG and brain Imaging [phase III]. Prevalence rates for specific dementia subtypes were 1.4% for Alzheimer's disease [AD], 1.05% for vascular dementia [VaD], 0.5% for mixed dementia [MD], other dementias represented 0.44% and undetermined cases 0.22%. Age specific prevalence ratios for dementia increased steeply with increasing age. There was no gender difference in the prevalence rates of dementia or its subtype. This study proved that professional and administration occupations and higher levels of education had inverse relation with dementia prevalence. Some risk factors such as DM, hypertension and hypercholesterolemia were significantly more frequent in our patients than in controls, while positive family history of dementia was significantly higher among AD patients. Comparison with previous studies suggests that dementia is as frequent in Sharkia, Egypt as elsewhere