The evaluation of Prevalence and Determinants of Cognitive impairment in older Indian Adults attending a tertiary care memory clinic: A cross-sectional study

Background: Globally, including India, the rise in the population of older persons is accompanied by a concomitant rise in age-related conditions, such as cognitive impairment.

Objective: This study aims to evaluate the prevalence and determinants of Mild Cognitive Impairment (MCI) and Major Neurocognitive Disorder (MNCD) among older adults aged ≥ 60 years attending a tertiary care memory clinic.

Methods: A cross-sectional study was conducted in consecutive individuals attending the memory clinic. Participants were subjected to detailed clinical assessment and potential risk factors were analysed using clinical questionnaires and validated assessment tools, including Addenbrooke’s Cognitive Examination III (ACE III)-Hindi version for cognition and 15-item Geriatric Depression Scale (GDS-15) for depressive symptoms. 

Result: A total of 668 participants were enrolled in each MCI and MNCD group. Mean age of study participants was 71.4 ± 6.8 years. The prevalence rate was 69% for MCI and 63.6% for MNCD. Females aged 61-80 years demonstrated significantly higher proportional rates of MCI (38.3% vs 24.6%) and MNCD (39.5% vs 24.7%) than males, who represented more in cognitively normal groups. Regression analysis showed Age, Type 2 Diabetes Mellitus, and caregiver presence to have significantly (p <0.05) higher odds of MCI and MNCD, whereas education and hypertension demonstrated significant (p ≤0.001) inverse association. All individual cognitive domains i.e. memory, language, fluency, visuospatial and attention were significantly impaired (p <0.001) in both groups.

Conclusion: Cognitive impairment involves multiple cognitive domains and is more prevalent in older women. Advancing age, Type 2 Diabetes Mellitus and, less educational attainment are independently associated factors. Caregiver presence may serve as a surrogate marker of family-perceived behavioural changes, enabling early clinical detection and management. The independent inverse association of hypertension in both groups warrants further stratified or temporal analysis in multicentre population-based studies.