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Title: Constructs underlying mild cognitive impairment of relevance to low and middle income countries
Author: Sosa-Ortiz, Ana Luisa
Awarding Body: King's College London (University of London)
Current Institution: King's College London (University of London)
Date of Award: 2012
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Background: Numbers of older people are increasing rapidly in most low and middle income countries and there is a pressing need for adequate information on dementia and cognitive disorders in these regions. Mild cognitive impairment is increasingly recognized as an important ‘transition’ prior to dementia onset, but is poorly understood outside Western settings, as are key constructs underlying this concept: namely, subjective memory complaints, informant-reported memory deficits and the relationship between cognition and disability. Methods: Data were analysed in relation to these questions from a series of catchment area surveys of older people carried out following identical methodologies in Cuba, Mexico, Dominican Republic, Peru, Venezuela, India and China, involving over 15,000 participating residents aged 65 years and over. Measurements had been rigorously assessed for cross-cultural applicability and were identically administered. Results: Normative data for cognitive function are described and compared, followed by the prevalence of amnestic mild cognitive impairment. Substantial variations were found between sites in the prevalence of subjective memory complaints and informant-reported memory deficits, and in their associations with dementia, and with cognitive function in participants without dementia. Variation was also found in the association between cognitive function and informant-reported disability in participants. For example, subjective memory complaints in China were relatively rare but much more strongly associated with dementia and/or cognitive function than in other sites. Conclusions: The high level of between-site variability in the associations in question suggests that mild cognitive impairment as a construct is strongly influenced by cultural factors which need to be taken into account when interpreting it or applying it in healthcare.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available