CLINICAL PROFILE OF DEMENTIA IN YOUNGER PERSONS IN EASTERN INDIA

Medical science and epidemiology

Dementia is an increasingly recognized cause of morbidity and mortality in India and in other parts of the world, especially in the elderly population. There are very few reports about the causes of dementia in rural populations of eastern India. This was a retrospective study carried out using outpatient department records through the course of 2 years in a medical college in West Bengal. Cases which were diagnosed as dementia on the basis of the MMSE or Addenbrooke tests were included. Diagnosis of vascular dementia was done with the aid of DSM-IV. The diagnosis of FTD and DLB (Dementia with Lewy Bodies) were done on the basis of Lund-Manchester criteria and International Consensus Consortium Criteria respectively.The aim of this study is to delineate the clinical profile of dementia in patients attending a medical college outpatient department in eastern India. About one-fourth (93 out of 400) of the patients were of young onset. Women constituted about 1/3rd of the cases. With increasing age, the proportion of cases increased. The most common etiology was Alzheimer Disease (49%) followed by Frontotemporal Lobar Degeneration (20%) and vascular dementia (8%). Positive family history was found in less than 10% of cases. The decreased proportion of vascular dementia compared to frontotemporal lobar degeneration could be due to referral bias. Another 10% of cases had causes of dementia that could be considered as reversible. The study also showed that degenerative dementias were the most common cause of dementia even amongst young-onset patients. The limitations of this study include the lack of postmortem histopathological confirmation of the clinical diagnosis.

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