Background

Mild cognitive impairment is considered as a precursor to dementia. The mild cognitive impairment is often seen in elderly, above 50 years of age in general. If the condition is not identified on time, the condition may progress to dementia [1]. Dementia is a degenerative disorder which may be a resultant of neuronal degeneration or depletion of neurons at an unexpected pace. Dementia is estimated have affected 75 millions of people world-wide and the prevalence figures are more in low to mid income countries.

Though dementia is considered to be degenerative and is irreversible in nature. Early identification is the key of effective intervention even in dementia. Hence awareness becomes the key for effective identification and intervention of dementia. The awareness is found to vary as a function of age, gender and educational status of the individuals older individuals are expected to know more about dementia compared to younger individuals as they are bound to visit hospitals and doctors who may sensitise these individuals [2]. There is contradicting evidence on the same which reflects better awareness in younger individuals as they are inclined towards social media and reading which may increase their awareness pertaining to the same [1].

General public are expected to be aware of the consequences of normal aging and may not be aware of the difference between normal and pathological aging, they are generally aware about prevention of the condition and maintenance of systemic illness (which can be connected to dementia) and most of the studies in this direction have tapped regarding the awareness of the terminologies, characteristics, deficits associated with the condition, however studies have not tapped about the knowledge on MCI and the progression of MCI to dementia. 

Need of the Study

Degenerative conditions such Mild Cognitive impairment and Dementia can have devastating consequences [3]. Most of the conditions are irreversible, however the aftermath consequences may be curtailed if the conditions are identified earlier in other words, and the rate of cognitive-linguistic decline can be prevented if the conditions are identified early. Awareness about the consequences warrants early identification. The current study was carried out with the aim of determining the awareness for conditions like MCI and Dementia in commoners [4].

Awareness of conditions like Mild Cognitive Impairment and Dementia is directly dependent on factors like age, occupation, education status etc. There is a clear sparsity of such studies in the Indian context especially in regard to sub-urban scenarios. The commoners with minimal medical knowledge may exhibit lacunae in their knowledge on such conditions [5].

A questionnaire tapping details on the awareness of MCI and Dementia was constructed for the aforementioned purpose. The questionnaire was constructed by a speech language pathologist with over 15 years of clinical experience. The first part of the questionnaire elicited details like name, age, gender, education and occupation details of the participants, along with details on hobbies and source of knowledge with the details on medical conditions. The primary motive of collecting details regarding the source of knowledge is to determine the relationship between the source of knowledge and the extent of dementia awareness

The second part of the questionnaire comprised of 15 questions tapping details on the awareness of terms, causes, prevention, age of onset, core deficits, progression (of MCI) in specific, role of the family members/caregivers etc. The intended response was ‘Yes’ for few questions and ‘No’ for other questions. The questionnaire also included details about Mild Cognitive Impairment in addition to questions pertaining to Dementia as the general public may have limited information on the former compared to the latter.

A total of 107 respondents filled the questionnaire. The respondents were in the age range of 40-60 years. The participants were divided into four subgroups with a class interval of 5 years. The four sub groups (40-45, 46-50, 51-55, 56-60) comprised of 35, 25, 30 and 17 respondents basically. The respondents were from both the genders. Majority of the respondents. Most of the respondents were females (62%) and a greater proportion of respondents (59%) had access to social media and 41% of the respondents had inclination towards reading.

In order to assess the content validity of the questionnaire, it was circulated to three experts (comprising of one speech language pathologist, one psychologist and one content writer) for assessing the comprehensiveness, simplicity, catering the purpose. The expert reviewers were asked to review from the perspective of commoners. Cronbach’s alpha values were elicited and the values were above 0.90 indicating that the content validity was good and the revisions suggested by the expert panel was incorporated before circulating the final version of the questionnaire.

The responses provided by the respondents on the close ended questions were analysed. The responses were compared with the intended response. The maximum number of correct responses accounted to 15. Thus, the maximum score was 15. The four sub-group of participants secured a median score of 11, 9, 8 and 7 respectively. In order to verify if there were any significant differences between the four subgroups.

Figure 1: Awareness as a function of age.

Kruskal-Wallis test was administered and the X2 obtained was 2.13 and the corresponding p values showed significant differences and further Mann Whitney U test was used to verify group wise differences. The Z scores showed significant difference when the first sub-group was compared to third and fourth sub groups.  Thus, the results showed that the first sub-group were aware of the condition better, however the difference between the sub-groups was marginal only. 

Though some of the participants were aware of the conditions, there was heterogeneity in the performance Many of the respondents were not aware of the continuum between MCI to Dementia. The descriptive scores showed that the younger respondents were much aware of dementia compared to the older respondents. The younger respondents had more inclination towards social media and relatively more contemporary knowledge. The participants regardless of their age were aware about consequences of dementia, identification of dementia etc. They had limited knowledge about the progression and the professionals to be consulted for intervention. The findings of the study was not in consonance/agreement with the findings of the study by Chung, 2000. Chung postulated that older individuals would have better awareness when compared to younger individuals as they are expected to pay visit to hospitals and may be sensitised better, however this study was carried out in western context. The other important finding was that this study considered individuals above 60 years of age while the current study individuals up to 60 years of age hence there would have been a disparity.

The results were not analysed in regard to the gender and hobbies of the respondents as it was beyond the objectives considered for the current study and is a part of future directions and will be considered in the future papers coined from the data.

Awareness is key to prevention in case of dementia hence the study was carried out in middle aged adults to determine their awareness levels. The results showed that the awareness varied with age and most importantly participants regardless of their age required sensitisation on certain domains pertaining to prevention and early identification.

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