A STUDY TO ASSESS THE COGNITIVE-CLINICAL PROFILE OF DEMENTIA PATIENTS ATTENDING PSYCHIATRY OPD IN A SELECTED TERTIARY CARE HOSPITAL, WESTERN U.P

Abstract

Introduction: Dementia is a progressive neurocognitive disorder characterized by deterioration in memory, thinking, behavior and the ability to perform daily activities. It is a major public health concern, especially among the elderly population., 57 million peoples suffered with dementia world widely in 2021 (WHO), Around 60% of people living with dementia reside in low- and middle-income countries, in India, dementia prevalence among aged 60 years and above is estimated 7.4% affecting nearly 8.8 million older adults and Forgetfulness is one of the initial symptoms in most types of dementia. Dementia is listed by WHO as the 7th leading cause of global death and major contributor towards disability and dependency among older people, early identification and comprehensive assessment of cognitive impairment and cognitive domains are essential for effective management. Psychiatry outpatient department (OPD) serve as the first point of contact for diagnosis and care, making them an important setting for cognitive-clinical evaluation. Objective: To assess the cognitive-clinical profile of dementia patients attending psychiatry OPD in a selected tertiary care hospital, Western U.P. Methodology: The study adopted a quantitative descriptive cross-sectional research design. a total of 116 dementia patients attending psychiatry OPD were selected using a non-probability consecutive sampling technique. Data were collected using a structured demographic sheet and the Mini-Mental State examination (MMSE) tool to assess cognitive clinical profile domains such as orientation, attention & calculation, registration, recall and language. Descriptive and inferential statistics were used for data analysis. Results: The finding reveals that the majority of participants on the basis of level of cognitive-clinical profile 58.62% mild to moderate, 29.32 % severe cognitive impairment and 12.06% normal cognitive-clinical profile. Among the cognitive domains Attention & Calculation (39.14%), indicating that are most affected cognitive- clinical profile domain among the dementia patients where as Repeated measures ANOVA was conducted to compare MMSE cognitive domain scores among 116 dementia patients, the multivariate test using Pillai’s trace showed statistically significant result with F (4,112) = 1976.89, p < 0.001. This indicates that there was a highly significant difference among the measured domains across the repeated observations. Statistical analysis showed a significant association between the level of cognitive clinical profile and demographic variables such as Age, Marital Status, Education, Place of Residence, and Timing of First Medical Visit. showed with the level of (p < 0.05). Other variables such as Gender, Family History, Handedness, Employment Status, Socio-economic Status, and Co-morbid illnesses were not significantly associated. Conclusion:The study concludes that dementia patients attending Psychiatry OPD predominantly exhibited mild to moderate cognitive impairment, attention & calculation being the most affected cognitive domains. Repeated measures ANOVA demonstrated a highly significant difference among MMSE cognitive domain scores (p < 0.001), indicating variations in the pattern of cognitive impairment across domains. Furthermore, cognitive-clinical profile was significantly associated with selected demographic variables, underscoring the need for early cognitive assessment and evidence-based interventions to improve dementia care outcomes.