Prevalence and predictors of dementia among older adults with memory complaints at a primary care hospital in Nakhon Ratchasima province

Abstract

Background: Thailand’s rapid transition into a completely aged society has brought cognitive impairment and dementia to the forefront of public health challenges. In primary care settings, the lack of systematic screening in routine practice often leads to delayed or missed diagnoses of dementia.

Objectives: This study aimed to determine the prevalence of dementia and related factors among older adults presenting with memory complaints at the geriatric clinic of Phimai Hospital, a general hospital in Nakhon Ratchasima Province, Thailand.

Methods: This cross-sectional descriptive study included 125 older adults aged 60 years or older who attended the geriatric clinic with memory complaints. Data were collected using a demographic questionnaire; the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE); the Thai Geriatric Depression Scale (TGDS-15); the MiniMental State Examination, Thai 2002 version (MMSE-Thai 2002); the Montreal Cognitive Assessment (MoCA); the Barthel Activities of Daily Living (ADL) Index; the Chula ADL Index; and clinical diagnosis based on DSM-5 criteria. Data were analyzed using descriptive statistics, the chi-square test, Fisher’s exact test, Pearson’s correlation coefficient, and binary logistic regression.

Results: The participants were predominantly female (60.8%), with a mean age of 76.7 years. Clinical diagnosis showed prevalences of dementia, mild cognitive impairment (MCI), and depression of 45.6%, 44.8%, and 4.8%, respectively. Factors independently associated with dementia in the binary logistic regression analysis included being without a partner (adjusted odds ratio [aOR] = 2.733), monthly income below 5,000 Thai baht (aOR = 15.530), poor self- perceived health status (aOR = 4.482), lack of regular exercise (aOR = 3.577) and abnormal IQCODE result (aOR = 6.921).

Conclusion: In a geriatric clinic of a general hospital, nearly half of the older adults presenting with memory complaints were diagnosed with dementia. Systematic cognitive screening and identification of associated factors may support early diagnosis and individualized care planning for cognitive impairment.