Publication: The dementia and disability project in Thai elderly: rational, design, methodology and early results
Issued Date
2013
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eng
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Mahidol University
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BioMed Central
Bibliographic Citation
BMC Neurology. Vol. 13, (2013), 3
Suggested Citation
Vorapun Senanarong, Kamolthip Harnphadungkit, Niphon Poungvarin, Sathit Vannasaeng, Samut Chongwisal, Tipa Chakorn, Piyanuch Jamjumrus, Atthapon Raksthaput, Sinisa Chaichanettee, Nattapol Aoonkaew, Suthipol Udompunthurak, Doody, Rachelle S., Cummings, Jeffrey L. The dementia and disability project in Thai elderly: rational, design, methodology and early results. BMC Neurology. Vol. 13, (2013), 3. doi:10.1186/1471-2377-13-3 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/2652
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The dementia and disability project in Thai elderly: rational, design, methodology and early results
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Abstract
Background: A strong inverse relationship of functional limitation and socioeconomic status has been established
in western ageing society. Functional limitation can be related to chronic diseases, disuse, cognitive decline, and
ageing. Among chronic diseases in the Thai population, cerebrovascular diseases, diabetes, and arthritis are
common. These factors are known to contribute to disability and poor quality of life in the elder population.
Neuropsychiatric problems, cognitive decline, dementia, and cultural issues in elderly people also can alter the
quality of life of the elderly.
Methods: The Dementia and Disability Project in Thai Elderly (DDP) aims at comprehensively assessing community
dwelling Thai elderly to understand the relationship between disability and motor function, neuropsychiatric
symptoms, cognitive function, and chronic diseases. The DDP is the first study to look at the prevalence and
etiology of dementia and of mild cognitive impairment (MCI) in Thai elders and to explore the relationship of
cognition, disability, small vessel diseases and cortical degeneration with neuroimaging in Thai elderly people. 1998
Thai elders were screened in 2004–2006 and diagnosed as having MCI or dementia. 223 elders with MCI or
dementia and cognitively normal elderly had brain magnetic resonance imaging (MRI) or at baseline. 319 elders
from the 3 groups had blood tests to investigate the risks and possible etiologies of dementia including
genotyping at baseline.
Results: The mean age of elders in this study is 69.51(SD=6.71, min=60, max=95) years. 689(34.9%) are men and
1284(65.1%) are women. Mean body weight was 58.36(SD=11.20) kgs. The regression model reveals that
performance on gait and balance and serum triglyceride predicts activity of daily living performance (adjusted
r2 = 0.280, f=2.644, p=0.003). The majority of abnormal gait in Thai elders was lower level gait disturbance. Only
1.5% (29/1952) had highest level gait disorders. 39.5% of 1964 subjects were free of chronic diseases. Treatment gap
(indicating those who have untreated or inadequate treatment) of diabetes mellitus and hypertension in Thai elders
in this study was 37% and 55.5% respectively. 62.6% of Thai elders have ApoE3E3 allele. Prevalence of positive
ApoE4 gene in this study is 22.85%. 38.6% of Thai elders who had MRI brain study have moderate to severe white
matter lesions. Conclusion: The large and comprehensive set of measurements in DDP allows a wide-ranging explanation of the
functional and clinical features to be investigated in relation to white matter lesions or cortical atrophy of the brain
in Thai elderly population. An almost 2 year follow up was made available to those with MCI and dementia and
some of the cognitively normal elderly. The longitudinal design will provide great understanding of the possible
contributors to disability in the elderly and to the progression of cognitive decline in Thai elders.