Clinical Spectrum, Risk Factors, and Behavioral Abnormalities among Dementia Subtypes in a North Indian Population: A Hospital-Based Study

Abstract

Background: As variability in the clinical profile of dementia subtypes had been reported with regional differences across the world, we conducted a retrospective hospital-based study in a North Indian population. Methods: We retrieved patient records from 2007 to 2014 for details of clinical evaluation, diagnosis, neuroimaging, biochemical investigations, and follow-up of 1,876 patients with dementia (PwD), and the data were analyzed using descriptive statistics. Results: Of the total PwD, Alzheimer disease (AD) accounted for 30% followed by vascular dementia (VaD) 26%, mixed dementia (MD) 21%, Parkinson-related dementia 11%, frontotemporal dementia (FTD) 7%, and infective dementia 5%. Of all PwD excluding the infective group (n = 1,777), 63% were men, 39% were from rural areas, 87% had behavioral abnormalities along with cognitive deficits, and 73% had impaired ADLs. Among dementia subtypes, a positive family history, cardiovascular and metabolic risk factors, and behavioral abnormalities were found to be distributed. However, there existed a predominance of specific behavioral pattern in each subtype. The mean duration of follow-up varied from 2.9 ± 2.3 (VaD) to 3.6 ± 2.1 (AD) and greater than 30% were found to be stable on treatment (except in dementia with Lewy body). Conclusions: This large hospital-based study provides a distribution pattern and clinical spectrum of dementia subtypes in a North Indian population.