Social Determinants of Dementia and Caregivers’ Perspectives in the Field Practice Villages of Rural Health Training Centre, Thiruvennainallur

OBJECTIVES: (1) To find out the prevalence of dementia in the study population and its social determinants. (2) To explore the family caregivers’ perceptions and their support needs. MATERIALS AND METHODS - STUDY SETTING: This study was undertaken in the field practice area of 55 villages of three Primary Health Centres in Villupuram District of Tamil Nadu. STUDY DESIGN: An exploratory mixed-methods study design, where a qualitative method (key informant interview) was followed by a quantitative method (survey). SAMPLE SIZE: A representative sample of 1300 respondents was selected by two-stage sampling. ANALYSIS: Manual content analysis was done for qualitative data. Multiple logistic regression was performed on quantitative data. RESULTS: The prevalence of dementia among study sample was found to be 3.1%. The determinants for dementia were age, sex, socioeconomic status, and previous involvement in family decision making and cardiovascular risk factors. The family caregivers strongly felt that caregiving interferes with their personal and professional life; they also felt that caregiving is an integral part of Indian culture, and the elderly prefer home-based care. Caregivers preferred government owned public health facility for medical care. All the responding caregivers strongly felt that they are not adequately trained in caregiving. CONCLUSIONS AND RECOMMENDATIONS: Routine screening of elderly for early identification of dementia and its medical and social risk factors should be initiated in primary health care facility. Care of caregivers should be seen as an integral part of dementia care program.