The level of Memory Impairment among elderly in a rural community of Ernakulam District

Ms. Dhanya George¹, Anu Jacob Kachappillil²*

¹II Year MSc Nursing Student, MOSC College of Nursing, Kolenchery, Ernakulam, Kerala

²Assistant Professor, Department of Medical Surgical Nursing, MOSC College of Nursing, Kolenchery, Ernakulam, Kerala

*Corresponding Author Email: a.blossoms@gmail.com

ABSTRACT:

Aim: A descriptive study was conducted to assess the level of memory impairment among elderly in a rural community of Ernakulum district. Background: Ageing is a series of process that begins with life and continues throughout the life cycle. Ageing in India is exponentially increasing due to the impressive gains that society has made in terms of increased life expectancy. It is projected that the proportion of Indians aged 60 years and above will rise from 7.5% in 2010 to 11.1% in 2025^1. As individuals age, their brain shrinks. They gradually lose nerve cells that they had from birth and process information more slowly. As a consequence, learning new concepts and patterns becomes more difficult. Memory also begins to fail. The ability to store, process, and manipulate information drops.²Decline of memory function is a normal process of aging, but it may also be the result of a pathological condition such as Alzheimer's disease. Age related memory impairment is preventable by adoption of healthy lifestyle practices and by performing activities that stimulate the brain and mind.³ The present study was undertaken to assess the level of memory impairment among elderly in a rural community of Ernakulam district and to find its association with selected demographic variables. Methods: A descriptive analytical study was conducted in a rural area of Ernakulam district. 200 elderly people aged 65 years and above were selected by using convenient sampling technique. The data collection tools were structured interview schedule to collect the demographic data and Modified Addenbrooke’s Cognitive Examination (ACE)-III Malayalam version with emphasis on memory function to assess the level of memory impairment among elderly. Results: The present study concluded that 45.5% of the subjects had memory impairment (36% had mild memory impairment, 7% had moderate memory impairment and 2.5% of the subjects had severe memory impairment). The study also revealed that there is a significant association between level of memory impairment with demographic variables of elderly such as age and educational qualification (p<0.05). Conclusion: The findings of the present study highlight that nearly half of the elderly had memory impairment ranging from mild to severe forms.

KEYWORDS: Alzheimer's disease, Dementia, Elderly, Memory, Memory impairment, Modified Addenbrooke’s Cognitive Examination (ACE)-III.

INTRODUCTION:

The world is aging rapidly through “demographic transition.” Decline of memory function is a normal process of aging, but it may also be the result of a pathological condition such as Alzheimer's disease. Studies indicate that many individuals report mild cognitive impairment (MCI), subjective memory impairment, and functional complaints years before the development of dementia and Alzheimer's disease. Elderly individuals with memory impairment also have a rapid rate of conversion to Alzheimer's disease and the annual rates of conversion of mild Cognitive Impairment to dementia were found to be 5%–15%.⁴ Prevention is always better than cure. Early identification of memory impairment among elderly will help to prevent further worsening of the condition by early initiation of treatment. It also helps to improve the quality of life of elderly and to reduce the stress of caregiver. Age related memory impairment is preventable by adoption of healthy lifestyle practices like doing regular exercise, avoiding smoking and alcohol, weight control, eating a healthy diet, maintaining healthy blood pressure, cholesterol and blood sugar levels.⁵

MATERIALS AND METHODS:

A descriptive analytical study was conducted in a rural area of Ernakulam district. 200 elderly people aged 65 years and above were selected by using convenient sampling technique. The data collection tools were structured interview schedule to collect demographic data and Modified Addenbrooke’s Cognitive Examination⁶ (ACE)-III Malayalam version with emphasis on memory function to assess the level of memory impairment among elderly. Data were analysed using SPSS version 20.

RESULTS:

Section A: Distribution of demographic variables:

Table 1 shows that majority of the elderly (47%) were in the age group of 67-70 years. More than half of the subjects (56.5%) were females and (59%) were Christians. Majority of the subjects (83.5%) were non vegetarians. More than half (57%) of the subjects were on regular medications.

Table 1: Frequency and percentage distribution of demographic characteristics of elderly n=200

Sl. No

Demographic Variables

Frequency (f)

Percentage (%)

Age in years

a. 65-70

b. 71-76

c. 77& above

Gender

a. Male

b. Female

113

43.5

56.5

Religion

a. Hindu

b. Christian

118

Type of diet

a. Vegetarian diet

b. Mixed diet

167

16.5

83.5

History of head injury

a. Yes

b. No

159

20.5

79.5

History of regular medication

a. Yes

b. No

114

History of health problems

a. Yes

b. No

106

History of hypertension

a. Yes

b. No

128

History of diabetes mellitus

a. Yes

b. No

144

Habit of cigarette smoking

a. Yes

b. No

188

Habit of alcohol consumption

a. Yes

b. No

163

18.5

81.5

History of stroke

a. Yes

b. No

195

2.5

97.5

Family history of memory impairment

a. Yes

b. No

188

20.5% elderly had history of head injury. 36% of subjects were hypertensive and 28% were diabetic. 6% of subjects were smokers and 18.5% were alcoholic. 2.5% elderly had history of stroke and 6% had family history of memory impairment.

Section B: Assessment of the level of memory impairment among elderly

Table 2: Frequency and percentage distribution of the level of memory impairment among elderly n=200

Sl No	Level of memory impairment	Frequency (f)	Percentage (%)
1	Normal memory	109	54.5
2	Mild memory impairment	72	36
3	Moderate memory impairment	14	7
4	Severe memory impairment	5	2.5

Table 2 shows that out of 200 elderly people, 54.5% of the subjects had normal memory, 36% had mild memory impairment, 7% had moderate memory impairment and 2.5% had severe memory impairment.

Section C: Association between the level of memory impairment and selected demographic variables:

There was significant association between the level of memory impairment with the age of elderly ( $χ 2 =$ 18.994, p value = 0.0001^*) at p <0.05 level of significance.

There was significant association between the level of memory impairment with the educational qualification of elderly ( $χ 2 =$ 79.66, p value =0.0001^*) at p <0.05 level of significance.

There was no significant association between level of memory impairment with any of the other demographic variables of elderly such as gender, type of diet, history of head injury, history regular medications, history of any health problems, family history of memory loss, history of hypertension, history of diabetes mellitus, habit of alcohol consumption and cigarette smoking, history of stroke etc.

DISCUSSION:

The present study revealed that about 54.5% of the subjects had normal memory, 36% of the subjects had mild memory impairment, 7% of the subjects had moderate memory impairment and 2.5% of the subjects had severe memory impairment.

The results of the present study were consistent with the findings of a similar study conducted to assess the prevalence of cognitive impairment among elderly in North India. The study revealed that the prevalence of cognitive impairment among elderly was 8.8%, in which 60.8% had mild cognitive impairment, 23.5% had moderate and 15.7% had severe impairment. There was a significant association between cognitive impairment with increasing age and educational status of elderly.⁷

ACKNOWLEDGEMENT:

Here we extend our sincere thanks to all elderly people who participated in the study.

CONFLICT OF INTEREST:

The authors declare no conflict of interest in the study.

REFERENCE:

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Received on 29.10.2019 Modified on 26.11.2019

Asian J. Nursing Education and Research. 2020; 10(1): 107-109.

DOI: 10.5958/2349-2996.2020.00024.5