Sociodemographic and risk factor analysis of the SMRUTHI India: a cohort of at risk elderly Indians for primary prevention of dementia

Abstract Background Around 40% of dementia cases can be prevented or delayed by modifying the risk factors. The SMRUTHI INDIA study will be conducted to establish a trial‐ready cohort of elderly Indians who are at high risk of developing dementia. Method The present study utilizes the design of “Cohort Multiple Randomized Controlled Trial” (cmRCT) with in‐built provisions to conduct multiple randomized controlled trials (Figure 1). A large cohort of the rural population (4 zones of India, through established Indian Council of Medical Research ‐ Model Rural Health Research Units) has been established aiming to explore risk factors for dementia and follow them systematically with yearly neuropsychological evaluation for 5 years. Active screening is ongoing at multiple sites of the project. Detailed neuropsychological testing and risk factor analysis are in progress. An ancillary study proposes to design a multimodal “care bundle” for the prevention of dementia, which is culturally tailored and context‐specific to the Indian population (Figure 2). This intervention will undergo testing for feasibility in the hospital setting at the central coordinating site, through a pilot randomized controlled trial (six months). The curated care bundle will be the first intervention tested in phase 2 of SMRUTHI INDIA cmRCT cohort. Result We have recruited 432 (South zone 236, East zone 130, West zone 42, North zone 24) participants so far. The mean age is 66.1 ± 7.6 years. 258 (59.7%) participants are females. 266 (69.1%) have no formal education. Only 109 (25.3%) are actively employed. 374 (86.6%) are married, with 259 (60.1%) living in a joint family. 104 (36.1%) are overweight or have grade 1 obesity. Hypertension is present in 136 (31.5%), active smoking in 131 (30.3%), diabetes in 59 (13.7%), current alcohol consumption in 52 (12%), uncorrected vision loss in 33 (7.7%), hearing loss in 7 (1.6%), known coronary artery disease in 2 (0.5%). Conclusion SMRUTHI‐India study intends to find the potential of sustainable multimodal interventions for the prevention of dementia among Indians with rural background. Low education is highly prevalent. Obesity, hypertension and smoking affect nearly one‐third of the participants and could represent important targets for dementia prevention in India. (CTRI/2014/01/061172)