Clinical, Behavioral, and Socio-Cultural Manifestations of Dementia: Evidence from Caregiver Reports

Background/Objectives: Dementia represents a complex syndrome in which biological, psychological, social, and cultural dimensions intersect. While its clinical features are well documented, less is known about how lived experiences, caregiving contexts, and cultural beliefs shape the trajectory of illness. This study explored clinical, behavioral, and socio-cultural dimensions related to the quality of life of people living with dementia from an anthropological perspective, focusing on the interaction between comorbidities, cognition, lifestyle, and caregiving environments as reported by their informal caregivers. Methods: We conducted a single-center, observational cross-sectional study including 73 family caregivers of patients with clinically diagnosed dementia who accessed care at the Neurology–Psychiatry Department of the C.F.2 Clinical Hospital (Bucharest, Romania) between November 2023 and April 2024. Caregivers provided socio-demographic, behavioral, lifestyle, and cultural information using a newly developed anthropological questionnaire. Descriptive and exploratory inferential analyses were performed to examine relationships between cognitive performance, comorbidities, lifestyle factors, and socio-cultural variables. Results: People with dementia had a mean age of 79.2 ± 7.5 years (range 66–95) and were predominantly female (71.2%). Multimorbidity was common, averaging 2.22 ± 1.03 chronic conditions, mainly neurological (84.9%) and cardiovascular (68.5%). The mean BMI was 26.1 ± 3.8 kg/m2. Cognitive impairment was substantial (MMSE mean 11.47 ± 7), with descriptively lower scores among older individuals and those with lower education or income, although inferential tests were underpowered. Appetite and sleep disturbances were frequent and tended to co-occur with lower activity levels. Disclosure of diagnosis occurred in 74% of cases; reactions varied widely, ranging from acceptance to denial, confusion, anxiety, and sadness. Family responses likewise reflected a heterogeneous and often ambivalent adjustment process. Cultural beliefs and spirituality played a salient role in shaping explanatory models and coping strategies, with many caregivers attributing importance to religious practices and, to a lesser extent, alternative treatments. Conclusions: In this Romanian cohort, dementia was shaped not only by age-related multimorbidity and cognitive decline but also by caregiving practices, socioeconomic constraints and culturally grounded interpretations of illness. These findings highlight the relevance of integrative approaches to dementia care that consider medical, behavioral, and socio-cultural dimensions and that incorporate caregiver perspectives to improve the quality of life of both patients and families.