February 2019

Issue Home >>


Many of us have the experience of an elderly relation afflicted with dementia. It takes a powerful toll on the sufferer and those close to them. We accept it as a consequence of ageing. But dementia is not natural or normal. It’s an illness, one that is having an abnormally heavy impact on Trinidad and Tobago.

A prevalence study by researchers at UWI’s St Augustine Campus has revealed that some 23.5% (nearly one in four) Trinidadians over the age of 70 have dementia. This figure is almost three times the prevalence in other countries. At age 85 and older it rises to 47%. The comprehensive study had over 1,850 active participants chosen randomly from 120 districts in Trinidad.

"Dementia is a major public health concern and is a global epidemic," says Dr Nelleen Baboolal, Senior Lecturer in Psychiatry and Head, Department of Clinical Medical Sciences at UWI St Augustine’s Faculty of Medical Sciences (FMS). Dr Baboolal is a member of the research team.

The UWI study, titled “The Prevalence and Economic Cost of Dementia Project in Trinidad and Tobago”, was carried out in collaboration with the University’s Health Economics Unit. The project was co-funded by the UWI-Trinidad and Tobago Research and Development Impact (RDI) Fund and the Ministry of Health.

The researchteam attributes the unusually high number of dementia sufferers to two main factors – the country's ageing population and, more importantly, the high prevalence of vascular risk factors including diabetes mellitus, hypertension, high cholesterol and obesity.

“The risk factors for diabetes and cardiovascular diseases such as hypertension are also the risk factors for dementia,” says Dr Gershwin Davis, Senior Lecturer in Chemical Pathology, Head of Department of Paraclinical Sciences (Laboratory Medicine) at FMS and member of the research team.

Dementia is a neurocognitive disease that affects memory, thinking, behaviour and the ability to perform everyday activities. Globally, Alzheimer's disease is the most common form of dementia, representing about 65% of the afflicted. Vascular dementia (problems with blood supply to the brain) is the second most common cause. Other causes include conditions such as vitamin B12 deficiency, HIV and AIDS, Parkinson's disease, tumors and head trauma resulting from activities such as boxing.

Covered in UWI Today in 2014 : (https://sta.uwi.edu/uwitoday/archive/august_2014/article11.asp)

The study originated from the work of Dr Baboolal, Dr Gershwin Davis and Professor Amanda McRae, Professor of Human Anatomy at FMS (now retired), who have been collaborating on Alzheimer's and dementia research since 2003.

It followed the methodology of the 10/66 Dementia Research Group, a UK-based collective of researchers that has developed measurement tools for dementia prevalence that are currently being used in over 20 countries. Professor Robert Stewart, a founding member of the 10/66 Group, was also a co-author and consultant on the UWI study.

Apart from the prevalence of dementia in Trinidad, the study also looked at the cost, material and otherwise, to the society. Dementia has a huge socioeconomic impact. The diagnosis and treatment for dementia is also extremely costly.

The prevalence study was completed in 2015 and since then the team has been analysing the data and sharing their findings. The results have been published in several widely recognised international journals such as the British Medical JournalOpenand the Oxford Journal of Public Health. Now that the results have been verified the next step is using the study to address the issue.

Dr Davis says, “The research could give impetus to a thrust as a matter of policy to create a dementia friendly society”.

In 2017, the UWI research team met with Health Minister Terrence Deyalsingh. The main objective of the meeting was to ask the Minister to request that Cabinet declare dementia a “chronic disease”. This designation would open up dementia-related activities to new avenues of international funding, a major step in creating policy, advocacy and public awareness, as well as further research.

Dr Baboolal says, “We need more research, more training of caregivers and more advocacy. Dementia is a priority in Trinidad and Tobago and we need to develop a national dementia plan to ensure that health and social services are adequately structured and funded to provide high-quality care and support to people throughout the dementia journey. The policymakers should initiate national debates regarding the future of long-term care, with all stakeholders and an informed public. I am hoping that we can come together and work to improve the quality of services for persons living with dementia”.