8
UWI TODAY
– SUNDAY 3RD AUGUST, 2014
ENERGY
HEALTH
Imagine that an elderly loved one,
perhaps an aunt, started
to forget the names of everyday objects or recent events.
She remembers the family luncheon she attended ten years
ago, but not what she had for breakfast, or the name of
your recently born baby. The changes are small; you chalk
them up to old age. But, as time progresses, she is no longer
able to find the right words to express herself, and is in an
increasingly confused state of mind. She develops mood
swings and personality changes, loses interest in what she
once loved, and forgets how to conduct daily tasks. You take
her for a checkup and the doctor hits you with a staggering
blow: she is showing symptoms of dementia.*
What makes dementia confusing is that it is not actually
a disease, but rather a collection of symptoms that can be
caused by various diseases. The leading cause is Alzheimer’s
disease, but dementia can also develop due to brain damage
from an injury or stroke, and from other diseases such as
Parkinson’s and Huntington’s.
What might be even more confusing is trying to find
out how many people here in our little twin islands suffer
from this debilitating and incurable condition, and the costs
incurred by having the disorder, or having to take care of
someone who does. However, that is soon to change, thanks
to a project being done in collaboration with the HEU
Centre for Health Economics, and spearheaded by a team
of remarkable people from the Faculty of Medical Sciences,
Dr. Nelleen Baboolal, Senior Lecturer in Psychiatry, Dr.
Gershwin Davis, Senior Lecturer in Chemical Pathology,
and Professor Amanda McRae, Professor of Human
Anatomy. They are assisted by Professor Robert Stewart
(Institute of Psychiatry, King’s College London), who is a
founding member of the 10/66 dementia research group*.
The two-part project, titled the
Prevalence and
Economic Cost of Dementia Project in Trinidad and
Tobago
, has a fairly detailed history. It was officially launched
in April 2012, but the impetus for this particular study was
there long before. In 2003, the three project leads were
working on a project that focused on identifying biomarkers
for dementia. Most of the study cohort was comprised of
patients from Dr. Baboolal’s Memory Clinic, founded in
the same year. As the study progressed, one question was
repeatedly asked: “How prevalent is dementia in T&T?”
So whose idea was it to add another branch to the
tree? Prof. McRae says with a chuckle that it was probably
all three of them at the same time. They agree that their
individual, yet greatly similar interests in the disease brought
them all together for what Prof. McRae calls “the greatest
collaboration on the face of the earth” and what Dr. Davis
describes as “a fantastic merger, a perfect fit”. Both insist that
Dr. Baboolal was at the core of it all, given that the cause is
one “dear to her heart”, and the initial project began with her
Memory Clinic patients. Drs Baboolal, Davis and Professor
McRae have been working together for ten years and
together they form the Dementia Awareness and Research
Group of Trinidad and Tobago (DARTT).***
The prevalence study explores the multidisciplinary
nature and extent of dementia, as well as the cost of the
illness. In essence, the study seeks to establish the prevalence
of dementia and the associated risk factors amongst the
elderly population as well as evaluate the economic burden
of the illness on households. It only really took off in 2014,
as, with any good undertaking, there were a few “teething
problems”. However, these setbacks were taken in stride and
a pilot study in Mayaro/Rio Claro was conducted by a team
of five field workers in 2012. 13 persons in the age ranges 60-
69, 70-79, 80-89 and 90 and above were interviewed using
the 10/66 instrument and the socio-economic questionnaire.
This investigation allowed for the testing of the instruments
to be used in the actual study. The feedback was very
*
The Pan-American Health Organization (PAHO) defines dementia as a syndrome that a
estimates that the number of people living with dementia worldwide is currently esti
** The 10/66 Dementia Research Group is a collective of researchers carrying out populati
income countries.
*** DARTT is a voluntary non-profit which aims to educate the population, promote brain
on Alzheimer’s disease. Much more information on the study and the group’s other fas
Lost
Worlds
The disease that strips
you from yourself
STUDY TRACKS PREVALENCE AND COST OF DEMENTIA
Jhivan Pargass
discusses a fascinating new study coming out of UWI with
the Faculty of Medical Sciences’
Dr. Nelleen Baboolal
, Senior Lecturer in
Psychiatry,
Dr. Gershwin Davis
, Senior Lecturer in Chemical Pathology,
Professor Amanda McRae
, Professor of Human Anatomy, and
Professor
Robert Stewart
of the Institute of Psychiatry, King’s College London. As they
trace the prevalence and socio-economic cost of dementia in Trinidad and
Tobago, she learns that dementia is a complex collection of complications.
positive, which delighted the project leaders, as participants
were cooperative and expressed interest.
Toadequately explainwhy this study is so extraordinarily
important, we must first understand that the population of
Trinidad and Tobago is aging. Dr. Davis explains that one
of the main problems with aging is a change in the disease
pattern from one of viruses and communicable diseases, to
chronic non-communicable diseases, e.g. Alzheimer’s. With
the increase in the numbers of the elderly, a predicament
arises. But what is the extent of the problem? That’s the
question they’re trying to answer, and this is really the
driving force behind the study.
The results of many prevalence studies are readily
available, but these originate mainly from the developed
world, with few in the Caribbean.ThreeHispanic-Caribbean
countries, Cuba, Puerto Rico and the Dominican Republic,
have done such studies, but the DARTT study is the first of
its kind in Trinidad and in the English-speaking Caribbean,
which gives it even more weight. Prof. Stewart explains
that determining a central figure such as the prevalence
of dementia in Trinidad and Tobago is critical because for
the first time, it will provide the Government, and anyone
Dr Nelleen Baboolal
Dr Gershwin Dav
