title: Cognitive impairment and reduced quality of life among old-age groups in Southern Urban India: home-based community residents, free and paid old-age home residents.
abstract: OBJECTIVE
  The purpose of the study were (i) to screen for cognitive impairment using Mini-Mental Status Examination among three old-age groups based on dwelling types in Chennai, India i.e. residential paid old-age homes, residential free (charitable) homes and home-based community-dwelling residents; (ii) secondly to investigate factors (demographic, psychological, medical and disability) associated with cognitive impairment in the these old-age; (iii) third, to investigate the independent association between cognitive impairment and health-related quality of life (QOL) among elderly across aged care dwelling types.
  
  
  METHODS
  A total of 499 elderly from three old-age groups were interviewed in this cross-sectional study (173 elderly home-based community-dwellers, 176 paid-home and 150 free-home residents). All the participants were interviewed for their socio-economic condition, medical morbidity, self-reported worry and anxiety, disability and QOL.
  
  
  RESULTS
  42.7% free-home elderly residents were found to have cognitive impairment, whereas 32.4% of paid-home and 21.9% of community-dwelling elderly had cognitive impairment. The residents of free-home were less educated, had lower income and reported higher incidence of worry, anxiety, disability and poor QOL than community-dwelling or paid-home residents. Increasing age, low education, female gender, high blood pressure and disability were associated with cognitive impairment. Cognitive impairment had significant negative effect on their health-related QOL (b = -0.10, P = 0.01), independent of age, gender, education, chronic illness and dwelling type.
  
  
  CONCLUSIONS
  The burden of cognitive impairment was high in all aged-care dwelling types in urban India; with free charitable home residents being worse affected. Cognitive impairment was associated with disability and poor health-related QOL in these age-care settings.
authors.affiliation: From the Department of Social Work, Loyola College, University of Madras, Nungambakkam, Chennai 600 034, Tamil Nadu, India rsam_67@yahoo.co.uk.
authors.forename: R
authors.initials: R
authors.lastname: Samuel
authors.affiliation: Rural Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia.
authors.forename: C S
authors.initials: CS
authors.lastname: McLachlan
authors.affiliation: From the Department of Social Work, Loyola College, University of Madras, Nungambakkam, Chennai 600 034, Tamil Nadu, India.
authors.forename: U
authors.initials: U
authors.lastname: Mahadevan
authors.affiliation: Rural Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia.
authors.forename: V
authors.initials: V
authors.lastname: Isaac
mesh_terms: D000368:Aged; D060825:Cognitive Dysfunction / Q000453:epidemiology / Q000534:rehabilitation*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006707:Homes for the Aged / Q000191:economics; D006801:Humans; D057187:Independent Living; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011788:Quality of Life; D012111:Residence Characteristics; D012959:Socioeconomic Factors