title: Dementia in a tribal landlocked elderly population at high altitude: What explains the lower prevalence?
abstract: BACKGROUND
  Studies across the populations have suggested that dementia is differentially distributed with a lower prevalence in developing regions than the developed ones. A comparison in the prevalence of dementia across populations may provide an insight into its risk factors. Earlier, we reported on the prevalence of dementia in elderly population in migrant, urban, rural, and tribal populations. The present study was conducted with a view to estimating the prevalence of dementia in Tribal Landlocked Elderly Population at high altitude and therefore to draw some conclusions on the differential distribution of dementia across populations.
  
  
  METHODS
  A cross-sectional comprehensive two-phase survey of all residents aged 60 years and older was conducted. Phase 1 involved screening of all individuals aged 60 and above with the help of a cognitive screen specifically developed for the tribal population. Phase 2 involved clinical examination of individuals who were suspected of dementia as per the developed cognitive screening test.
  
  
  RESULTS
  The results revealed that six individuals out of a total of 481 studied above 60 years of age in the studied population scored between 17 and 23, thus qualifying as suffering from mild cognitive impairment. Importantly, none of the individuals above 60 years of age scored <17.
  
  
  CONCLUSIONS
  The current study is in conformity with our previous study conducted on urban, rural, and migrant areas of the state of Himachal Pradesh again emphasizing on dementia being rare in tribal populations and thereby pointing to the presence of some protective factors among tribal people.
authors.affiliation: Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.
authors.forename: Sunil Kumar
authors.initials: SK
authors.lastname: Raina
authors.affiliation: Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.
authors.forename: Vishav
authors.initials: V
authors.lastname: Chander
authors.affiliation: Department of Neurology, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Bhardwaj
keywords: Dementia; high altitude; prevalence; tribal