| Popis: |
Background: As the elderly population in Britain continues to grow, so will the number of people with dementia. Notably, those affected will include an increasing proportion of people from black and minority ethnic (BME) communities, as they too are reaching old age in large numbers. Preliminary studies indicate that African-Caribbean people may be at higher risk of developing dementia than the indigenous, white older population, although the findings are inconclusive. It has also been hypothesised that an excess of dementia in this group may be related to an increased risk of hypertension and its ineffective detection or treatment. Hypertension and diabetes, also common in African-Caribbean people, are established risk factors for cerebrovascular disease and dementia. However, despite these findings, it has been observed that people from BME groups, including those of African-Caribbean descent, may be less likely to have their dementia treated with an equitable level of resources. Aims and Hypotheses: The aim of this study is to enhance our knowledge regarding dementia and its risk factors in older African-Caribbean people in Britain. It tests the primary hypothesis that the prevalence of dementia is higher in the African-Caribbean, than the white British-born older population, using General Practice lists in the London Borough of Haringey as sampling frames. The study also tests the secondary hypothesis, that dementia in African-Caribbean people is under-recognised in primary care and that the rate of referral to specialist dementia services is lower than that in the white-British population. Methods: The study comprises a comparative cross-sectional and a medical notes survey. Five General Practices were recruited in Haringey, North London. From their practice lists, 218 African-Caribbean people and 218 white-British people aged \geq 60 years were recruited and screened for cognitive impairment using culturally valid versions of the Mini Mental State Examination (MMSE). Those in either group who screened positive (scoring |
