CSI Holdsworth Memorial Hospital, Mysore
MRCPsych Royal College of Psychiatrists, United Kingdom
Ageing in inevitable. While the majority age healthily, disease and disability in late life are common. During my formative years in the medical school, I was struck by the health inequalities that older adults face. My training in geriatric psychiatry in the UK provided me with necessary skills and competencies in assessment and management of older adults with dementia and associated co morbidities. As a trainee in psychiatry, I had closely followed the work of 10/66 Dementia Research Group in low and middle income countries. Recent findings by this research group have renewed the interest in early life origins of late life cognitive impairment. I was keen to examine this in Indian population where late life cognitive impairment is a leading cause of disability and burden. The Mysore birth cohort in South India (established by CSI Holdsworth Hospital in Collaboration with Medical Research Council, UK) to examine early life origins of adult cardiometabolic disorder provided me with a rare and unique opportunity to develop my fellowship.
Moving out of traditional boundaries of a clinician from the UK to public health research in India meant crossing disciplines and continents, which nevertheless has been a challenging task. My passion to work with the disadvantaged elderly in India, to make a meaningful difference to their life, gave me the necessary impetus and strength to achieve this in a relatively short period.
India is experiencing a phenomenal increase in adult cardio-metabolic disorders, a trend attributed to widespread intra-uterine and infant growth retardation and recent economic transition. These disorders in adult life increase the risk of cognitive impairment in old age where co-morbidity with chronic non-communicable disorders is common. Despite the growing interest in chronic diseases in the elderly, there are few detailed data available on their prevalence, impact and developmental origins in the developing world.
My fellowship constitutes a unique opportunity to begin to chart the epidemiologic transition and its impact upon older persons in India. In addition to cognitive impairment, this cross-sectional survey includes ascertainment of mental disorders and other chronic conditions in late-life. As well as providing a rich baseline for studying the aetiology of cognitive decline in future follow-up studies, this will allow me to explore the relative, independent and interactive contributions of various chronic conditions to late-life cognitive functioning. I aspire to establish myself as an independent researcher in ageing generating evidence that will inform the development of public health services. I will effectively disseminate the findings from my research to raise awareness; inform evidence-based policymaking and service development for older people in India.