Ageing, dementia and society - an epistemological perspective

Abstract

Recent data show that as populations age, the number of people affected by neurodegenerative dementia is growing at an epidemic pace in various regions of the world. This cross-cultural study examined the relationships among age, gender, ethnicity, religion, and education as well as the attitudes and perceptions related to ageing and dementia. A random sample of 980 participants was selected to represent the multicultural population of Singapore. Data were collected using standardised questionnaires through online portals and by conducting interviews. These data were ultimately analysed by comparing percentage responses and correlation coefficients and by conducting a multiple regression analysis. The results indicate that the perceptions and attitudes of individuals toward ageing and dementia differ among different age groups. Moreover, the level of education attained was significantly correlated with understanding dementia; regardless of education level, Christians had the most positive mindset toward dementia, although most religious individuals did not believe in divine healing. In this study, it was determined that attitudes and perceptions about ageing and dementia are influenced by multiple factors, such as education, age, and religion, and that it is imperative that younger generations develop coping strategies, including healthy lifestyles and social and/or religious communities to provide quality care to the elderly, in general, and to dementia patients, in particular.

Keywords: Aging; Belief; Culture; Dementia; Education; Psychology; Religion; Society.

Figure 1

Increasing longevity and decreasing fertility rates lead to an ageing population and the proliferation of age-related diseases. Multiple factors affect attitudes toward and perceptions of ageing and dementia.

Figure 2

The distribution of the sample population is categorised into different ethnic groups. Comprising Chinese (62.9 Percent), Indian (21.4), Malaysian (14.6 Percent), Caucasian (0.5 Percent) and Pakistani (0.6 Percent).

Figure 3

Random sample population of respondents from different religious backgrounds. They included Christianity (22.3 Percent), Islam (17.5 Percent), Hinduism (15.9 Percent), Buddhism (19.7 Percent), Freethought (19.6 Percent), Taoism (4.6 Percent), and Others (0.4 Percent).

Figure 4

The educational backgrounds of respondents. They included PSLE (8.4 percent), ‘O’ levels (10.8 percent), ‘A’ levels (9.3 percent), ITC/NITEC (2.3 percent), Diploma (13.4 percent), Bachelor’s (19.3 percent), Bachelor’s (honours) (30.7 percent), Master’s (4.1 percent), MD (0.1 percent), PhD (1.3 percent) and others (0.3 percent).

Figure 5

The responses of participants to the following statement: ‘I have heard of dementia’. The responses of participants from each of the ethnic groups were rearranged into a 3-point Likert subscale format of ‘disagree’, ‘not sure’ and ‘agree’. At least 70.8 percent of Chinese, 71.4 percent of Malaysians, 71.7 percent of Indians, 80.0 percent of Caucasians, and 50.0 percent of Pakistanis had heard of dementia, which suggests that the majority of the Singaporean population was aware of dementia.

Figure 6

Responses of participants to the following statement: ‘Ageing is a major risk factor for dementia’. When asked whether ageing is a major risk factor for dementia, no significant difference was observed between the responses of the ethnic groups. At least 47.3 percent of Chinese, 55.3 percent of Malaysian, 56.0 percent of Indians, 20.0 percent of Caucasians, and 33.3 percent of Pakistanis agreed that ageing is a major risk factor for dementia, whereas 15.6 percent of Chinese, 23.1 percent of Malaysians, 17.2 percent of Indians, 80.0 percent of Caucasians, and 33.3 percent of Pakistanis disagreed.

Figure 7

Participant responses regarding whether dementia patients should be placed in caretaking centres (homes). Participants were categorised according to their ethnic groups. Significant differences in the responses of participants were observed, with 69.9 percent of Chinese, 67.2 percent of Malaysians, 67.9 percent of Indians, 60.0 percent of Caucasians, and 83.3 percent of Pakistanis disagreeing with placing dementia patients in homes, whereas 11.8 percent of Chinese, 14.7 percent of Malaysians, 16.3 percent of Indians, 0.0 percent of Caucasians, and 0 percent of Pakistanis agreed with placing dementia patients in homes.

Figure 8

The responses of participants from different ethnic groups to the following statement: ‘Dementia patients should be taken care of by professionals instead of family members’. When asked whether professionals should be employed to care for dementia patients, there was no significant difference in responses across ethnic groups, with 43.5 percent of Chinese, 46.8 percent of Malaysians, 34.9 percent of Indians, 40.0 percent of Caucasians, and 33.4 percent of Pakistanis who disagreed with hiring professionals to care for dementia patients to some extent (instead of using family members) and 29.4 percent of Chinese, 36.4 percent of Malaysians, 46.9 percent of Indians, 20.0 percent of Caucasians, and 16.7 percent of Pakistanis who at agreed with the same proposition to some extent.

Figure 9

The responses of participants from different ethnic groups to the following statement: ‘A healthy lifestyle reduces the occurrence of dementia’. With respect to the effect of a healthy lifestyle on dementia, 42.8 percent of Chinese, 60.9 percent of Malaysians, 67.0 percent of Indians, 20.0 percent of Caucasians, and 83.3 percent of Pakistanis agreed that it reduces or prevents the occurrence of dementia. A higher percentage of Malaysians and Indians than Chinese thought that a healthy lifestyle reduces the occurrence of dementia. Of Caucasians, 60.0 percent disagreed with the proposition that a healthy lifestyle reduces or prevents dementia (which should be interpreted with caution, as the sample size is small).

Figure 10

The response distribution of participants from different religious backgrounds to the following statement: ‘I have heard of dementia’. Participants had different religious backgrounds, including Christianity, Islam, Hinduism, Buddhism, Freethought, Taoism, and others. A high percentage of participants from all religions were aware of dementia.

Figure 11

The responses of participants from different religious groups to the following statement: ‘Ageing is a major risk factor for dementia’. Christians (45.0 percent), Muslims (56.5 percent), Hindus (54.8 percent), Buddhists (50.5 percent), Freethinkers (46.6 percent), Taoists (44.4 percent), and others (100.0 percent) thought that ageing was a major risk factor for dementia (Figure 10), whereas other Christians (13.8 percent), Muslims (21.8 percent), Hindus (18.5 percent), Buddhists (21.1 percent), Freethinkers (12.4 percent), Taoists (17.8 percent), and others (0.0 percent) disagreed.

Figure 12

The responses of participants from different religious groups to the following statement: ‘Dementia patients should be placed in homes’. Although higher percentages disagreed, other Christians (12.4 percent), Muslims (12.9 percent), Hindus (16.6 percent), Buddhists (18.0 percent), Freethinkers (7.3 percent), Taoists (6.7 percent) and others (33.3 percent) agreed with the practice.

Figure 13

The responses of participants from various religious groups to the following statement: ‘Having a religion alleviates the effects of dementia’. Christians (33.5 percent), Muslims (40.0 percent), Hindus (24.8 percent), Taoists (17.8 percent), Buddhists (19.6 percent), Freethinkers (7.3 percent) and others (0.0 percent) agreed that religion helps to alleviate the effects of dementia. However, the remaining Christians (28.9 percent), Muslims (37.6 percent), Hindus (45.9 percent), Taoists (55.6 percent), Buddhists (50.0 percent), Freethinkers (63.2 percent) and others (33.3 percent) disagreed.

Figure 14

The responses of participants from different religious backgrounds to the following statement: ‘Having a religion reduces the probability of developing dementia in the future’. Some Christians (46.8 percent), Muslims (51.8 percent), Hindus (58.6 percent), Buddhists (59.3 percent), Freethinkers (82.9 percent), Taoists (68.9 percent) and others (66.7 percent) disagreed with the proposition that religion reduces the probability of developing dementia in the future, whereas other Christians (28.4 percent), Muslims (24.1 percent), Hindus (15.9 percent), Buddhists (16.5 percent), Freethinkers (3.1 percent), Taoists (13.3 percent) and others (0.0 percent) agreed.

Figure 15

The responses of participants from different religious backgrounds regarding whether they believed that dementia can be cured through divine healing, such as through prayer (‘Dementia can be cured through divine healing such as prayer’). Some Christians (34.9 percent), Muslims (21.8 percent), Hindus (15.9 percent), Buddhists (9.3 percent), Freethinkers (5.2 percent), Taoists (11.1 percent) and Others (0.0 percent) agreed with the proposition, whereas other Christians (34.8 percent), Muslims (51.2 percent), Hindus (62.4 percent), Buddhists (80.4 percent), Freethinkers (88.1 percent), Taoists (84.4 percent) and Others disagreed.

Figure 16

The responses of participants to the following statement: ‘A healthy lifestyle reduces the occurrence of dementia’. Some Christians (40.4 percent), Muslims (58.2 percent), Hindus (68.2 percent), Buddhists (56.2 percent), Freethinkers (35.2 percent), Taoists (46.7 percent), and others (66.7 percent) agreed, whereas other Christians (22.9 percent), Muslims (18.2 percent), Hindus (10.8 percent), Buddhists (19.1 percent), Freethinkers (24.9 percent), Taoists (24.4 percent), and others (33.3 percent) disagreed.

Figure 17

The responses of participants to questions concerning dementia. The responses and resulting scores ranging from 1 (strongly disagree) to 5 (strongly agree) were averaged and plotted as shown.

Figure 18

Participants were asked whether they thought ageing was a major risk factor for dementia. Participants were categorised according to their educational attainment: ‘Diploma and below’, ‘Undergraduate degree’ and ‘Postgraduate degree’. Of the respondents, 51.3 percent with a ‘Diploma and below’, 49.2 percent of those with an ‘Undergraduate degree’ and 50.0 percent of ‘Postgraduate degree’ holders agreed, whereas 22.2 percent of those with a ‘Diploma and below’ and 13.2 percent of ‘Undergraduate degree’ and 18.8 percent of ‘Postgraduate degree’ holders disagreed.

Figure 19

The distribution of the education-dependent responses of the participants to the following statement: ‘Religion reduces the probability of developing dementia in the future’. Participants with different educational levels are categorised as shown.

Figure 20

The distribution of the education-dependent responses of participants to the following statement: ‘Having a religion alleviates the effects of dementia’. Participants were categorised according to levels of educational attainment with respect to responses to the question of ‘disagree’, ‘not sure’ and ‘agree’.

Figure 21

This figure depicts the responses of participants to whether dementia can be cured by divine healing through prayer (‘Dementia can be cured by divine healing, such as through prayer’). The education level-dependent responses of participants are categorised according to educational attainment: ‘Diploma and below’, ‘Undergraduate degrees’ and ‘Postgraduate degrees’. ‘Strongly disagree’ and ‘agree’ responses were combined into a single subscale of ‘disagree’. ‘Strongly agree’ and ‘agree’ responses were combined into a single subscale of ‘agree’. The responses were as follows: 66.5 percent of individuals with a ‘Diploma and below’ and 62.3 percent of ‘Undergraduate degree’ and 56.3 percent of ‘Postgraduate degree’ holders do not believe that divine intervention is able to cure dementia.

Figure 22

The education-dependent responses of participants regarding whether a healthy lifestyle reduces the occurrence of dementia. Participants were categorised according to their level of educational attainment. The ‘Disagree’ bar represents the combination of the subscales ‘strongly disagree’ and ‘disagree’. The ‘Agree’ bar represents the combination of the subscales ‘strongly agree’ and ‘agree’. Affirmative responses were reported by 58.0 percent of individuals with a diploma or below and 43.9 percent of undergraduate degree and 68.8 percent of postgraduate degree holders.

Figure 23

The age-dependent responses of participants to the following statement: ‘I have heard of dementia’. The numbers of participants who ‘have not heard of it’, ‘not sure’ and ‘heard of it’ were calculated as percentages. It was found that 69.0 percent of the 19–30 age group, 62.0 percent of the 31–40 age group, 72.0 percent of the 41–55 age group, 88.7 percent of the 56–65 age group and 93.3 percent of the >65 age group were aware of dementia.

Figure 24

The age-dependent responses of participants to the following statement: ‘Ageing is a major risk factor for dementia’. The responses of participants were categorised into ‘disagree’, ‘not sure’ and ‘agree’. The results were as follows: 45.8 percent of the 19–30, 45.0 percent of the 31–40, 62.5 percent of the 41–55, 70.8 percent of the 56–65 and 40 percent of the >65 age groups thought that ageing was a major risk factor for dementia.

Figure 25

The age-dependent responses of participants to the following statement: ‘Having a religion reduces the probability of developing dementia in the future’. The responses were as follows: 60.9 percent of the 19–30 age group, 53.0 percent of the 31–40 age group, 51.9 percent of the 41–55 age group, 67.9 percent of the 56–65 age group and 80.0 percent of the >65 age group disagreed with the proposition.

Figure 26

The responses of participants to the following statement: ‘Dementia patients should be cared for by professionals instead of family members’. With 46.6 percent of the 19–30 age group, 33.0 percent of the 31–40 age group, 35.6 percent of the 41–55 age group, 33.0 percent of the 56–65 age group and 26.7 percent of the >65 age group disagreeing, and with 25.3 percent of the 19–30 age group, 42.0 percent of the 31–40 age group, 50.0 percent of the 41–55 age group, 60.4 percent of the 56–65 age group, and 66.7 percent of the >65 age group agreeing with this proposition.

Figure 27

The age-dependent percentage responses of participants to the following statement: ‘Dementia patients should be placed in homes. 73.1 percent of the 19–30 age group, 60.0 percent of the 31–40 age group, 63.5 percent of the 41–55 age group, 60.4 percent of the 56–65 age group and 60.0 percent of the >65 age group disagreed with the notion, whereas 6.9 percent of the 19–30 age group, 19.0 percent of the 31–40 age group, 25.0 percent of the 41–55 age group, 30.2 percent of the 56–65 age group, and 40.0 percent of the >65 age group agreed with this proposition.

Figure 28

Human beings’ cognitive functions and mindsets are controlled by various objective and subjective parameters that must be considered when evaluating human behaviour.