Community-Based Dementia Screening Initiative in Brunei: Final Results

The objective was to expand community-based dementia screening across diverse settings in Brunei and evaluate the prevalence of risk factors, cognitive symptoms and factors associated with suspected cognitive impairment using the Mini-COG. Cross-sectional community screening was conducted across community and healthcare settings among adults aged 60 years and older, or aged 50 years and older with dementia risk factors. Participants completed a structured questionnaire on demographics, dementia risk factors and cognitive symptoms, followed by the Mini-COG. Multivariable logistic regression was used to examine factors associated with suspected cognitive impairment. A total of 1358 participants were included, with a median age of 60 years, and 63.5% were female. Two-thirds had hypertension, over half had hypercholesterolaemia and over one-third had diabetes mellitus. The most commonly reported symptoms were misplacing things (42.6%), forgetfulness (32.5%) and visuospatial difficulties (24.2%). Among those with symptoms, 14.5% reported worsening symptoms and 12.0% had impaired activities of daily living. From the Mini-COG, 14.4% had suspected cognitive impairment. Multivariable analysis revealed that older age (adjusted OR 1.06 per year, p < 0.001) and education level (adjusted OR 2.25 for primary versus tertiary, p = 0.007) were independently associated with Mini-COG impairment, while vascular risk factors showed no significant associations. Community-based dementia screening using a brief questionnaire and the Mini-COG was feasible across multiple settings in Brunei. There was a high prevalence of vascular risk factors and cognitive symptoms. Age and educational attainment were stronger predictors of abnormal Mini-COG results compared to vascular risk factors in this study. These findings support opportunistic screening in healthcare and community settings, and an emphasis on public education on dementia symptoms and risk reduction.