Shaji et al (Reference Shaji, Bose and Verghese2005) have estimated the prevalence of dementia in an urban population in Kerala, India and have provided a glimpse into the various factors associated with dementia in their study. A few methodological issues of the study need further clarification.

Although a cut-off score of 23 on the Mini-Mental State Examination (MMSE) was used for all the participants, a different cut-off score would have been appropriate among those who were illiterate (11.2%) as educational status has been shown to affect MMSE scores.

With no objective evidence to suggest hypertension in the participants other than the verbal account of the caregivers, the very high odds ratio for hypertension is misleading. Furthermore, with such a small number of individuals, the selection of the controls should have been more stringent. It would be advisable to take a larger number of controls for such a small sample of individuals with vascular dementia (n=22).

Although age has been shown to be a risk factor for dementia in many studies, how this conclusion was reached in this study is not clear.

There is a discrepancy in the number of patients reported as receiving treatment for Alzheimer's dementia (21 out of 31) compared with the total number of individuals with Alzheimer's dementia detected in the study (n=30).

Despite a few limitations, this study adds to the growing literature of the epidemiology of dementia in developing countries and would be helpful for healthcare planners for adequate resource allocation for preventive and curative services.