Risk Factors, Behavioral Manifestations and Quality of Life in Dementia: Evidence from Caregiver Reports

Background/Objectives: Dementia represents a complex syndrome in which biological, psychological, social and cultural dimensions intersect. While the clinical course is well described, less is known about the lived experiences of families and caregivers in shaping patient trajectories. This study aimed to explore risk factors, behavioral manifestations and quality of life in dementia from an anthropological perspective, focusing on the interplay between comorbidities, cognition, lifestyle, cultural beliefs and caregiving contexts. Methods: We conducted a single-center, observational, cross-sectional study including 73 family caregivers of patients with clinically diagnosed dementia who accessed care at the Neurology–Psychiatry Department of the C.F.2 Clinical Hospital (Bucharest, Romania) between November 2023 and April 2024. Caregivers provided socio-demographic information and reported behavioral, lifestyle and relational aspects of their care recipients through an anthropological questionnaire. Descriptive and inferential analyses were performed to evaluate associations between cognitive performance, comorbidities, lifestyle and socio-cultural variables. Results: The mean age of patients was 79.2 ± 7.5 years (range 66–95) and most of them were female (71.2%). Multimorbidity was common, with an average of 2.22 ± 1.03 chronic conditions, dominated by neurologic (84.9%) and cardiovascular (68.5%) diseases. The mean body mass index (BMI) was 26.1 ± 3.8 kg/m², with men presenting higher values than women. MMSE scores averaged 11.47 ± 7 , with significantly lower values among older patients and those with lower education or income levels. Appetite and sleep disturbances were frequent and poorer appetite correlated with lower BMI and reduced physical activity. Disclosure of diagnosis was reported in 74% of cases, with highly variable reactions ranging from acceptance to denial, confusion and persistent sadness. Families frequently expressed worry, sadness or anxiety, with adaptation processes described as nonlinear and ambivalent. Cultural beliefs and spirituality played a salient role in shaping explanatory models and coping strategies, with many caregivers attributing importance to religious practices, alternative treatments or traditional explanations. Conclusions: Findings highlight that dementia in this Romanian cohort is shaped not only by age-related multimorbidity and cognitive decline but also by caregiving practices, socio-economic constraints and culturally grounded explanatory models. The results underscore the need for integrative approaches to dementia care that recognize the interplay between medical, social and cultural dimensions, aiming to improve both patient and caregiver quality of life.