Alzheimer ’ s Disease Research in India : A Scientometric Analysis of Publications Output during 2002-11

Objectives: This study analyses the research output of India in Alzheimer’s disease research during 2002-11 on several parameters including the growth, rank and global publications share, citation impact, share of international collaborative papers and collaborative partner countries, sub-field wise distribution and productive institutions and author’s contribution and their impact and communication media. Methods: The Scopus Citation Database has been used to retrieve the data for 10 years (200211) by searching the keywords Alzheimer’s disease research in the combined Title, Abstract and


Introduction
Alzheimer's disease is a progressive neurological disease of the brain leading to the irreversible loss of neurons and the loss of intellectual abilities, including memory and reasoning, which become severe enough to impede social or occupational functioning.Alzheimer's disease is also known as simply Alzheimer's, and Senile Dementia of the Alzheimer Type (SDAT).Patients with Alzheimer's have a deficiency in the levels of some vital brain chemicals which are involved with the transmission of messages in the brain neurotransmitters.Alzheimer's disease is the most common form of dementia.There is no current cure for Alzheimer's, although there are ways of slowing down its advance and helping patients with some of the symptoms.Alzheimer's is also a terminal disease -it is incurable and causes death.Aloysius Alzheimer was a German neuropathologist and psychiatrist.He is credited with identifying the first published case of "presenile dementia" in 1906, which Kraepelin later identified as Alzheimer's disease -naming it after his colleague.Alzheimer's disease accounts for 50 to 80 percent of dementia cases 1 .Alzheimer's is the most common form of dementia in human population.Although affecting primarily older age groups (60+), symptoms can start appearing a bit earlier and are often ignored as age-related changes or stress disorders.This disease has been estimated to affect anywhere between 25 to 50 million people worldwide, though its prevalence is believed to be increasing due to changing lifestyle habits and exposure to environmental hazards.We are finding increased numbers of Alzheimer's cases in India like out of per 1,000 population almost 33 people are affected.The true prevalence of these diseases in our country has been difficult to estimate, though some studies suggest that there are about 37 lakh Indians affected by Alzheimer's at present 2 .It is estimated that the number of people suffering from Alzheimer's will double by 2030.Therefore, it is indeed a source of concern, and a concerted effort by government and private healthcare providers is required to create awareness and generate facilities for early and timely diagnosis, treatment and rehabilitation of these cases.Around 50-75% proportion of dementia cases in India are because of Alzheimer's disease 3 .
Few quantitative studies have been carried out in the area of Alzheimer's disease research.Mache et al 4 evaluates the scientific efforts in Alzheimer disease by analyzing 50030 publications from 1985 to 2008.Large scale data analysis, density equalizing algorithms and scientific methods were used to evaluate the quantity and quality of research achievements in this area.Sorenson 5 analyzed the role of Alzheimer's disease (AD) within neurosciences and presents the summary of the various research foci within the AD scientific community.It identifies the top 100 AD researchers and assesses their productivity and scientific impact.There are no specific studies available in the literature dealing with scientometric analysis of publications in the area of Alzheimer's disease research in country context.However, the various Indian scholars and the present authors have carried out similar studies in Indian context on other diseases such as diabetes 6 , tuberculosis 7 , malaria 8 , asthma 9 and typhoid 10

Objectives
The main objective of this study is to analyze the research performance of India in Alzheimer's disease research in national context, as reflected in its publications output during 2002-11.In particular, the study focuses on the following objectives: (i) To study the Indian research output, its growth, rank and global publications share and impact, (ii) To study the patterns of international collaboration and major collaborative partners, (iii) To study the publications productivity and impact of leading institutions and authors of India; and (iv) To study the media of communication.

Methodology and Database Used
This study is based on the Indian publication data in Alzheimer's disease research retrieved from the Scopus Citation database [http://www.scopus.com/search/]for the 10 years (2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011).The string used to retrieve the data in Alzheimer's disease research was developed using the Alzheimer* disease keyword in title, abstract and keywords and India in affiliation field becomes finally our main string.Similar strings were used to generate publications output data on top 20 countries.For citations data, three years, two year, one year and zero year citations window has been used for computing average citations per paper in Alzheimer's disease research during 2002-08, 2009, 2010 and 2011 respectively.(e.g. for the papers published during 2002, the total citations received by these papers during three years from 2002-2005 has been derived from the database.Similarly for papers published during 2003, the total citations received by these papers during three years from 2003-2006 has been derived from the database and so on).For searching and calculating the total international collaborative papers, a separate search strategy, which combines India's collaboration with 200 major countries, was prepared and this string was combined with the main string to generate India's total international collaborative output.For analyzing institutional, author and journals output, the separate search strategies for generating institutional, author and journal outputs were developed, which later combined with the main string to generate the desired output.

Analysis Global Publication Share & Rank
The global publication share of the top 20 most productive countries in Alzheimer's disease research varies from 0.98% to 37.21% during 2002-11.The United States tops the list, with a share of 37.21% during 2002-11.The United Kingdom ranks second (with 8.74% share), followed by Germany, Italy, Japan, China, France and Canada (with publications share ranging from 4.46% to 6.74%.Spain, Australia, Sweden, Netherlands and Sweden ranks at 9 th to 13 th positions (their global publications share ranging from 2.09% to 3.62%).The countries that fall between 14 h and 20 th positions are South Korea, Belgium, India, Brazil, Israel, Austria and Poland with their global publications share ranging from 0.98% to 1.70% (Table 1).

Table 1 . Publications Output, Share and Rank of Top 20 Countries in Alzheimer's Disease Research, 2002-11 S. No. Country Number of Papers Share of Papers Total Citations
).

Table 3 . Contribution of Major Collaborative Partners of India in Alzheimer's Disease Research during 2002-11
Total collaborating papers of India.In all collaborating papers of India, there are one or more foreign collaborating countries.As a result, the combined output of 15 foreign collaborating countries listed above in Indian international collaborative output will be more than its total international collaborative papers

Indian Alzheimer's Disease Research Output in Context of Different Subjects
_______________ B. M. Gupta and Adarsh Bala (2013), Research in Neurology: An International Journal, DOI: 10.5171/2013.204542

Table 4 . Subject-Wise Break-up of Indian Alzheimer's Disease Publications during 2002-11
Total of India in Alzheimer's disease research.There is some overlapping of literature under different subject fields.As a result, the combined output of India under 7 subject fields will be more than its total research output

Research Profile of Most Productive Indian Institutions in Alzheimer's Disease Research
_______________ B. M. Gupta and Adarsh Bala (2013), Research in Neurology: An International Journal, DOI:

Table 5 . Productivity & Impact of Top Twenty Indian Institutions in Alzheimer's Disease
Gupta and Adarsh Bala (2013), Research in Neurology: An International Journal, DOI: 10.5171/2013.204542

Table 7 : List of Most Productive Journals Publishing Indian Papers in Alzheimer's Disease, 2002-11 S.No Name of the Journal Number of Papers 2002-06 2007-11 2002-11
DOI:  10.5171/2013.204542in the country.The government must develop a strategy to respond to the growing need for care from early diagnosis to end of life care for Alzheimer's disease patients.The government should declare Alzheimer's disease as a national priority and sufficient budget should be provided for its care and research in the Five Year Plans of the Ministry of Health & Family Welfare.There is a need to increase the quantum of research efforts through extramural funding of all major Indian science agencies/departments. Education of the general public as well as training of health service providers and social services sector is required for early identification of the disease.Early identification of people involved with Alzheimer's disease and care training of such people should be made a core and substantial part of the training curriculum for physicians, other medical specialists, nurses, health workers and other non-specialist health workers.Existing Indian government policies and programmes do not adequately address issues and concerns of Alzheimer's disease patients; there is a need to be comprehensive and also evolve a strategy.There is a need to relook and review existing policies and laws for elders Alzheimer's disease patients and develop a new.The National Policy for Older Persons may be amended to include Alzheimer's disease patients.