Severity of Neuropsychiatric Symptoms and Distress in Dementia among Older People in Central Africa (EPIDEMCA Study).

Journal: Journal of the American Geriatrics Society

Volume: 68

Issue: 1

Year of Publication: 2020

Affiliated Institutions:  INSERM UMR, Tropical Neuroepidemiology, University of Limoges, Limoges, France. Department of Neurology, Brazzaville University Hospital, Brazzaville, Republic of the Congo. Inserm Research Centre U «Bordeaux Population Health», Bordeaux, France.

Abstract summary 

Neuropsychiatric symptoms are common in dementia. Limited data are available concerning their association with dementia in developing countries. Our aim was to describe the severity of neuropsychiatric symptoms among older people, evaluate the distress experienced by caregivers, and assess which neuropsychiatric symptoms were specifically associated with dementia among older adults in Central Africa.This study is part of the EPIDEMCA program, a cross-sectional multicenter population-based study.The EPIDEMCA program was conducted from November 2011 to December 2012 in urban and rural areas of the Central African Republic and the Republic of the Congo.Participants were older people (≥65 y) included in the EPIDEMCA program who underwent a neuropsychiatric evaluation. The sample included overall 532 participants, of whom 130 participants had dementia.Neuropsychiatric symptoms were assessed with the brief version of the Neuropsychiatric Inventory including the evaluation of severity and associated distress. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision, criteria were followed to diagnose dementia. A logistic regression model was used to identify associated neuropsychiatric symptoms.The prevalence of neuropsychiatric symptoms was 89.9% (95% confidence interval = 84.6-95.1) among people living with dementia. The overall median severity score for neuropsychiatric symptoms was 9 [interquartile range [IQR] = 6-12], and the overall median distress score was 7 [IQR = 4-10]. Overall median scores of both severity and distress were significantly increased with the number of neuropsychiatric symptoms, the presence of dementia, and dementia severity. Depression, delusions, apathy, disinhibition, and aberrant motor behavior were associated with dementia after multivariate analysis.This report is one of the few population-based studies on neuropsychiatric symptoms among older people with dementia in Sub-Saharan Africa and the first one evaluating the severity of those symptoms and distress experienced by caregivers. Individual neuropsychiatric symptoms were strongly associated with dementia in older people and require great attention considering their burden on populations. J Am Geriatr Soc 68:180-185, 2019.

Authors & Co-authors:  Yoro-Zohoun Houinato Nubukpo Mbelesso Ndamba-Bandzouzi Clément Dartigues Preux Guerchet

Study Outcome 

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Statistics
Citations :  Jost BC, Grossberg GT. The evolution of psychiatric symptoms in Alzheimer's disease: a natural history study. J Am Geriatr Soc. 1996;44(9):1078-1081.
Authors :  10
Identifiers
Doi : 10.1111/jgs.16234
SSN : 1532-5415
Study Population
Male,Female
Mesh Terms
Africa, Central
Other Terms
behavioral and psychological symptoms of dementia;cognitive disorders;dementia;neuropsychiatric symptoms;older adults
Study Design
Study Approach
Country of Study
Republic of the congo
Publication Country
United States