Dementia -associated mortality and its predictors among older adults in sub-Saharan Africa: results from a 2-year follow-up in Congo (the EPIDEMCA-FU study)

Harielle Samba, Maelenn Mari Guerchet, Bebene Ndamba-Bandzouzi, Pascal Mbelesso, Philippe Lacroix, J F Dartigues, Pierre-Marie Preux

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Abstract

Background: Between 2001 and 2012 we carried out a study of dementia prevalence in central Africa throughout the EPIDEMCA (Epidemiology of Dementia in Central Africa) programme.
Objective: To assess dementia related mortality among Congolese older people from the EPIDEMCA study after two years of follow-up.
Design: Longitudinal population-based cohort study.
Setting: Gamboma and Brazzaville, Republic of Congo.
Methods: Older participants were traced and interviewed in rural and urban Congo annually between 2012 and 2014. DSM-IV and NINCDS-ADRDA criteria were required for dementia diagnosis. Data on vital status were collected throughout the follow-up. Cox proportional hazards model was used to assess the link between baseline dementia diagnosis and mortality risk.
Results: Of 1,029 participants at baseline, 910 (88.4%) have a complete cognitive diagnosis. There were 791 participants (76.87%) with normal cognition, 56 (5.44%) with MCI, and 63 (6.12%) with dementia. After two years of follow-up, 101 (9.8%) participants had died. Compared to participants with normal cognition, mortality risk was more than 2.5 times higher among those with dementia (HR= 2.53, 95% CI: 1.42-4.49, p=0.001). Among those with dementia, only clinical severity of dementia was associated with an additional increased mortality risk (HR=1.91; CI 95%, 1.23-2.96; p=0.004). Age (per 5-year increase), male sex and living in an urban area were independently associated with increased mortality risk across the full cohort.
Conclusion: Among Congolese older adults, dementia is associated with increased mortality risk. Our results highlight the need for targeted health policies and strategies for dementia care in sub-Saharan Africa (SSA).
Original languageEnglish
JournalAge and Ageing
Early online date26 May 2016
DOIs
Publication statusE-pub ahead of print - 26 May 2016

Keywords

  • Dementia
  • Mortality
  • Older people
  • sub-Saharan Africa
  • Republic of Congo

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