Absztrakt
Background and Objective: Neurocognitive impairment is currently a major reason for neurological consultation in sub-Saharan Africa (SSA). Mild cognitive impairment (MCI) and dementia are the two most common subtypes.Identification of individuals with MCI is important because of high likelihood of developing dementia. The aim of this study was to document the pattern of and risk factors for cognitive impairment in a Nigerian community.
Methodology: The studytook place in Lalupon and utilized a door-to-door visit of homes covering the entire community. Eligible participants had face-to-face interviews to document their cognitive abilities using the Identification and Intervention for Dementia in Elderly Africans (IDEA) Cognitive Screen. Frequency counts, univariate analysis and multivariate logistic regression were carried out to document the pattern of impairment and identify variables associated with cognitive impairment
Result: One hundred and forty two (22.1%) participants had cognitive impairment. For subjects with MCI, praxis, 53 (37.6%), memory, 51 (35.9%) and abstract reasoning 38 (26.8%) were the most affected domains. Impairment in recall, abstraction, language fluency and praxis were independently associated with MCI (p < 0.05). Age and hypertension were associated with neurocognitive impairment (OR = 1.1 and 2.4 respectively). Regression analysis modelled for dementia showed that impaired recall and long term memory were independently associated with that diagnosis (OR: 6.0 & 6.5 respectively).
Conclusion: The frequency of neurocognitive impairment in the community was high with praxis, memory and abstract reasoning being the most affected domains. Age remains a consistent risk factor for neurocognitive impairment. Control of hypertension could reduce the risk of neurocognitive impairment in the elderly.
Keywords: Neurocognitive impairment, dementia, mild cognitive, impairment risk factors, Nigerian community
Résumé
Contexte et objectif: La déficience neurocognitive est actuellement uneraison principale de la consultation neurologique en Afrique subsaharienne (ASS). Ladéficiencecognitive légère (MCI) et la démence sont les deux soustypes les plus courants. L’identification des personnes atteintes de MCI est importante en raison de la probabilité élevée de développer une démence. Le but de cette étude était de documenter le modèle et les facteurs de risque de déficience cognitive dans une communauté Nigériane.
Méthodologie: L’étude a eu lieu à Lalupon et a utilisé une visite porte-à-porte des maisons, couvrant toute la communauté. Les participants admissibles ont eu des entrevues face à face pour documenter leurs capacités cognitives à l’aide de l’Ecran Cognitif d’Identification et d’Intervention pour la Démence chez les personnes âgées Africaines (IDEA). Les estimations de fréquence, l’analyse univariée et la régression logistique multivariée ont été effectués pour documenter le profil de déficience et identifier les variables associées à la déficience cognitive.
Résultat: Cent quarante-deux (22,1%) participants avaient une déficience cognitive. Pour les sujets atteints de MCI, praxis, 53 (37,6%), mémoire, 51 (35,9%) et raisonnement abstrait 38 (26,8%) ont été les domaines les plus touchés. Les déficiences dans le rappel, l’abstraction, la maîtrise du langage et la praxis ont été associées indépendamment au MCI (p <0,05). L’âge et l’hypertension étaient associés à une déficience neurocognitive (OR = 1,1 et 2,4 respectivement). L’analyse de régression modélisée pour la démence a montré que la défaillance du rappel et de la mémoire à long terme étaient indépendamment associés à ce diagnostic (OR: 6,0 et 6,5 respectivement).
Conclusion: La fréquence des troubles neurocognitifs dans la communauté était élevée avec la praxis, la mémoire et le raisonnement abstrait étant les domaines les plus touchés. L’âge demeure un facteur de risque constant de déficience neurocognitive. Le contrôle de l’hypertension pourrait réduire le risque d’atteinte neurocognitive chez les personnes âgées.
Mots-clés: Déficience neurocognitive, démence, facteur cognitif léger, facteurs de risque de déficience, communauté nigériane
Correspondence: Prof. A. Ogunniyi, Department of Medicine, Neurology Unit, College of Medicine, University of Ibadan, Ibadan, Nigeria. E-mailaogunniyi@comui.edu.ng
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