Am J Geriatr Psychiatry. 2014 Dec;22(12):1613-22. doi: 10.1016/j.jagp.2014.02.004.

The prevalence of dementia subtypes in rural Tanzania.

Paddick SM1, Longdon A2, Kisoli A3, Gray WK4, Dotchin CL5, Jusabani A6, Iqbal A7, Hughes J8, Teodorczuk A8, Chaote P3, Walker RW9.
  • 1Institute of Ageing and Health, Newcastle University, Newcastle upon Tyne, United Kingdom; Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom.
  • 2South Devon Healthcare NHS Foundation Trust, Torquay, United Kingdom.
  • 3District Medical Office, Hai District Hospital, Boma’ngombe, Kilimanjaro Region, Tanzania.
  • 4Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom.
  • 5Institute of Ageing and Health, Newcastle University, Newcastle upon Tyne, United Kingdom; Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom. Electronic address: catherine.dotchin@nhct.nhs.uk.
  • 6Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
  • 7Institute of Neurosciences, Southern General Hospital, Glasgow, United Kingdom.
  • 8Institute of Ageing and Health, Newcastle University, Newcastle upon Tyne, United Kingdom.
  • 9Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom; Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom.

 

Abstract

OBJECTIVES: The prevalence of dementia is predicted to increase rapidly in developing countries. Vascular risk factors may contribute to this rise. Our aim was to estimate the proportions of Alzheimer’s disease (ADD) and vascular dementia (VAD) in a prevalent cohort of dementia cases in rural Tanzania.

DESIGN: A two-stage door-to-door dementia prevalence study.

SETTING: Hai district, Tanzania

PARTICIPANTS: In Phase I, the Community Screening Instrument for Dementia (CSI-D) was used to screen 1198 community-dwelling people for dementia. In Phase II, 168/184 (91.3%) of those with poor performance, 56/104 (53.8%) of those with intermediate performance and 72/910 (7.9%) of those with good performance on CSI-D were interviewed and diagnoses were made using the DSM-IV criteria.

MEASUREMENTS: For subtype diagnosis, DSM-IV dementia criteria plus NINCDS-ADRDA criteria were used for ADD and NINDS-AIREN criteria for VAD. Other dementias were diagnosed by international consensus criteria. Diagnoses were confirmed or excluded by computerised tomography where clinically appropriate.

RESULTS: Of 78 dementia cases, 38 (48.7%) were ADD and 32 (41.0%) were VAD. The crude prevalence of ADD was 3.7% (95% CI 2.5 to 4.9) and of VAD was 2.9% (95% CI 1.9 to 3.9). The age-adjusted prevalence was 3.0% (95% CI 1.8 to 4.2) for ADD and 2.6% (95% CI 1.6 to 3.6) for VAD. A previous diagnosis of diabetes mellitus was independently associated with greater odds of having VAD than ADD.

CONCLUSIONS: VAD accounted for a greater proportion of dementia cases than expected. Further investigation and treatment of risk factors is required in this setting.

KEYWORDS: Africa; Alzheimer disease; Dementia; Tanzania; prevalence; vascular dementia

PMID: 25134968

 

 

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