Factors Associated with Dementia Among Elderly People Living in Two Cities in Central Africa: The EDAC Multicenter Study

Article type: Research Article

Authors: Guerchet, Maëlenn^a | Mouanga, Alain M.^{a; b} | M'belesso, Pascal^{a; c} | Tabo, André^d | Bandzouzi, Bébène^e | Paraïso, Moussiliou N.^{a; f} | Houinato, Dismand S.^{a; g} | Cowppli-Bony, Pascale^h | Nubukpo, Philippe^{a; i} | Aboyans, Victor^{a; j} | Clément, Jean-Pierre^{a; i} | Dartigues, Jean-François^h | Preux, Pierre-Marie^{a; k; *}

Affiliations: [a] INSERM U1094, Tropical Neuroepidemiology, Limoges, France; University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, Limoges, France; CNRS FR 3503 GEIST, CHU Limoges, France | [b] Department of Psychiatry, Brazzaville University Hospital, Brazzaville, Congo | [c] Department of Neurology, Amitié Hospital, Bangui, Bangui, Central African Republic | [d] Department of Psychiatry, Bangui National Hospital, Bangui, Central African Republic | [e] Department of Neurology, Brazzaville University Hospital, Brazzaville, Congo | [f] Regional Institute of Public Health, Ouidah, Cotonou, Benin | [g] Abomey Calavi University, Faculty of Health Sciences, Neurological Teaching and Research Unit, Cotonou, Benin | [h] INSERM U897, Victor Segalen Bordeaux II University, Bordeaux, France | [i] Department of Memory Research, Limoges University Hospital, Esquirol Hospital, Limoges, France | [j] Department of Cardiology, Dupuytren University Hospital, Limoges, France | [k] Department of Medical Information and Evaluation, Clinical Research and Biostatistic Unit, University Hospital, Limoges, France

Correspondence: [*] Correspondence to: Pr. Pierre-Marie Preux, Institut de Neuroépidémiologie et de Neurologie Tropicale, Faculté de Médecine, 2 rue du Docteur Marcland, 87025 Limoges, France. Tel.: +335 55 43 58 20; Fax: +335 55 43 58 21; E-mail: [email protected].

Abstract: Risk factors for dementia in American and European countries have been well investigated. However, little research has been carried out in sub-Saharan Africa, where life events as well as environmental, socio-economic, and modifiable risk factors (i.e., cardiovascular risk factors) may differ. Two cross-sectional surveys were conducted in representative samples of the older general population living in Bangui (Central African Republic) and Brazzaville (Congo). Dementia was defined according to the DSM-IV criteria. Multivariate regression analyses were performed in order to identify independent factors associated with dementia. Among the 977 elderly Africans included in this analysis, 75 (7.6%) were diagnosed as having dementia. Increasing age, female gender, hypertension, a body mass index <18.5 kg/m2, depressive symptoms, and the lack of a primary education were significantly associated with dementia. Among life events, the death of one parent during childhood and recently having moved house were also associated with dementia. Beyond the usual risk factors for dementia, this study highlights the role of stressful events in low-income countries. Factors associated with dementia in African countries seem different from established factors in high-income countries and require further investigation.

Keywords: Africa, Alzheimer's disease, dementia, epidemiology, risk factors

DOI: 10.3233/JAD-2011-111364

Journal: Journal of Alzheimer's Disease, vol. 29, no. 1, pp. 15-24, 2012