Neuropsychiatric symptoms among older adults living in two countries in Central Africa (EPIDEMCA study)

Abstract

Objectives Our study aimed at estimating the prevalence of neuropsychiatric symptoms and investigating associated factors among older adults living in two countries in Central Africa (Central African Republic [CAR] and Republic of Congo [ROC]). Methods The EPIDEMCA multicentre population‐based study was carried out in rural and urban areas of CAR and ROC between 2011 and 2012 among people aged 65 and over. After cognitive screening using the Community Screening Interview for Dementia, participants with low performances underwent neurological examination including the brief version of the Neuropsychiatric Inventory Questionnaire (NPI‐Q). Multivariate logistic regression analyses were performed to identify factors independently associated with neuropsychiatric symptoms in this population. Results NPI‐Q data were available for 532 participants. Overall, 333 elderly people (63.7%) reported at least one neuropsychiatric symptom. The prevalence of neuropsychiatric symptoms was 89.9% (95% CI, 84.6‐95.1) in participants with dementia, 73.4% (95% CI, 65.1‐81.7) in participants with mild cognitive impairment (MCI), and 48.7% (95% CI, 42.9‐54.6) in participants with no MCI nor dementia after neurological examination (P < 0.0001). The most common symptoms were depression, anxiety, and irritability. Participants living in Gamboma, with normal hearing and with friends in the community, were less likely to present neuropsychiatric symptoms. Physical disability, difficulties in eating, female sex, and dementia were significantly associated with neuropsychiatric symptoms. Conclusion Neuropsychiatric symptoms are common among older people with neurocognitive disorders in CAR and ROC. Our results confirm those from previous studies in Nigeria and Tanzania. Nevertheless, knowledge of these symptoms remains limited in sub‐Saharan Africa, hampering their appropriate management.

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

“…The increase in median scores of severity and distress might reflect the increase of the number of NPS according to the cognitive impairment and the severity of dementia as reported in our previous study . We can therefore confirm that the increase in the number of NPS among older PWD can increase the severity or distress score as previously reported in Nigeria and in Tanzania …”

“…The Epidemiology of Dementia in Central Africa (EPIDEMCA) study was a multicenter population‐based survey carried out in rural and urban areas of CAR and ROC between 2011 and 2012 including people aged 65 years and older. The detailed methodology was fully described elsewhere …”

“…The Geriatric Mental State was used to assess mental state alongside a structured questionnaire investigating sociodemographics, lifestyle, and medical history. In the second phase, participants with a CSI‐D cognitive score of 24.5 or lower underwent a neurological assessment including psychometric tests and evaluation of NPS …”

“…All the assessments were conducted in local languages. Translation of the questionnaires was performed following World Health Organization guidelines …”

“…In our previous study conducted in CAR and ROC, the prevalence of at least one NPS was 63.7% (95% confidence interval [CI] = 59.5‐67.8) among older people, and NPS appeared to be strongly associated with dementia (odds ratio [OR] = 7.7; 95% CI = 3.4‐17.5) . However, severity of the symptoms and distress were not reported.…”