Prevalence of Severe Neurocognitive Impairment and Its Association with Socio-Demographics and Functionality Among Ugandan Older Persons: A Hospital-Based Study

Atim, Letizia Maria; Kaggwa, Mark Mohan; Mamun, Mohammed A.; Ashaba, Scholastic; Maling, Samuel

doi:10.2147/cia.s319891

Cited by 5 publications

(8 citation statements)

References 56 publications

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“…This cross-sectional descriptive study was conducted in February 2021 among older adults aged 60 years and above attending a referral hospital outpatient clinic in Uganda that attends approximately 600 older adults every month [6,25]. After receiving care for various ailments, elders were recruited by convenience sampling after obtaining written consent from the outpatient departments.…”

Section: Study Design Setting and Populationmentioning

confidence: 99%

“…Financial abuse in this study was associated with increasing age above 80 years because individuals above 80 years are more vulnerable to abuse. After all, they are at higher risk of neurocognitive disorders and functional dependence, which makes them unable to manage their finances or forget to request financial assistance [6]. They may also be more likely to make poor financial decisions and fall victim to fraudulent deals [41].…”

Section: Financial Abusementioning

confidence: 99%

“…However, the increasing older adult population faces physical and mental health challenges, including older persons/elder abuse [4]. For instance, in Uganda, older persons face multiple challenges, including poverty, poor health, unemployment, chronic ill-health, HIV/ AIDS, lack of social security systems, low land productivity, political instability, low agricultural returns, and functional inability [5][6][7][8]. Culturally, in Uganda, older people were highly respected; younger people and children would even kneel to greet them, and were considered a symbol of knowledge and power, but all has changed in recent years mainly due to cultural dilution [5].…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with elder abuse and neglect in rural Uganda: A cross-sectional study of community older adults attending an outpatient clinic

et al. 2023

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Background Elderlies are vulnerable to abuse, and evidence suggests that one in three elderlies experience abuse. Abuse can impact the well-being of older persons, decreasing their quality of life, leading to mental health challenges, and increasing morbidity and mortality rates. Evidence on older person/elder abuse and neglect is vital to facilitate initiatives, but there are fewer studies on elder abuse and neglect in Africa, particularly in Uganda. Thus, this study aimed to determine the prevalence of different types of abuse and neglect, and their associated factors among older persons (aged 60 years and above) attending an outpatient clinic. Methods In this cross-sectional study, information on sociodemographic characteristics, functional impairment using the Barthel Index, and elder abuse severity using the Hwalek-Sengstock Elder Abuse Screening Test were collected. In addition, types of abuse were assessed using questions adapted from the US National Research Council on elder mistreatment monograph. Linear and logistic regression analyses were used to determine the factors associated with elder abuse severity and the different types of abuse, respectively. Results Overall, the prevalence of elder abuse was 89.0%. Neglect was the most common type of elder abuse (86%), followed by emotional abuse (49%), financial abuse (46.8%), physical mistreatment (25%), and sexual abuse (6.8%). About 30.4% of the abused elders experienced at least two forms of abuse. Factors associated with elder abuse severity were having a secondary level of education and physical impairment. Moderate to severe functional dependence was associated with almost all forms of abuse. Individuals who reported the presence of a perpetrator were likely to experience neglect, emotional, and physical mistreatment. However, those who reported their perpetrators to the police had a higher likelihood of experiencing emotional abuse but were less likely to experience financial abuse. Emotional abuse was also associated with age above 80 years and attaining education (primary and secondary). Physical impairment and chronic medical conditions reduced the likelihood of experiencing neglect and financial abuse, and physical abuse, respectively. Conclusions Uganda has a high prevalence of elder abuse and neglect. There is a need to design interventions for older adults at risk to prevent elder abuse from escalating further, where the present findings can be worthy of help.

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Section: Study Design Setting and Populationmentioning

confidence: 99%

Section: Financial Abusementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors associated with elder abuse and neglect in rural Uganda: A cross-sectional study of community older adults attending an outpatient clinic

et al. 2023

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“…These observations are consistent with previous reports from Uganda and beyond. [ 20 , 21 , 30 , 31 ] In this study, all cases of seizures were reported in patients with cognitive deficits.…”

Section: Discussionmentioning

confidence: 96%

“…Among older persons in western Uganda, severe cognitive impairment was observed in 28% of the participants. [ 30 ] Another study from rural Uganda reported a dementia prevalence of 20% among the general population of persons older than 60 years. [ 31 ] On the other hand, Mukisa and colleagues reported a 20% prevalence of dementia among patients who recently recovered from stroke.…”

Section: Discussionmentioning

confidence: 99%

Cognitive functioning and prevalence of seizures among older persons in Uganda: A hospital-based, cross-sectional study

et al. 2022

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There is limited data on the prevalence of seizures and dementia among older persons in Uganda. We evaluated cognitive functioning, and the prevalence and factors associated with seizures among older persons attending an outpatient medical clinic in Uganda. We randomly selected older adults (60 years and above) attending Kiruddu National Referral Hospital medical outpatient clinics between October 2020 and March 2021. We excluded individuals with a history of head injury, brain tumors, mental retardation, co-morbidity with HIV and patients who have had recent brain surgery. Cognitive functioning was assessed using the Identification for Dementia in Elderly Africans (IDEA) tool. We enrolled 407 participants, with a median (inter-quartile range) age of 67 (64–73) years. Majority were female (n = 292, 71.7%). The prevalence of seizure was 1.5% (95% confidence interval [CI]: 0.7–3.3). All 6 participants reported generalized tonic-clonic seizure type. Self-reported seizure was associated with being female (adjusted prevalence ratio [aPR]: 0.79, 95%CI: 0. 67–0.93, P = .02) and residing in Mukono district (aPR: 17.26, 95%CI: 1.64–181.55, P = .018). Overall, 114 (28.1%) participants had cognitive deficit; 9 (2.2%) dementia and 105 (25.9%) impaired cognition. Cognitive deficit was independently associated with female gender (aPR: 0.61, 95%CI: 0.44–0.85, P = .003), formal employment (aPR: 0.53, 95%CI: 0.35–0.81, P = .003), age 70–74 (aPR: 1.69, 95%CI: 1.00–2.86, P = .049), and ≥ 75 years (aPR: 2.81, 95%CI: 1.71–4.61, P = .001). Prevalence of seizures among participants with cognitive deficit was 5.3% (6/114). Among older persons attending a medical clinic in Uganda, almost one-third had cognitive deficit with seizure prevalence being higher among these individuals.

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Prevalence of dementia and its association with central nervous system infections among older persons in northern Uganda: cross-sectional community-based study

Benyumiza,

Kumakech,

Gutu

et al. 2023

BMC Geriatr

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Background Dementia is a condition in which there is deterioration in cognitive function beyond what might be expected from the usual consequence of biological aging. Few studies have been conducted on the prevalence of dementia and its association with central nervous system (CNS) infections among older persons in African settings, particularly in Uganda. Therefore, this study assessed the prevalence of dementia and its association with CNS infections among older persons in Lira District, northern Uganda. Methods This was a cross-sectional community-based study in Lira district northern Uganda. The study was conducted in March 2022 among 434 older persons aged 50 and above years who were selected by multistage sampling. Data were collected using an interviewer-administered questionnaire supplemented with information from participant’s medical records and a brief community screening instrument for dementia. The instrument classifies dementia into unlikely, probable or possible dementia. Data were entered in duplicate into EpiData version 3.0, then transferred to Statistical Package for Social Sciences (SPSS) version 23 for statistical analysis. Results Our study found almost one in four (23%) of the older persons in Lira district northern Uganda were suffering from probable or possible dementia. Our study further found that older persons in Lira district northern Uganda with a positive history of central nervous system infections (CNS) had nearly five times higher odds of having probable or possible dementia compared to their counterparts (cOR: 4.5; 2.76–7.23; p ≤ 0.001). Being in advanced age of 70 + years (aOR: 2.6; 1.6–4.3; p ≤ 0.001), positive history of CNS infection particularly Herpes simplex virus-1 (aOR: 5.4; 1.4–20.5; p = 0.013), and chronic headache (aOR: 1.9; 1.1–3.1; p = 0.019) were independent predictors of probable or possible dementia among participants in this study. Conclusion and recommendations Dementia is a common condition among older persons in Lira district northern Uganda with a prevalence of 23% in our study. Older persons with a positive history of CNS infection had higher odd of developing dementia compared to their counterparts. Having advanced age, cerebral malaria, Herpes simplex virus − 1 (HSV-1) infections, and chronic headache were independent predictors for dementia. These results imply that health assessment for the risk of dementia should include screening for history of CNS conditions particularly cerebral malaria, HSV-1 and chronic headache.

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Prevalence of Severe Neurocognitive Impairment and Its Association with Socio-Demographics and Functionality Among Ugandan Older Persons: A Hospital-Based Study

Cited by 5 publications

References 56 publications

Factors associated with elder abuse and neglect in rural Uganda: A cross-sectional study of community older adults attending an outpatient clinic

Factors associated with elder abuse and neglect in rural Uganda: A cross-sectional study of community older adults attending an outpatient clinic

Cognitive functioning and prevalence of seizures among older persons in Uganda: A hospital-based, cross-sectional study

Prevalence of dementia and its association with central nervous system infections among older persons in northern Uganda: cross-sectional community-based study

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