Profile of clinically-diagnosed dementias in a neuropsychiatric practice in Abeokuta, South-Western Nigeria

Abstract

Objective: Many subjects with dementia present primarily to neuropsychiatric practices because of behavioural and psychological symptoms (BPSD). This study reviewed the profile of clinically-diagnosed dementias and BPSD seen in a pioneer neuropsychiatric practice in Abeokuta, southwestern Nigeria over a ten year period (January1998 -December 2007). Methods: A review of hospital records of all patients with diagnoses of dementia or dementing illness using the ICD-10 criteria as well as specific diagnostic criteria for different dementia phenotypes. Associated BPSD, co-morbidities and treatments were also reviewed. Results: Out of a total of 240,294 patients seen over the study period, 108 subjects met clinical diagnostic criteria for probable dementia giving a hospital frequency of 45 per 100,000. Alzheimer's disease (AD) and Vascular dementia (VaD) were the predominant phenotypes seen in 62 (57.4%) and 18 (16.7%) subjects respectively. Others include mixed dementia (4 cases), frontotemporal dementia (4 cases), Lewy body dementia (3 cases), alcohol-related dementia (3 cases), PD dementia (1 case) and unclassifiable (13 cases). Apathy, night time behaviour, aberrant motor behaviour, agitation and irritability were the most common BPSD features, while hypertension was the most common co-morbidity. Neuroleptics, anticholinergics and anti-hypertensives were most commonly prescribed. Anticholinesterase inhibitors were sparingly used. Conclusion: Probable AD was the most prevalent dementia phenotype seen in this practice. Increased awareness of dementia and better utilization of specific treatments are needed among psychiatrists and primary care practitioners in Nigeria.

Behavioural and Psychological Symptoms in Dementia (BPSD) and Its Impact on Caregiver Burden

“…In the present study by using NPI-Q most common BPSD found was apathy (88%), followed by irritability (66%), appetite and change in eating pattern (57%). The findings are consistent with the studies performed earlier 11,12 In our study night time behaviour changes i.e. night time awakening, inability to sleep in night with frequent wandering and early morning awakening were also common.…”

Epidemiology of Dementia among the Elderly in Sub-Saharan Africa

“…The reported prevalence of dementia for hospital-based studies ranged from 0.05% at a neuropsychiatric practice in southwestern Nigeria (survey period 1998–2007) [45], to 8.87% at a geriatric center in Dakar, Senegal [51]. Further, dementia accounted for 6.90% of patients with acute confusional state in a hospital in Tanzania [48], while 74.00% of 305 patients who presented to a memory clinic in South Africa were diagnosed with dementia [53].…”

The prevalence and burden of behavioural and psychological symptoms of dementia in rural Tanzania

“…However, few data on the prevalence and presentation of BPS in SSA exist. The only other data from SSA were also collected in Nigeria and suggested that BPS were at least as common as reported in HICs (Amoo et al, 2011;Baiyewu et al, 2003;Baiyewu et al, 2012;Hendrie et al, 2000). The only other data from SSA were also collected in Nigeria and suggested that BPS were at least as common as reported in HICs (Amoo et al, 2011;Baiyewu et al, 2003;Baiyewu et al, 2012;Hendrie et al, 2000).…”