Apolipoprotein E ϵ4 allele and neuropsychiatric symptoms among older adults in Central Africa (EPIDEMCA study)

2021 ◽  
Vol 33 (3) ◽  
pp. 295-306 ◽  
Author(s):  
Inès Yoro-Zohoun ◽  
Dismand Houinato ◽  
Philippe Nubukpo ◽  
Pascal Mbelesso ◽  
Bébène Ndamba-Bandzouzi ◽  
...  
Keyword(s):  
Older People ◽  
Apolipoprotein E ◽  
Urban Areas ◽  
Neuropsychiatric Symptoms ◽  
Central Africa ◽  
Complete Information ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Two Phase ◽  
Community Screening

AbstractObjectives:To evaluate the association between neuropsychiatric symptoms and apolipoprotein E (APOE) ϵ4 allele among older people in Central African Republic (CAR) and the Republic of Congo (ROC).Design:Multicenter population-based study following a two-phase design.Setting:From 2011 to 2012, rural and urban areas of CAR and ROC.Participants:People aged 65 and over.Measurements:Following screening using the Community Screening Interview for Dementia, participants with low cognitive scores (CSI-D ≤ 24.5) underwent clinical assessment. Dementia diagnosis followed the DSM-IV criteria and Peterson’s criteria were considered for Mild Cognitive Impairment (MCI). Neuropsychiatric symptoms were evaluated through the brief version of the Neuropsychiatric Inventory (NPI-Q). Blood samples were taken from all consenting participants before APOE genotyping was performed by polymerase chain reaction (PCR). Logistic regression models were used to evaluate the association between the APOE ϵ4 allele and neuropsychiatric symptoms.Results:Overall, 322 participants had complete information on both neuropsychiatric symptoms and APOE status. Median age was 75.0 years and 81.1% were female. Neuropsychiatric symptoms were reported by 192 participants (59.8%) and at least 1 APOE ϵ4 allele was present in 135 (41.9%). APOE ϵ4 allele was not significantly associated with neuropsychiatric symptoms but showed a trend toward a protective effect in some models.Conclusion:This study is the first one investigating the association between APOE ϵ4 and neuropsychiatric symptoms among older people in sub-Saharan Africa (SSA). Preliminary findings indicate that the APOE ϵ4 allele was not associated with neuropsychiatric symptoms. Further research seems, however, needed to investigate the protective trend found in this study.

Self-Reported Vision Impairment and Frailty among Older People with Low Cognitive Performance in Central Africa: EPIDEMCA Population-Based Study

2021 ◽  
pp. 1-7
Author(s):  
Antoine Gbessemehlan ◽  
Gilles Kehoua ◽  
Catherine Helmer ◽  
Cécile Delcourt ◽  
Achille Tchalla ◽  
...  
Keyword(s):  
Older People ◽  
Cognitive Performance ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Central Africa ◽  
Population Based ◽  
Vision Impairment ◽  
Sub Saharan Africa ◽  
Population Based Study ◽  
The Impact

<b><i>Introduction:</i></b> Very little is known about the impact of vision impairment (VI) on physical health in late-life in sub-Saharan Africa populations, whereas many older people experience it. We investigated the association between self-reported VI and frailty in Central African older people with low cognitive performance. <b><i>Methods:</i></b> It was cross-sectional analysis of data from the Epidemiology of Dementia in Central Africa (EPIDEMCA) population-based study. After screening for cognitive impairment, older people with low cognitive performance were selected. Frailty was assessed using the Study of Osteoporotic Fracture index. Participants who met one of the 3 parameters assessed (unintentional weight loss, inability to do 5 chair stands, and low energy level) were considered as pre-frail, and those who met 2 or more parameters were considered as frail. VI was self-reported. Associations were investigated using multinomial logistic regression models. <b><i>Results:</i></b> Out of 2,002 older people enrolled in EPIDEMCA, 775 (38.7%) had low cognitive performance on the screening test. Of them, 514 participants (sex ratio: 0.25) had available data on VI and frailty and were included in the analyses. In total, 360 (70%) self-reported VI. Prevalence of frailty was estimated at 64.9% [95% confidence interval: 60.9%–69.1%] and 23.7% [95% CI: 20.1%–27.4%] for pre-frailty. After full adjustment, self-reported VI was associated with frailty (adjusted odds ratio = 2.2; 95% CI: 1.1–4.3) but not with pre-frailty (adjusted odds ratio = 1.8; 95% CI: 0.9–3.7). <b><i>Conclusion:</i></b> In Central African older people with low cognitive performance, those who self-reported VI were more likely to experience frailty. Our findings suggest that greater attention should be devoted to VI among this vulnerable population in order to identify early frailty onset and provide adequate care management.

scholarly journals Association between mild cognitive impairment and dementia and undernutrition among elderly people in Central Africa: some results from the EPIDEMCA (Epidemiology of Dementia in Central Africa) programme

2015 ◽  
Vol 114 (2) ◽  
pp. 306-315 ◽  
Author(s):  
Sophie Pilleron ◽  
Pierre Jésus ◽  
Jean-Claude Desport ◽  
Pascal Mbelesso ◽  
Bébène Ndamba-Bandzouzi ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Elderly People ◽  
Central Africa ◽  
Cognitive Disorders ◽  
Binary Logistic Regression ◽  
Population Based ◽  
Two Phase ◽  
Cross Sectional ◽  
Community Screening

Several studies in Western countries have shown an association between cognitive disorders and low BMI or weight loss in elderly people. However, few data are available in Africa. We analysed the association between cognitive disorders and undernutrition among elderly people in Central Africa. A cross-sectional, multicentre, population-based study using a two-phase design was carried out in subjects aged 65 years and above in the Central African Republic (CAR) and the Republic of Congo (ROC). All subjects were interviewed using the Community Screening Interview for Dementia, and those with low performance were clinically assessed by a neurologist and underwent further psychometrical tests. Diagnostic and Statistical Manual-IV and Petersen's criteria were required for the diagnoses of dementia and mild cognitive impairment (MCI), respectively. Undernutrition was evaluated using mid-upper arm circumference (MUAC) < 24 cm, BMI < 18·5 kg/m2 and arm muscular circumference (AMC) < 5th percentile. Multivariate binary logistic regression models were used to estimate the associations. In CAR, MCI was associated with MUAC < 24 cm (OR 0·7, 95 % CI 0·4, 1·0) and dementia with BMI < 18·5 kg/m2 (OR 2·3, 95 % CI 1·6, 3·1), AMC < 5th percentile (OR 2·3, 95 % CI 1·1, 4·6) and MUAC < 24 cm (OR 1·8, 95 % CI 1·4, 2·4). In ROC, both MCI and dementia were associated with all markers of undernutrition, but only AMC < 5th percentile was significantly associated with MCI (OR 3·1, 95 % CI 1·9, 4·8). In conclusion, cognitive disorders were associated with undernutrition. However, further studies are needed to elucidate the relationship between MCI and undernutrition in CAR.

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

2019 ◽  
Vol 68 (1) ◽  
pp. 180-185 ◽  
Author(s):  
Inès Yoro‐Zohoun ◽  
Dismand Houinato ◽  
Philippe Nubukpo ◽  
Pascal Mbelesso ◽  
Bébène Ndamba‐Bandzouzi ◽  
...  
Keyword(s):  
Older People ◽  
Neuropsychiatric Symptoms ◽  
Central Africa

Cardiovascular health and near visual impairment among older adults in the Republic of Congo: a population-based study

2020 ◽  
Author(s):  
Antoine Gbessemehlan ◽  
Catherine Helmer ◽  
Cécile Delcourt ◽  
Farid Boumediene ◽  
Bébène Ndamba-Bandzouzi ◽  
...  
Keyword(s):  
Older Adults ◽  
Visual Acuity ◽  
Visual Impairment ◽  
Cardiovascular Health ◽  
Central Africa ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Logistic Regression Models ◽  
Sub Saharan

Abstract Background Visual impairment (VI) and determinants of poor cardiovascular health are very common in sub-Saharan Africa. However, we do not know whether these determinants are associated to VI among older adults in this region. This study aimed at investigating the association between the determinants of poor cardiovascular health and near VI among older adults living in Congo. Methods Participants were Congolese older adults aged ≥ 65 years included in EPIDEMCA-FU (Epidemiology of Dementia in Central Africa - Follow-up) population-based cohort. Near VI was defined as visual acuity &lt; 20/40 measured at 30 cm. Associations between determinants of poor cardiovascular health collected at baseline and near visual acuity measured at 1 st follow-up were investigated using multivariable logistic regression models. Results Among the 549 participants included, 378 (68.8% [95% Confidence Interval: 64.9%-72.7%]) had near VI. Of the determinants of poor cardiovascular health explored, we found that having high BMI ≥ 25 kg/m 2 (Odds Ratio= 2.15 [95% CI: 1.25–3.68]), diabetes (OR=2.12 [95% CI: 1.06–4.25]) and hypertension (OR=1.65 [95% CI: 1.02–2.64]) were independently associated with near VI. Conclusions Several determinants of poor cardiovascular health were associated to near VI in this population. This study suggests that promoting a good cardiovascular health could represent a target for VI prevention among older adults.

scholarly journals Pensions, consumption and health: evidence from rural South Africa

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Peter Lloyd-Sherlock ◽  
Sutapa Agrawal ◽  
Francesc Xavier Gómez-Olivé
Keyword(s):  
South Africa ◽  
Body Mass Index ◽  
Older People ◽  
Body Mass ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Food Scarcity ◽  
Sub Saharan ◽  
Food And Drink

Abstract Background Increasing numbers of older people in sub-Saharan Africa are gaining access to pension benefits and it is often claimed that these benefits promote healthy forms of consumption, which contribute to significant improvements in their health status. However, evidence to support these claims is limited. Methods The paper uses data for 2701 people aged 60 or over who participated in a population-based study in rural north-eastern South Africa. It analyses effects of receiving a pension on reported food scarcity, body mass index and patterns of consumption. Results The paper finds that living in a pension household is associated with a reduced risk of reported food scarcity and with higher levels of consumption of food and drink. The paper does not find that living in a pension household is associated with a higher prevalence of current smoking nor current alcohol consumption. However, the paper still finds that tobacco and alcohol make up over 40% of reported food and drink consumption, and that the correlation between reported food scarcity and body mass index status is imperfect. Conclusions The paper does not show significant associations between pension receipt and the selected risk factors. However, the context of prevalent obesity and high shares of household spending allocated to tobacco and alcohol call into question widely-made claims that pensions enhance healthy consumption among older people in low and middle-income countries.

[P3-547]: EARLY LIFE AND COGNITIVE RESERVE: ASSOCIATIONS WITH DEMENTIA AMONG OLDER PEOPLE IN CENTRAL AFRICA IN THE EPIDEMCA POPULATION-BASED STUDY

2017 ◽  
Vol 13 (7S_Part_24) ◽  
pp. P1187-P1188
Author(s):  
Maëlenn Guerchet ◽  
Sophie Pilleron ◽  
Bebene Ndamba Bandzouzi ◽  
Pascal Mbelesso ◽  
Jean-Pierre Clement ◽  
...  
Keyword(s):  
Older People ◽  
Early Life ◽  
Cognitive Reserve ◽  
Central Africa ◽  
Population Based ◽  
Population Based Study

Association between Stressful Life Events and Cognitive Disorders in Central Africa: Results from the EPIDEMCA Program

2015 ◽  
Vol 44 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Sophie Pilleron ◽  
Maëlenn Guerchet ◽  
Bébène Ndamba-Bandzouzi ◽  
Pascal Mbelesso ◽  
Jean-Francois Dartigues ◽  
...  
Keyword(s):  
Life Events ◽  
Stressful Life Events ◽  
Multinomial Logistic Regression ◽  
Central Africa ◽  
Cognitive Disorders ◽  
The Elderly ◽  
Population Based ◽  
Stressful Life ◽  
Community Screening ◽  
Logistic Regression Models

Background: Stressful life events (SLEs) are considered potential risk factors for cognitive disorders. Our objective was to investigate the association between SLEs and cognitive disorders among the elderly people in Central Africa. Method: A population-based study was conducted in the Central African Republic (CAR) and the Republic of Congo (ROC). Participants aged ≥65 were interviewed using the Community Screening Interview for Dementia. Those who performed poorly were clinically assessed by neurologists. DSM-IV and Petersen criteria were required for a diagnosis of dementia or mild cognitive impairment (MCI), respectively. SLEs were assessed through 18 questions about events that occurred during childhood, adulthood and late-life. Sociodemographic, vascular and psychological factors were also documented. Multivariate multinomial logistic regression models were used to estimate the associations. Results: MCI was positively associated with: the total number of SLEs (OR = 1.1, 95% CI: 1.0-1.2), the number of SLEs from the age of 65 (OR = 1.2, 95% CI: 1.0-1.3), the number of SLEs before the age of 16 among non-depressive participants (OR = 1.6, 95% CI: 1.2-2.2) and with a serious illness in a child experienced when the participant was aged 65 or more (OR = 2.8, 95% CI: 1.6-4.6). No association with dementia was observed. Conclusion: SLEs were positively associated with MCI but not dementia. More comprehensive studies are needed to further investigate this relationship.

scholarly journals 330 - Depression and Anxiety among Older people in Central Africa: Results of the EPIDEMCA population-based study

2020 ◽  
Vol 32 (S1) ◽  
pp. 89-89
Author(s):  
Maëlenn Guerchet ◽  
Antoine Gbessemehlan ◽  
Caroline Adou ◽  
Jean-Pierre Clément ◽  
Bébène Ndamba-Bandzouzi ◽  
...  
Keyword(s):  
Older People ◽  
Rural Areas ◽  
Psychiatric Symptoms ◽  
Central Africa ◽  
Diagnostic System ◽  
Population Based ◽  
Computer Assisted ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Population Based Study

Introduction:Depression and anxiety are two very common psychiatric disorders in late-life. They are markers of poor quality of life and are strongly associated with death among older people. Yet, few studies on these comorbidities have been conducted in the African population. This study aims to present the epidemiology of depression and anxiety among older people in Central Africa.Method:A cross-sectional population-based study was carried out in Republic of Congo (ROC) and Central African Republic (CAR) between 2011 - 2012 among older people aged ? 65 years (EPIDEMCA study). Data were collected using a standardized questionnaire and participants underwent a brief physical examination. Depression and anxiety symptoms were ascertained using a community version of the Geriatric Mental State (GMS-B3) and the Automated Geriatric Examination for Computer Assisted Taxonomy diagnostic system (AGECAT), probable cases were defined as having a GMS-AGECAT level of 3 or more. Logistic regression models were used to investigate the association between potential risk factors collected and each symptom.Results:Overall 2002 participants were included in the EPIDEMCA study (500 in Brazzaville and 529 in Gamboma in ROC, 500 in Bangui and 473 in Nola (473) in CAR). Median age of the participants was 72 years [interquartile range: 68 – 78 years] and females were mostly represented (61.8%). Prevalence was 38.1% (95% Confidence Interval: 35.9% - 40.2%) for depression, 7.7% (95% CI: 6.5% - 8.9%) for anxiety and 5.7% (95% CI: 4.6% - 6.7%) for the co-occurrence of both disorders. For all three outcomes, prevalence was significantly higher among females and in rural areas. Only depression increased with age. Preliminary analyses showed that female sex, living in a rural area, and living without a partner were associated with the three outcomes (Odds Ratios from 1.59 to 3.27; p<0.01). In-depth results regarding correlates of depression, anxiety and the co-occurrence of both will be presented.Conclusion:The prevalence of depression and anxiety was high among Central African older people. Evidence on the epidemiology of these common psychiatric symptoms are of importance for care management and also emphasize the need to maintain and/or strengthen social support around older people in the region.

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