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

Introduction: 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. Methods: 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. Results: 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). Conclusion: 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.

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

International Psychogeriatrics ◽

10.1017/s1041610220003993 ◽

2021 ◽

Vol 33 (3) ◽

pp. 295-306 ◽

Cited By ~ 1

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.

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Religiousness, social support and the use of antidepressants among the elderly: a population-based study

Ciência & Saúde Coletiva ◽

10.1590/1413-81232018233.05922016 ◽

2018 ◽

Vol 23 (3) ◽

pp. 963-971 ◽

Cited By ~ 5

Author(s):

Adriano Roberto Tarifa Vicente ◽

Érico Castro-Costa ◽

Josélia de Oliveira Araújo Firmo ◽

Maria Fernanda Lima-Costa ◽

Antônio Ignácio de Loyola Filho

Keyword(s):

Social Support ◽

Mental Health Professionals ◽

Health Professionals ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Depressive Disorders ◽

The Elderly ◽

Population Based ◽

Community Dwelling ◽

Population Based Study

Abstract The purpose of the study was to investigate whether religiousness and social support were associated with the use of antidepressants among community-dwelling elders. The research involved 1,606 older adults who make up the cohort of Bambuí Project, a study on ageing and health. The dependent variable was the use of antidepressants in the last 90 days, and the exposures of interest were social support and religiousness. Logistic regression was used to test the associations and to estimate crude and adjusted Odds Ratio and their 95% confidence intervals. The chances of use of antidepressants were significantly lower among older people with higher level of religiosity (OR = 0.45; 95% CI: 0.29 to 0.70), but none of the descriptors social support was associated with the event. In this population, it is possible that religion occupies a prominent role in the arsenal of health problems coping strategies, especially mental. Health professionals attending this particular segment of the population (elderly people with depressive disorders) should consider religiousness of patients when the proposed guidelines and treatment in coping with their mental suffering.

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

Alzheimer s & Dementia ◽

10.1016/j.jalz.2017.06.1767 ◽

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

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

International Psychogeriatrics ◽

10.1017/s1041610220002306 ◽

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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Maternal intensive care unit admission as an indicator of severe acute maternal morbidity: A population-based study

10.21203/rs.2.22398/v1 ◽

2020 ◽

Author(s):

Charlotte Godeberge ◽

Catherine Deneux-Tharaux ◽

Aurélien Séco ◽

Mathias Rossignol ◽

Anne Alice Chantry ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Intensive Care Unit Admission ◽

Odds Ratio ◽

Maternal Morbidity ◽

Adjusted Odds Ratio ◽

Population Based ◽

Population Based Study ◽

Icu Admission ◽

Severe Acute Maternal Morbidity

Abstract Background Severe acute maternal morbidity, accounting for any life-threatening complication during pregnancy or after delivery, is a major issue in maternal health. Measuring and monitoring it seems critical for assessing the quality of maternal health care. We explored the relevance of maternal ICU admission as an indicator of severe acute maternal morbidity by characterizing, among maternal ICU admissions, the profile of women with severe acute maternal morbidity and their ICU stay, according to the association with other criterion of severe acute maternal morbidity. Methods Secondary analysis of a multiregional prospective population-based study of 2,540 women with severe acute maternal morbidity according to a multicriteria definition based on national experts’ consensus and including ICU admission. Results 511 women were admitted to an ICU during or up to 42 days after pregnancy (2.8 per 1,000 deliveries; 20.1% of women with severe acute maternal morbidity); 15.5% had no other severe acute maternal morbidity criterion. Among women with severe acute maternal morbidity, on multivariable multinomial analysis and adjusting for cause, the odd of intensive care unit admission with another morbidity criterion was increased for migrant from outside of Europe or Africa (adjusted odds ratio = 2.1 [95% CI 1.3-3.4]), with multiple gestation (adjusted odds ratio =1.5 [1.0-2.2]), and intrapartum cesarean (adjusted odds ratio =1.5 [1.1-2.2]). The odd of intensive care unit admission with no other morbidity criterion was increased with pre-existing medical conditions (adjusted odds ratio =2.2 [1.2-4.0]) and cesarean before labor (adjusted odds ratio =3.0 [1.4-6.1]). Women admitted to an ICU with no other morbidity criterion had no interventions for organ support. Conclusions Among women with severe acute maternal morbidity, one in five is admitted to an ICU; 15.5% of these have no other severe acute maternal morbidity criterion and their admission appears mostly indicated for continuous monitoring. The use of ICU admission alone as a single criterion morbidity is misleading to define severe acute maternal morbidity; this criterion needs to be refined to be included in the definition of severe acute maternal morbidity. These results also challenge the current organization of acute care for women with severe maternal morbidity.

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