Population normative data for three cognitive screening tools for older adults in sub-Saharan Africa

ABSTRACT In sub-Saharan Africa (SSA),cognitive screening is complicated by both cultural and educational factors, and the existing normative values may not be applicable. The Identification of Dementia in Elderly Africans (IDEA) cognitive screen is a low-literacy measure with good diagnostic accuracy for dementia. Objective: The aim of this study is to report normative values for IDEA and other simple measures [i.e., categorical verbal fluency, the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) 10-word list] in representative community-dwelling older adults in SSA. Methods: Individuals aged ≥60 years resident in 12 representative villages in Kilimanjaro, Tanzania and individuals aged ≥65 years resident within three communities in Akinyele Local Government Area, Oyo State, Nigeria underwent cognitive screening. The normative data were generated by the categories of age, sex, and education. Results: A total of 3,011 people in Tanzania (i.e., 57.3% females and 26.4% uneducated) and 1,117 in Nigeria (i.e., 60.3% females and 64.5% uneducated) were screened. Individuals with higher age, lower education, and female gender obtained lower scores. The 50th decile values for IDEA were 13 (60–64 years) vs. 8/9 (above 85 years), 10–11 uneducated vs. 13 primary educated, and 11/12 in females vs. 13 in males. The normative values for 10-word list delayed recall and categorical verbal fluency varied with education [i.e., delayed recall mean 2.8 [standard deviation (SD) 1.7] uneducated vs. 4.2 (SD 1.2) secondary educated; verbal fluency mean 9.2 (SD 4.8) uneducated vs. 12.2 (SD 4.3) secondary educated], substantially lower than published high-income country values. Conclusions: The cut-off values for commonly used cognitive screening items should be adjusted to suit local normative values, particularly where there are lower levels of education.

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Prevalence and factors associated with poor self-rated health among community dwelling older adults in Lomé (Togo) in 2019

Journal of Public Health in Africa ◽

10.4081/jphia.2020.1302 ◽

2020 ◽

Vol 11 (1) ◽

Author(s):

Fifonsi Adjidossi Gbeasor-Komlanvi ◽

Martin Kouame Tchankoni ◽

Ama Boilassi Adjonko ◽

Wendpouire Ida Carine Zida-Compaore ◽

Nicolas Konan Kouakou ◽

...

Keyword(s):

Older Adults ◽

Cross Sectional Study ◽

Community Dwelling ◽

Sub Saharan Africa ◽

Cross Sectional ◽

Herbal Products ◽

Factors Associated ◽

Self Rated Health ◽

Sub Saharan ◽

Community Dwelling Older Adults

The number of older adults is increasing worldwide, including in sub-Saharan Africa (SSA). However, there is a paucity of data on the overall health status of older adults living in SSA. To assess the prevalence and factors associated with poor Self-Rated Health (SRH) among community-dwelling older adults in Lomé, Togo, we conducted a cross-sectional study from January to June 2019 in Lomé among community-dwelling older adults aged 50 years and older. A 30- minute questionnaire was used to collect socio-demographic characteristics, medical history, patterns of medication use and use of herbal products and dietary supplements during a face-to-face interview. SRH was assessed using a single item: Overall, you would say that your health is… (1) excellent, (2) very good, (3) good, (4) fair and (5) poor with response fair or poor defining poor SRH. A total of 344 respondents with median age 63 years, (IQR: 55-72) were enrolled in the study. Women represented 57.6% of the sample. Overall prevalence of poor SRH was 56.4% (95%CI: 51.0-61.9) and was the highest among females (62.6% vs 47.9%; P=0.007) and participants >60 years (61.5% vs 51.1%; P=0.021). Female sex, aged ≥60 years, osteoarthritis, hospitalization within the 12 months preceding the survey, polypharmacy, and the use of herbal products were factors associated with poor SRH (P<0.05). More than half of community- dwelling older adults had poor SRH in Lomé. Further studies are needed to guide policymakers in their efforts to design and implement meaningful policies to improve older adults health conditions.

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Ageing, urban marginality, and health in Ghana

Alberta Academic Review ◽

10.29173/aar102 ◽

2019 ◽

Vol 2 (3) ◽

pp. 11

Author(s):

Dominic A. Alaazi ◽

Devidas Menon ◽

Tania Stafinski ◽

Gian Jhangri ◽

Joshua Evans ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Survey Data ◽

Community Dwelling ◽

Life Assessment ◽

Sub Saharan Africa ◽

World Health ◽

Slum Dwellers ◽

Sub Saharan

The world’s population is rapidly ageing. Global estimates for the next three decades indicate a two-fold increase in the population of older adults aged ≥60 years. Nearly 80% of this growth will occur in low and middle-income countries in Asia and sub-Saharan Africa, where population health is already under threat from poverty, degraded environments, and deficient healthcare systems. Although the world’s poorest region, sub-Saharan Africa, ironically, will witness the fastest growth in older populations, rising by 64% over the next 15 years. Indications are that the majority of this population will live in resource-poor settings, characterized by deficient housing and neighbourhood conditions. Yet, very little research has systematically examined the health and wellbeing of older adults in such settings. Drawing on the ecological theory of ageing, the present study explores the living conditions and quality of life of elderly slum dwellers in Ghana, a sub-Saharan African country with a growing population of older adults. Data collection was undertaken in two phases in two environmentally contrasting neighbourhoods in Accra, Ghana. In Phase 1, we carried out a cross-sectional survey of older adults in a slum community (n = 302) and a non-slum neighbourhood (n = 301), using the World Health Organization quality of life assessment tool (WHOQoL-BREF). The survey data were complemented in Phase 2 with qualitative interviews involving a sample of community dwelling older adults (N = 30), health service providers (N = 5), community leaders (N = 2), and policymakers (N = 5). Preliminary analysis of the survey data revealed statistically significant differences in the social and environment domains of quality of life, while the qualitative data identified multiple health barriers and facilitators in the two neighbourhoods. Insights from the research are expected to inform health and social interventions for older slum dwellers in Ghana.

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Comparison between two tests of delayed recall for the diagnosis of dementia

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2006000100008 ◽

2006 ◽

Vol 64 (1) ◽

pp. 35-40 ◽

Cited By ~ 29

Author(s):

Leonel Tadao Takada ◽

Paulo Caramelli ◽

Helenice Charchat Fichman ◽

Cláudia Sellitto Porto ◽

Valéria Santoro Bahia ◽

...

Keyword(s):

Word List ◽

Roc Curves ◽

Educational Background ◽

Community Dwelling ◽

Cognitive Screening ◽

Delayed Recall ◽

Line Drawings ◽

Screening Battery ◽

Diagnosis Of Dementia ◽

Similar Accuracy

Diagnosis of dementia is a challenge in populations with heterogeneous educational background. OBJECTIVE: To compare the accuracies of two delayed recall tests for the diagnosis of dementia in a community with high proportion of illiterates. METHOD: The delayed recall of a word list from the CERAD battery (DR-CERAD) was compared with the delayed recall of objects presented as line drawings from the Brief Cognitive Screening Battery (DR-BCSB) using ROC curves. Illiterate (23 controls and 17 patients with dementia) and literate individuals (28 controls and 17 patients with dementia) were evaluated in a community-dwelling Brazilian population. RESULTS: The DR-BCSB showed higher accuracy than the DR-CERAD in the illiterate (p=0.029), similar accuracy in the literate individuals (p=0.527), and a trend for higher accuracy in the entire population (p=0.084). CONCLUSION: the DR-BCSB could be an alternative for the diagnosis of dementia in populations with high proportion of illiterates.

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Altruism, Volunteering and Cognitive Performance Among Older Adults: A 2-Year Longitudinal Study

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988720964260 ◽

2020 ◽

pp. 089198872096426

Author(s):

Jimilly Caputo Corrêa ◽

Maria Priscila Wermelinger Ávila ◽

Alessandra Lamas Granero Lucchetti ◽

Giancarlo Lucchetti

Keyword(s):

Older Adults ◽

Longitudinal Study ◽

Verbal Fluency ◽

Mini Mental State Examination ◽

Word List ◽

Community Dwelling ◽

Cognitive Tests ◽

Community Dwelling Older Adults ◽

State Examination

This study aims to investigate whether altruism and volunteering are associated differently with cognitive functioning in community-dwelling older adults. A 2-year longitudinal study of 291 Brazilian older adults was conducted. In the baseline analysis, altruism, but not volunteering, was associated with higher scores for the composite cognitive score, the Mini-Mental State Examination, the verbal fluency and the CERAD Recall. Concerning the longitudinal analyses, volunteering at baseline, but not altruism, was associated with verbal fluency and CERAD Word List Recall after 2 years of follow up. Same results were obtained while investigating changes in score. Altruism and volunteering were associated with cognitive tests, albeit in different ways. Volunteering, but not altruism, was associated with lower cognitive decline. However, altruism, but not volunteering, was associated with higher absolute score on these tests. These findings can further understanding of this new field of health research.

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Normative data for the Brief Cognitive Screening Battery stratified by age and education

Dementia & Neuropsychologia ◽

10.1590/1980-57642016dn11-010008 ◽

2017 ◽

Vol 11 (1) ◽

pp. 48-53 ◽

Cited By ~ 5

Author(s):

Mônica Sanches Yassuda ◽

Henrique Salmazo da Silva ◽

Thais Bento Lima-Silva ◽

Meire Cachioni ◽

Deusivania Vieira da Silva Falcão ◽

...

Keyword(s):

Verbal Fluency ◽

Normative Data ◽

Neurocognitive Disorders ◽

Community Dwelling ◽

Cognitive Screening ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test ◽

Screening Battery ◽

Low Educated

ABSTRACT Introduction: Diagnosing neurocognitive disorders is challenging in low-educated individuals. Objective: To report normative data for the Brief Cognitive Screening Battery (BCSB) and to assess the association of age and education with performance on the BCSB in 240 community-dwelling elderly from Ermelino Matarazzo, São Paulo city. Methods: The inclusion criteria were scoring above the education-adjusted cut-off points on the Mini-Mental State Examination (MMSE) and below six points on the Geriatric Depression Scale (GDS). Results: Age was associated with performance on the Naming, Incidental Memory, Verbal Fluency, Clock Drawing Test, Delayed Recall and Recognition subtests. Education was associated with performance on Naming, Recognition, Verbal Fluency and the Clock Drawing Test. Conclusion: The normative values reported are relevant for diagnosing neurocognitive disorders in low-educated elderly.

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Exploring the Association between Multimorbidity and Cognitive Impairment in Older Adults Living in the Community: A Review of the Literature

Home Health Care Management & Practice ◽

10.1177/10848223211030468 ◽

2021 ◽

pp. 108482232110304

Author(s):

Grace F. Wittenberg ◽

Michelle A. McKay ◽

Melissa O’Connor

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Assessment Tool ◽

Adult Population ◽

Home Health ◽

Adverse Outcomes ◽

Community Dwelling ◽

Cognitive Screening ◽

Review Of The Literature ◽

Increased Risk

Two-thirds of older adults have multimorbidity (MM), or co-occurrence of two or more medical conditions. Mild cognitive impairment (CI) is found in almost 20% of older adults and can lead to further cognitive decline and increased mortality. Older adults with MM are the primary users of home health care services and are at high risk for CI development; however, there is no validated cognitive screening tool used to assess the level of CI in home health users. Given the prevalence of MM and CI in the home health setting, we conducted a review of the literature to understand this association. Due to the absence of literature on CI in home health users, the review focused on the association of MM and CI in community-dwelling older adults. Search terms included home health, older adults, cognitive impairment, and multimorbidity and were applied to the databases PubMed, CINAHL, and PsychInfo leading to eight studies eligible for review. Results show CI is associated with MM in older adults of increasing age, among minorities, and in older adults with lower levels of education. Heart disease was the most prevalent disease associated with increased CI. Sleep disorders, hypertension, arthritis, and hyperlipidemia were also significantly associated with increased CI. The presence of MM and CI was associated with increased risk for death among older adults. Further research and attention are needed regarding the use and development of a validated cognitive assessment tool for home health users to decrease adverse outcomes in the older adult population.

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