A longitudinal study of cognitive decline in rural Tanzania: rates and potentially modifiable risk factors
A longitudinal study of cognitive decline in rural Tanzania: rates and potentially modifiable risk factors
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DOI：
10.1017/s1041610217002861
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发表时间：
2018-09-01
影响因子：
7
通讯作者：
Walker, Richard W.
中科院分区：
文献类型：
--
作者：
Heward, Jessica;Stone, Lydia;Walker, Richard W.
背景：预计在未来几十年，撒哈拉以南非洲（SSA）的痴呆症患者人数将迅速增加。然而，我们对如何最好地降低人群中痴呆症风险的理解非常有限。作为在这种情况下制定干预策略以管理痴呆风险的第一步，我们调查了坦桑尼亚农村人口的认知能力下降率，并试图确定相关因素。方法：本研究在坦桑尼亚北部的农村海区进行。2014年，居住在六个村庄的65岁及以上的社区居民被邀请参加了一项认知筛查计划。来自6个村庄中的4个村庄的所有参与者在2年后进行了随访，并重新测试了认知功能。在基线和随访时，评估参与者的功能障碍、高血压和握力（作为虚弱的衡量标准）。在随访中，完成了视力、听力障碍、烟酒消费和中风临床评估的附加评估。结果：基线和随访数据为327人。在两年的随访中，50人的认知能力明显下降。未接受过正规教育、基线握力低、女性和随访时患有抑郁症与认知能力下降独立相关。结论：这是在SSA中进行的认知能力下降的首批研究之一。两年的下降率相对较高。未来的工作应侧重于识别认知能力下降的具体可改变的风险因素，以制定文化上适当的干预措施。
Background:The number of people living with dementia in sub-Saharan Africa (SSA) is expected to increase rapidly in the coming decades. However, our understanding of how best to reduce dementia risk in the population is very limited. As a first step in developing intervention strategies to manage dementia risk in this setting, we investigated rates of cognitive decline in a rural population in Tanzania and attempted to identify associated factors.Methods:The study was conducted in the rural Hai district of northern Tanzania. In 2014, community-dwelling people aged 65 years and over living in six villages were invited to take part in a cognitive screening program. All participants from four of the six villages were followed-up at two years and cognitive function re-tested. At baseline and follow-up, participants were assessed for functional disability, hypertension, and grip strength (as a measure of frailty). At follow-up, additional assessments of visual acuity, hearing impairment, tobacco and alcohol consumption, and clinical assessment for stroke were completed.Results:Baseline and follow-up data were available for 327 people. Fifty people had significant cognitive decline at two-year follow-up. Having no formal education, low grip strength at baseline, being female and having depression at follow-up were independently associated with cognitive decline.Conclusions:This is one of the first studies of cognitive decline conducted in SSA. Rates of decline at two years were relatively high. Future work should focus on identification of specific modifiable risk factors for cognitive decline with a view to developing culturally appropriate interventions.