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Beyene DA, Berha AB. Management Practice and Clinical Outcomes of Dementia in Sub-Saharan Africa: A Systematic Review. Behav Neurol 2023; 2023:2307443. [PMID: 37533682 PMCID: PMC10393511 DOI: 10.1155/2023/2307443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 06/03/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023] Open
Abstract
Background Dementia is a severe neurodegenerative disorder and it is a group of acquired symptoms associated with impaired cognitive functions. In low-income settings particularly in Sub-Saharan Africa (SSA), it is often seen as part of normal aging. Environmental, behavioral, and lifestyle interventions have the potential to alter the disease course of dementia. Objective This study is aimed to synthesize the literature/evidence(s) on the management practice and treatment outcomes of dementia in SSA. Method Comprehensive literature was searched in PubMed database, Cochrane Library, and Google Scholar. Eligibility has been set, and based on the criteria, initially, a total of 442 results were obtained, and from those around 183 articles were duplicated. After examining titles and abstracts of records 26 articles were identified. Finally, five randomized clinical trials (RCT) and three prospective cohort studies that were reported on the management practice and treatment outcome of dementia in SSA were eligible for analysis. RCT and prospective cohort studies were used to strengthen the quality of evidence. The quality of the included RCT studies was assessed by using the Cochrane Risk of Bias Tool. Result A total of 2781 patient data were included in the final analysis. Of these, 2354 patients were obtained from 5 RCTs and 427 patients from 3 prospective cohort studies, which were conducted in SSA countries. RCT studies were done on the feasibility and clinical effectiveness of cognitive stimulation therapy (CST) showed improvements in language memory domains and physical health. In addition, studies that focus on the management of human immunodeficiency virus-associated dementia (HIVAD) were reported to improve neurocognitively. Conclusion CST is applicable in low-resource settings and it shows improvements in cognitive function and quality of life. Early initiation of combination antiretroviral therapy in resource-limited settings has been associated with improvement in the cognitive function of HIVAD.
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Affiliation(s)
- Dessale Abate Beyene
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemseged Beyene Berha
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Stoner CR, Lakshminarayanan M, Mograbi DC, Vaitheswaran S, Bertrand E, Schimidt Brum P, Durgante H, Ferri CP, Mkenda S, Walker R, Dotchin C, Paddick SM, Chandra M, Krishna M, Du B, Shaji KS, Fisher E, Spector A. Development and acceptability of a brief, evidence-based Dementia Awareness for Caregivers course in low- and middle-income countries. DEMENTIA 2021; 21:598-617. [PMID: 34886707 PMCID: PMC8811332 DOI: 10.1177/14713012211055316] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Knowledge of and attitudes towards dementia vary across countries, and for caregivers in low- and middle-income countries (LMICs), access to information can be challenging. There is an urgent need for brief, easily accessible and culturally appropriate educational courses for caregivers of persons with dementia, providing much needed information whilst addressing important psychological concepts such as stigma. Methods An international and multidisciplinary team developed Dementia Awareness for Caregivers (DAC) courses in four stages: (1) scoping review and module agreement, (2) development of an International template (DAC-International) containing a standardised process for adding information, (3) development of local DACs using a standardised format and (4) acceptability of courses in Brazil, India and Tanzania. Findings The DAC-International was developed, comprising three modules: ‘What is dementia?’; ‘Positive engagement’ and ‘Caring for someone with dementia’. Three local versions were developed from this (DAC-Brazil, DAC-India and DAC-Tanzania), where additions of country-specific information included prevalent stereotypes and the addition of culturally relevant case studies. An initial field test was conducted in each country (n = 85), which indicated acceptability to participants. Conclusions The methods used here resulted in culturally valid and acceptable educational courses for carers of people with dementia. Future work will consist of large-scale, formal evaluations and the development of additional local courses.
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Affiliation(s)
- Charlotte R Stoner
- Centre for Chronic Illness and Ageing, Institute for Lifecourse Development, School of Human Sciences, University of Greenwich, London, UK
| | - Monisha Lakshminarayanan
- Dementia Care in Schizophrenia Research Foundation (DEMCARES in SCARF), Chennai, Tamil Nadu, India
| | - Daniel C Mograbi
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Brazil; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Sridhar Vaitheswaran
- Dementia Care in Schizophrenia Research Foundation (DEMCARES in SCARF), Chennai, Tamil Nadu, India
| | | | | | - Helen Durgante
- Psychology Department, Universidade Federal do Rio Grande (FURG), Rio de Janeiro, Brazil
| | - Cleusa P Ferri
- Department of Psychiatry, Universidade Federal de São Paulo, Brazil; Health Technology Assessment Unit, Hospital Alemão Oswaldo Cruz, Brazil
| | - Sarah Mkenda
- Occupational Therapy Department, Kilimanjaro Christian Medical University College, Tanzania
| | - Richard Walker
- Population Health Sciences Institute, Newcastle University, UK
| | - Catherine Dotchin
- Population Health Sciences Institute, Newcastle University, UK; North Tyneside General Hospital, Northumbria Healthcare National Health Service Foundation Trust, UK
| | - Stella-Maria Paddick
- Clinical and Translational Medicine, Newcastle University, Tyne and Wear, UK; Gateshead Health NHS Foundation Trust, UK
| | - Mina Chandra
- Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences (formerly Post Graduate Institute of Medical Education and Research) and Dr Ram Manohar Lohia Hospital, India
| | - Murali Krishna
- Foundation for Research and Advocacy in Mental Health (FRAMe), Mysore, India
| | - Bharath Du
- Foundation for Research and Advocacy in Mental Health (FRAMe), Mysore, India; Viveka Hospital, Mysore, India
| | | | - Emily Fisher
- Research Department of Clinical, Educational and Health Psychology, University College London (UCL), London, UK
| | - Aimee Spector
- Research Department of Clinical, Educational and Health Psychology, University College London (UCL), London, UK
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