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Wiese LK, Williams IC, Holt JK, Williams CL, Lingler J, Galvin JE, Schoenberg NE. Testing the 'Faith Moves Mountains model' to increase Alzheimer's disease awareness, detection, and diagnosis among rural, racially, and ethnically diverse older adults. Aging Ment Health 2024; 28:943-956. [PMID: 38127408 PMCID: PMC11144567 DOI: 10.1080/13607863.2023.2294062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES Racially and ethnically diverse populations have recently contributed to the majority of rural and small-town growth. Consequently, the disproportionately high risk and prevalence of Alzheimer's disease and related dementias (ADRD) among rural and minoritized older residents will likely increase. To address this threat, we tested the hypotheses that (1) a faith-based, resident-led approach would increase basic ADRD knowledge and diagnosis, and (2) older age, female gender, lower educational levels, and more years lived rural would predict number of referrals, new dementia diagnoses, and treatment. METHODS An adaptation of Schoenberg's Faith Moves Mountains model, previously successful in detection and management of other chronic illnesses in rural settings, guided this community-based participatory research. Local faith community members were trained as research assistants to recruit, administer surveys, conduct brief memory assessments, teach brain health strategies, and follow-up with residents. Outreaches were offered virtually during the pandemic, then in-person monthly at rotating church sites, and repeated ∼1 year later. RESULTS This rural sample was racially and ethnically diverse (74.5% non-White), with 28% reporting eight or less years of formal education. Findings included that referrals and years lived rural were significant and positive predictors of new ADRD treatments [(b = 3.74, χ2(1, n = 235) = 13.01, p < 0.001); (b = 0.02, χ2(1, n = 235 = 3.93, p = 0.048)], respectively, regardless of participant characteristics. CONCLUSION Resident-led action research in rural, diverse, faith communities is a successful approach to increasing ADRD disease knowledge, detection, diagnosis, and treatment.
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Affiliation(s)
- Lisa Kirk Wiese
- C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Ishan C Williams
- University of Virginia School of Nursing, Charlottesville, VA, USA
| | - Janet K Holt
- C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
- Southern Illinois University, Edwardsville, IL, USA
| | | | - Jennifer Lingler
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Boca Raton, FL, USA
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Dai Q, Ma Y, Liu C, Zhao R, Chen Q, Chen W, Wang X, Jiang X, Li S. Association of 8-hydroxy-2'-deoxyguanosine with motoric cognitive risk in elderly Chinese people: RUGAO longevity and aging cross-sectional study. BMC Geriatr 2024; 24:331. [PMID: 38605326 PMCID: PMC11007879 DOI: 10.1186/s12877-024-04943-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 04/03/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Motor cognitive risk syndrome (MCR) represents a critical pre-dementia and disability state characterized by a combination of objectively measured slow walking speed and subjective memory complaints (SMCs). This study aims to identify risk factors for MCR and investigate the relationship between plasma levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG) and MCR among Chinese community-dwelling elderly populations. METHODS A total of 1312 participants were involved in this study based on the data of the Rugao Longevity and Aging Study (RuLAS). The MCR was characterized by SMCs and slow walking speed. The SCCs were defined as a positive answer to the question 'Do you feel you have more problems with memory than most?' in a 15-item Geriatric Depression Scale. Slow walking speed was determined by one standard deviation or more below the mean value of the patient's age and gender group. The plasma of 8-OHdG were measured by a technician in the biochemistry laboratory of the Rugao People's Hospital during the morning of the survey. RESULTS The prevalence of MCR was found to be 7.9%. After adjusting for covariates, significant associations with MCR were observed in older age (OR 1.057; p = 0.018), history of cerebrovascular disease (OR 2.155; p = 0.010), and elevated 8-OHdG levels (OR 1.007; p = 0.003). CONCLUSIONS This study indicated the elevated plasma 8-OHdG is significantly associated with increased MCR risk in the elderly, suggesting its potential as a biomarker for early detection and intervention in MCR. This finding underscores the importance of monitoring oxidative DNA damage markers in predicting cognitive and motor function declines, offering new avenues for research and preventive strategies in aging populations.
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Affiliation(s)
- Qingqing Dai
- Department of Geriatrics, School of Clinical Medicines, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| | - Yajun Ma
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Chang Liu
- Department of Geriatrics, School of Clinical Medicines, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| | - Ruixue Zhao
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Department of Neurobiology, School of Basic Medical Science, Capital Medical University, Beijing, 100069, China
| | - Qi Chen
- Department of Geriatrics, School of Clinical Medicines, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| | - Weijia Chen
- Department of Geriatrics, School of Clinical Medicines, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| | - Xiaofeng Wang
- Human Phenome Institute and National Clinical Research Center for Aging and Medicine , Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoyan Jiang
- State Key Laboratory of Cardiology, Department of Pathology and Pathophysiology, School of Medicine, Tongji University, Shanghai, 200092, China.
| | - Shujuan Li
- Department of Neurology, FuWai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100037, China.
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Kassam F, Chen H, Nosheny R, McGirr A, Williams T, Ng N, Camacho M, Mackin R, Weiner M, Ismail Z. Cognitive profile of people with mild behavioral impairment in Brain Health Registry participants. Int Psychogeriatr 2023; 35:643-652. [PMID: 35130991 PMCID: PMC10063171 DOI: 10.1017/s1041610221002878] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Dementia assessment includes cognitive and behavioral testing with informant verification. Conventional testing is resource-intensive, with uneven access. Online unsupervised assessments could reduce barriers to risk assessment. The aim of this study was to assess the relationship between informant-rated behavioral changes and participant-completed neuropsychological test performance in older adults, both measured remotely via an online unsupervised platform, the Brain Health Registry (BHR). DESIGN Observational cohort study. SETTING Community-dwelling older adults participating in the online BHR. Informant reports were obtained using the BHR Study Partner Portal. PARTICIPANTS The final sample included 499 participant-informant dyads. MEASUREMENTS Participants completed online unsupervised neuropsychological assessment including Forward Memory Span, Reverse Memory Span, Trail Making B, and Go/No-Go tests. Informants completed the Mild Behavioral Impairment Checklist (MBI-C) via the BHR Study Partner portal. Cognitive performance was evaluated in MBI+/- individuals, as was the association between cognitive scores and MBI symptom severity. RESULTS Mean age of the 499 participants was 67, of which 308/499 were females (61%). MBI + status was associated with significantly lower memory and executive function test scores, measured using Forward and Reverse Memory Span, Trail Making Errors and Trail Making Speed. Further, significant associations were found between poorer objectively measured cognitive performance, in the domains of memory and executive function, and MBI symptom severity. CONCLUSION These findings support the feasibility of remote, informant-reported behavioral assessment utilizing the MBI-C, supporting its validity by demonstrating a relationship to online unsupervised neuropsychological test performance, using a previously validated platform capable of assessing early dementia risk markers.
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Affiliation(s)
- F. Kassam
- University of Calgary, Hotchkiss Brain Institute
| | - H. Chen
- University of Calgary, Hotchkiss Brain Institute
| | - R.L. Nosheny
- University of California, San Francisco, Department of Psychiatry
| | - A. McGirr
- University of Calgary, Department of Psychiatry
| | - T. Williams
- University of California, San Francisco, Departments of Radiology and Biomedical Imaging, Medicine, Psychiatry, and Neurology
| | | | - Monica Camacho
- University of California, San Francisco, Departments of Radiology and Biomedical Imaging, Medicine, Psychiatry, and Neurology
| | - R.S. Mackin
- University of California, San Francisco, Department of Psychiatry
| | - M.W. Weiner
- University of California, San Francisco, Departments of Radiology and Biomedical Imaging, Medicine, Psychiatry, and Neurology
| | - Z. Ismail
- University of Calgary, Hotchkiss Brain Institute
- University of Calgary, Department of Psychiatry
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Ogbuagu C, Uwakwe R, Kahn JG, Ogbuagu E, Emelumadu O, Okereke U, Okeke I, Chigbo G, Okoye O. Primary health care providers knowledge of dementia and cognitive assessment tools for elderly populations in Southeast Nigeria: A pilot survey. SAGE Open Med 2023; 11:20503121231204224. [PMID: 37846370 PMCID: PMC10576919 DOI: 10.1177/20503121231204224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 09/11/2023] [Indexed: 10/18/2023] Open
Abstract
Objectives Primary health care remains the widely available first point of medical care in Nigeria and in other low- and middle-income countries. Recognizing the rising prevalence of dementia in these settings, primary healthcare providers should be trained on cognitive assessment. However, little is known about the current Nigerian primary healthcare providers' knowledge of dementia, cognitive assessment tools, and use in elderly populations. The aim of this study was to evaluate primary healthcare providers' knowledge of dementia and cognitive assessment tools in Southeast Nigeria in preparation for the introduction of digital tablet-based assessment tool. Methods This is a cross-sectional mixed method descriptive pilot survey carried out in a comprehensive healthcare center affiliated with Nnamdi Azikiwe University Teaching Hospital. Fifty healthcare workers participated. Convenience sampling was employed involving all consenting primary healthcare providers in comprehensive healthcare center-Nnamdi Azikiwe University Teaching Hospital. A structured questionnaire was distributed for generation of both qualitative and quantitative data. Result The mean age of the 50 primary healthcare providers was 36.6 years, with females constituting 80%. Mean practice duration was 10.8 years. Their response on the mean age at which patients may need a cognitive assessment was reported as 52.8 years. Primary healthcare providers reported that dementia is associated with memory loss and can be genetically inherited. None of the respondents were familiar with Montreal cognitive assessment, or any form of tablet-based cognitive assessment tool. Most (86%) knew about the mini mental state examination. Conclusion Primary healthcare providers are deficient in knowledge of dementia Alzheimer's or cognitive assessment tools, and so they do not routinely carryout cognitive screening in elderly patients during clinic visits. It is important to train all cadres of primary healthcare staff on the use and benefit of cognitive assessment using culturally validated user-friendly tool to improve quality of care for the elderly population.
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Affiliation(s)
- Chukwuanugo Ogbuagu
- Comprehensive Health Center, Nnamdi Azikiwe University Teaching Hospital Neni, Neni, Anambra, Nigeria
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
| | - Richard Uwakwe
- Mental Health Unit, Department of Medicine, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Anambra, Nigeria
| | - James G Kahn
- Biostatistics and Epidemiology Department, University of California San Francisco, San Francisco, CA, USA
| | - Ekenechukwu Ogbuagu
- Family Medicine Department, Nnamdi Azikiwe University Teaching Hospital Neni, Neni, Anambra, Nigeria
| | - Obiageli Emelumadu
- Comprehensive Health Center, Nnamdi Azikiwe University Teaching Hospital Neni, Neni, Anambra, Nigeria
| | - Uzoma Okereke
- Comprehensive Health Center, Nnamdi Azikiwe University Teaching Hospital Neni, Neni, Anambra, Nigeria
| | - Irene Okeke
- Comprehensive Health Center, Nnamdi Azikiwe University Teaching Hospital Neni, Neni, Anambra, Nigeria
| | - Godswill Chigbo
- School of Public Health, University of Port-Harcourt, River State, Nigeria
| | - Obiora Okoye
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
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5
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Benyumiza D, Kumakech E, Gutu J, Banihani J, Mandap J, Talib ZM, Wakida EK, Maling S, Obua C. Prevalence of dementia and its association with central nervous system infections among older persons in northern Uganda: cross-sectional community-based study. BMC Geriatr 2023; 23:551. [PMID: 37697266 PMCID: PMC10496337 DOI: 10.1186/s12877-023-04174-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/15/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Dementia is a condition in which there is deterioration in cognitive function beyond what might be expected from the usual consequence of biological aging. Few studies have been conducted on the prevalence of dementia and its association with central nervous system (CNS) infections among older persons in African settings, particularly in Uganda. Therefore, this study assessed the prevalence of dementia and its association with CNS infections among older persons in Lira District, northern Uganda. METHODS This was a cross-sectional community-based study in Lira district northern Uganda. The study was conducted in March 2022 among 434 older persons aged 50 and above years who were selected by multistage sampling. Data were collected using an interviewer-administered questionnaire supplemented with information from participant's medical records and a brief community screening instrument for dementia. The instrument classifies dementia into unlikely, probable or possible dementia. Data were entered in duplicate into EpiData version 3.0, then transferred to Statistical Package for Social Sciences (SPSS) version 23 for statistical analysis. RESULTS Our study found almost one in four (23%) of the older persons in Lira district northern Uganda were suffering from probable or possible dementia. Our study further found that older persons in Lira district northern Uganda with a positive history of central nervous system infections (CNS) had nearly five times higher odds of having probable or possible dementia compared to their counterparts (cOR: 4.5; 2.76-7.23; p ≤ 0.001). Being in advanced age of 70 + years (aOR: 2.6; 1.6-4.3; p ≤ 0.001), positive history of CNS infection particularly Herpes simplex virus-1 (aOR: 5.4; 1.4-20.5; p = 0.013), and chronic headache (aOR: 1.9; 1.1-3.1; p = 0.019) were independent predictors of probable or possible dementia among participants in this study. CONCLUSION AND RECOMMENDATIONS Dementia is a common condition among older persons in Lira district northern Uganda with a prevalence of 23% in our study. Older persons with a positive history of CNS infection had higher odd of developing dementia compared to their counterparts. Having advanced age, cerebral malaria, Herpes simplex virus - 1 (HSV-1) infections, and chronic headache were independent predictors for dementia. These results imply that health assessment for the risk of dementia should include screening for history of CNS conditions particularly cerebral malaria, HSV-1 and chronic headache.
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Affiliation(s)
- Deo Benyumiza
- Department of Nursing and Midwifery, Faculty of Health Science, Lira University, Lira, Uganda
| | - Edward Kumakech
- Department of Nursing and Midwifery, Faculty of Health Science, Lira University, Lira, Uganda.
| | - Jastine Gutu
- Office of Health Professional Education Partnership Initiative - Transforming Ugandan Institution's Training Against HIV/AIDS (HEPI - TUITAH) program, Faculty of Health Science, Lira University, Lira, Uganda
| | - Jude Banihani
- Department of Medicine, California University of Science and Medicine, San Bernadinio, USA
| | - Joshua Mandap
- Department of Medicine, California University of Science and Medicine, San Bernadinio, USA
| | - Zohray M Talib
- Department of Medicine, California University of Science and Medicine, San Bernadinio, USA
- Office of Research Administration, Mbarara University of Science and Technology, P.O. BOX 1014, Mbarara, Uganda
| | - Edith K Wakida
- Department of Medicine, California University of Science and Medicine, San Bernadinio, USA
- Office of Research Administration, Mbarara University of Science and Technology, P.O. BOX 1014, Mbarara, Uganda
| | - Samuel Maling
- Office of Research Administration, Mbarara University of Science and Technology, P.O. BOX 1014, Mbarara, Uganda
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Celestino Obua
- Office of Research Administration, Mbarara University of Science and Technology, P.O. BOX 1014, Mbarara, Uganda
- Office of the Vice Chancellor, Mbarara University of Science and Technology, Mbarara, Uganda
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Kantawala B, Zahra N, Oseili T, Jawad A, Ouardouz S, Nazir A, Wojtara M, Uwishema O. Dementia challenges in Africa: Journeying through forgetfulness. Health Sci Rep 2023; 6:e1561. [PMID: 37701353 PMCID: PMC10494639 DOI: 10.1002/hsr2.1561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 08/25/2023] [Indexed: 09/14/2023] Open
Affiliation(s)
- Burhan Kantawala
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Faculty of General MedicineYerevan State Medical UniversityYerevanArmenia
| | - Najwa Zahra
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Faculty of MedicineBeirut Arab UniversityBeirutLebanon
| | - Taha Oseili
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Faculty of MedicineBeirut Arab UniversityBeirutLebanon
| | - Ali Jawad
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Faculty of MedicineDamascus UniversityDamascusSyria
| | - Souhail Ouardouz
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Faculty of Medicine and PharmacyCadi Ayyad UniversityMarrakechMorocco
| | - Abubakar Nazir
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Department of MedicineKing Edward Medical UniversityLahorePakistan
| | - Magda Wojtara
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Department of MedicineUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Olivier Uwishema
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Department of MedicineClinton Global Initiative UniversityNew YorkNew YorkUSA
- Faculty of MedicineKaradeniz Technical UniversityTrabzonTurkey
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Nakidde G, Kumakech E, Mugisha JF. Maternal mental health screening and management by health workers in southwestern Uganda: a qualitative analysis of knowledge, practices, and challenges. BMC Pregnancy Childbirth 2023; 23:477. [PMID: 37370024 DOI: 10.1186/s12884-023-05763-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Maternal mental health (MMH) problems, such as perinatal depression, maternal anxiety, suicide ideation and puerperal psychosis among others, have a significant impact on maternal morbidity and mortality, as well as the health and development of children. One in every four pregnant women and one in every five postpartum women in low-income countries, suffer from maternal mental health (MMH) problems. Despite this, MMH screening, diagnosis, and reporting remain scanty in Uganda. Consequently, this study aimed to investigate the knowledge, practices, and impediments that maternity care workers face when screening and managing women with maternal mental health disorders in health facilities in south-western Uganda. METHODS In-depth interviews were conducted with 22 health-care professionals who work in maternity care departments in primary and tertiary healthcare facilities in southwestern Uganda to investigate their medical knowledge, clinical practices, and challenges related to the screening and management of maternal mental health problems. Using qualitative content analysis, distinct categories and subcategories were found. RESULTS Medical staff especially midwives lacked specialized training in screening and managing women with maternal mental health problems They screened and managed MMH problems solely based on history and physical examination, and they referred nearly every mother displaying signs of mental illness because they felt ill-prepared to handle them. On the other hand, medical staff with some level of specialized training in mental health particularly staff working in mental health units, were more likely to use a mental health screening tool in addition to history and physical examination; and to treat any women exhibiting signs and symptoms of maternal mental problems without referring them. Lack of in-service training on maternal mental health, poorly coordinated referral systems, reluctance of mentally ill to visit medical facilities, scarcity of mental health specialists, and shortage of relevant medications were identified as the major challenges. Age, experience level, or gender had no effect on screening or management practices. CONCLUSIONS The results suggest that specialized training in mental health, and particularly maternal mental health, is essential for the effective screening and management of maternal mental health conditions in South Western Uganda.
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Affiliation(s)
- Gladys Nakidde
- Department of Obstetrics and Gynecology, College of medicine, Pan African University of life and Earth Sciences Institute, University of Ibadan, Ibadan, Nigeria.
- Department of Nursing, Faculty of Nursing and Health sciences, Bishop Stuart University, Mbarara, Uganda.
| | - Edward Kumakech
- Department of Nursing and midwifery, Faculty health sciences, Lira University, Lira, Uganda
| | - John F Mugisha
- Department of Obstetrics and Gynecology, College of medicine, Pan African University of life and Earth Sciences Institute, University of Ibadan, Ibadan, Nigeria
- Department of Health sciences, Faculty of Science and Technology, Cavendish University, Kampala, Uganda
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8
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Vancampfort D, Mugisha J, Kimbowa S, Lukwata H, Van Damme T, Vandenbulcke M. Efficacy of an 8-hour education intervention on dementia knowledge, attitude and skills in healthcare professionals in regional hospitals: a nation-wide study from Uganda. Pan Afr Med J 2023; 44:165. [PMID: 37455875 PMCID: PMC10349638 DOI: 10.11604/pamj.2023.44.165.36470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 04/02/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction dementia imposes an enormous burden, mainly in low-income countries (LICs). Due to lack of well-trained healthcare professionals, 70-90% of people with dementia do not receive adequate care in LICs. The aim of this study was to evaluate whether a one-day, 8-hour medical education intervention on dementia care improves the knowledge and attitude about and confidence in providing dementia care among healthcare professionals in 8 referral hospitals in UgandaMethods: in this pre-test/post-test study without a control group, participants completed the Alzheimer´s Disease Knowledge Scale (ADKS), Dementia Care Attitude Scale (DCAS), and 9 visual analogue scales (VAS) regarding confidence in specific dementia care skills pre- and post-medical education intervention. Results in one hundred twelve healthcare professionals (age = 41.7±10.2 years; 54.5% women), the ADKS, DCAS, and VAS scores for recognizing and assessing core dementia symptoms, communicating effectively, providing psycho-education, activating patients mentally and physically, managing behavioral and psychological symptoms, and involving carers in the treatment improved significantly (P < 0.001) post-medical education intervention. Conclusion our study demonstrates that brief educational interventions are efficacious in strengthening the dementia literacy among healthcare professionals in a low-income country. Future research should explore whether such brief educational interventions also result in implementation of efficacious dementia care into routine clinical practice and whether it ultimately may lead to improved health outcomes in patients and formal and informal caregivers.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - James Mugisha
- Kyambogo University, Faculty of Social Sciences, Kampala, Uganda
| | - Samuel Kimbowa
- Butabika National Referral Mental Health Hospital, Kampala, Uganda
| | - Hafsa Lukwata
- Division of Mental Health, Ministry of Health, Kampala, Uganda
| | - Tine Van Damme
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
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Abstract
BACKGROUND With the growing population of older adults in Nigeria comes a simultaneous rise in the incidence of dementia in the country. Adequate knowledge of dementia is needed to effectively administer interventions for persons living with dementia. Physiotherapy is one of the professions providing care for people with dementia. The aim of this study was to evaluate the knowledge of dementia among physiotherapists in Nigeria. METHODS An online survey method was used to collect data from the sample population of practicing physiotherapists in Nigeria. Data was collected using the 21-item Dementia Knowledge Assessment Tool Version Two (DKAT2) and the respondents also provided some demographic information. Mann Whitney test, Kruskal Wallis test and Spearman's rho correlation were used to test for association between the DKAT2 scores and the demographic variables and this association was further explored with multiple linear regression analysis. RESULTS A total number of 223 physiotherapists participated in this study. The findings of the study show that there is limited knowledge of dementia among the physiotherapists. Number of years of professional experience and specialty groups predicted significantly higher knowledge scores. CONCLUSION The knowledge deficits found among physiotherapists in Nigeria indicate that older adults living with dementia might not be receiving the best evidence-based physiotherapy treatments for their condition. This research therefore advocates for an educational intervention to be carried out within the physiotherapy profession in order to improve the quality of services rendered to their patients.
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Affiliation(s)
- Chisom I Onyekwuluje
- Chisom I Onyekwuluje, Department of
Gerontology, University of Southampton, 24 Akinyemi street, Southampton SO17
1BJ, UK.
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10
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Akinyemi RO, Yaria J, Ojagbemi A, Guerchet M, Okubadejo N, Njamnshi AK, Sarfo FS, Akpalu A, Ogbole G, Ayantayo T, Adokonou T, Paddick SM, Ndetei D, Bosche J, Ayele B, Damas A, Coker M, Mbakile-Mahlanza L, Ranchod K, Bobrow K, Anazodo U, Damasceno A, Seshadri S, Pericak-Vance M, Lawlor B, Miller BL, Owolabi M, Baiyewu O, Walker R, Gureje O, Kalaria RN, Ogunniyi A. Dementia in Africa: Current evidence, knowledge gaps, and future directions. Alzheimers Dement 2022; 18:790-809. [PMID: 34569714 PMCID: PMC8957626 DOI: 10.1002/alz.12432] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/21/2021] [Accepted: 06/11/2021] [Indexed: 12/19/2022]
Abstract
In tandem with the ever-increasing aging population in low and middle-income countries, the burden of dementia is rising on the African continent. Dementia prevalence varies from 2.3% to 20.0% and incidence rates are 13.3 per 1000 person-years with increasing mortality in parts of rapidly transforming Africa. Differences in nutrition, cardiovascular factors, comorbidities, infections, mortality, and detection likely contribute to lower incidence. Alzheimer's disease, vascular dementia, and human immunodeficiency virus/acquired immunodeficiency syndrome-associated neurocognitive disorders are the most common dementia subtypes. Comprehensive longitudinal studies with robust methodology and regional coverage would provide more reliable information. The apolipoprotein E (APOE) ε4 allele is most studied but has shown differential effects within African ancestry compared to Caucasian. More candidate gene and genome-wide association studies are needed to relate to dementia phenotypes. Validated culture-sensitive cognitive tools not influenced by education and language differences are critically needed for implementation across multidisciplinary groupings such as the proposed African Dementia Consortium.
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Affiliation(s)
- Rufus O Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Centre for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Neurology, University College Hospital, Ibadan, Nigeria
| | - Joseph Yaria
- Department of Neurology, University College Hospital, Ibadan, Nigeria
| | - Akin Ojagbemi
- Department of Psychiatry University College Hospital/College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Maëlenn Guerchet
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Njideka Okubadejo
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi Araba, Lagos, Nigeria
| | - Alfred K Njamnshi
- Department of Neurology, Yaoundé Central Hospital/Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
- Brain Research Africa Initiative (BRAIN), Geneva, Switzerland/Yaoundé, Cameroon
| | - Fred S Sarfo
- Department of Medicine, Kwame Nkrumah University of Science & Technology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Albert Akpalu
- Department of Medicine, University of Ghana Medical School/Korle Bu Teaching Hospital, Accra, Ghana
| | - Godwin Ogbole
- Department of Radiology, University College Hospital/College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Temitayo Ayantayo
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Thierry Adokonou
- Department of Neurology, University Teaching Hospital, Parakou, Benin
| | - Stella-Maria Paddick
- Translational and Clinical Research Institute, Newcastle University, UK/Gateshead Health NHS Foundation Trust, Gateshead, UK
| | - David Ndetei
- Department of Psychiatry, University of Nairobi and African Meatal Health and Training Foundation, Nairobi, Kenya
| | - Judith Bosche
- Kilimanjaro Christian Medical College, Moshi, Tanzania
| | - Biniyam Ayele
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Andrea Damas
- Mirembe Mental Health Hospital, Dodoma, Tanzania
| | - Motunrayo Coker
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Lingani Mbakile-Mahlanza
- Department of Psychology, Faculty of Social Sciences, University of Botswana, Gaborone, Botswana
| | - Kirti Ranchod
- Lufuno Neuropsychiatry Centre, Johannesburg, South Africa
| | - Kirsten Bobrow
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Udunna Anazodo
- Lawson Health Research Institute / Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Albertino Damasceno
- Department of Cardiology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, Texas, USA
| | - Margaret Pericak-Vance
- John T. Hussman Institute for Human Genomics and the Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Brian Lawlor
- Global Brain Health Institute, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Bruce L Miller
- Global Brain Health Institute, Memory and Aging Center, University of California, San Francisco, California, USA
| | - Mayowa Owolabi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Centre for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Neurology, University College Hospital, Ibadan, Nigeria
| | - Olusegun Baiyewu
- Department of Psychiatry University College Hospital/College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Richard Walker
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, North Tyneside General Hospital, North Shields, UK
| | - Oye Gureje
- Department of Psychiatry University College Hospital/College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Rajesh N Kalaria
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Translational and Clinical Research Institute, Newcastle University, Newcastle, UK
| | - Adesola Ogunniyi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Neurology, University College Hospital, Ibadan, Nigeria
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11
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Xiang K, Liu Y, Sun L. Motoric Cognitive Risk Syndrome: Symptoms, Pathology, Diagnosis, and Recovery. Front Aging Neurosci 2022; 13:728799. [PMID: 35185512 PMCID: PMC8847709 DOI: 10.3389/fnagi.2021.728799] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/14/2021] [Indexed: 12/20/2022] Open
Abstract
The motoric cognitive risk (MCR) syndrome is a pre-dementia condition, marked by the enhanced risk for Alzheimer's disease (AD) and vascular dementia, together with falls, disability, and abnormal movements. The research studies revealed the distinct neurological and non-neurological clinical gait irregularities during dementia and accelerated functional decline, such as postural and balance impairments, memory loss, cognitive failure, and metabolic dysfunctions. The disabling characteristics of MCR comprise altered afferent sensory and efferent motor responses, together with disrupted visual, vestibular, and proprioceptive components. The pathological basis of MCR relates with the frontal lacunar infarcts, white matter hyperintensity (WMH), gray matter atrophy in the pre-motor and pre-frontal cortex, abnormal cholinergic functioning, inflammatory responses, and genetic factors. Further, cerebrovascular lesions and cardiovascular disorders exacerbate the disease pathology. The diagnosis of MCR is carried out through neuropsychological tests, biomarker assays, imaging studies, questionnaire-based evaluation, and motor function tests, including walking speed, dual-task gait tests, and ambulation ability. Recovery from MCR may include cognitive, physical, and social activities, exercise, diet, nutritional supplements, symptomatic drug treatment, and lifestyle habits that restrict the disease progression. Psychotherapeutic counseling, anti-depressants, and vitamins may support motor and cognitive improvement, primarily through the restorative pathways. However, an in-depth understanding of the association of immobility, dementia, and cognitive stress with MCR requires additional clinical and pre-clinical studies. They may have a significant contribution in reducing MCR syndrome and the risk for dementia. Overall, the current review informs the vital connection between gait performance and cognition in MCR and highlights the usefulness of future research in the discernment and treatment of dementiating illness.
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Wakida EK, Atuhaire CD, Karungi CK, Maling S, Obua C. Mbarara University Research Training Initiative: Experiences and Accomplishments of the MEPI Junior D43 TW010128 Award in Uganda. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:1397-1410. [PMID: 34887692 PMCID: PMC8650769 DOI: 10.2147/amep.s339752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/23/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE In 2015, Mbarara University of Science and Technology was awarded the Mbarara University Research Training Initiative (MURTI) under grant number D43 TW010128 to build capacity of junior faculty to become the next generation of researchers in Africa. In this paper, we document the experiences and achievements of the research capacity building efforts at MUST. METHODS We conducted a descriptive evaluation study which involved document review and in-depth interviews. We used "Reach" and 'Effectiveness' from the RE-AIM framework to guide the document review, and the organizational theory of implementation effectiveness to guide the in-depth interviews. RESULTS In the MURTI program, we conducted 17 short courses between August 2015 and July 2021, a total of 6597 attendances were recorded. The most attended courses were responsible conduct of research (n = 826), qualitative research methods (n = 744), and data management (n = 613). Thirty-three fellows were recruited and funded to conduct mentored research leading to 48 publications and 14 extramural grant applications were yielded. From the in-depth interviews, the participants appreciated the research training program, the enhanced research skills attained, and the institutional capacity built. They attributed the success of the program to the training approach of using short courses, readiness of the junior faculty to change, and the supportive environment by the mentors and trainers in the program. CONCLUSION The D43 TW010128 research training grant-built capacity for the junior faculty at MUST, enhanced their research skills, promoted research capacity institutionally and provided career development for the junior faculty. This was possible due to the positive attitude of the junior faculty (organizational readiness) to change and the supportive environment (mentors and trainers) during implementation of the grant. These two factors provided a favorable institutional climate that guaranteed success of the funding goals.
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Affiliation(s)
- Edith K Wakida
- Office of Research Administration, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Clara D Atuhaire
- Office of Research Administration, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Christine K Karungi
- Office of Research Administration, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Samuel Maling
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Celestino Obua
- Office of the Vice Chancellor, Mbarara University of Science and Technology, Mbarara, Uganda
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13
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Ainamani HE, Bamwerinde WM, Rukundo GZ, Tumwesigire S, Mfitumukiza V, Bikaitwoha EM, Tsai AC. Fruit and vegetable intake and mental health among family caregivers of people with dementia in Uganda. MENTAL HEALTH & PREVENTION 2021; 24:None. [PMID: 34900574 PMCID: PMC8641063 DOI: 10.1016/j.mhp.2021.200223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 10/11/2021] [Indexed: 01/09/2023]
Abstract
Consumption of fruits and vegetables is correlated with improved mental wellbeing. Although this growing body of research has been recognized by researchers and clinicians in high-income countries, fewer studies examining this relationship have been conducted in low- and middle-income settings. In this study, we sought to estimate the association between fruit and vegetable intake and symptoms of depression and anxiety. We conducted a cross-sectional study among 242 family caregivers of people with dementia in southwestern Uganda. Fruit and vegetable intake in the past week was measured with a food frequency questionnaire. Depression and anxiety were assessed using the depression and anxiety subscales of the 42-item Depression, Anxiety and Stress Scales. Multivariable regression models were used to estimate the associations between fruits and vegetable consumption and depression and anxiety, adjusting for caregiving burden and other potential confounders. Depression symptom severity was negatively associated with consumption of jackfruits (b =-4.68; 95% confidence interval [CI], -8.96 to -0.39), green leafy vegetables (b =-14.1; 95% CI, -18.0 to -10.1), root vegetables (b =-14.0; 95% CI, -19.5 to -8.63), and other vegetables (b =-14.8; 95% CI, -19.3 to -10.3), and frequent consumption of vegetables (b =-1.91; 95% CI, -3.77 to -0.04). Anxiety symptom severity was negatively associated with consumption of green leafy vegetables (b =-12.2; 95% CI, -16.0 to -8.46), root vegetables (b=-12.6; 95% CI, -17.5 to -7.58), and other vegetables (b =-12.7; 95% CI, -17.0 to -8.40), and frequent consumption of vegetables (b =-2.07; 95% CI, -3.84 to -0.29). Our results suggest that fruit and vegetable consumption is associated with reduced depression and anxiety symptoms.
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Affiliation(s)
- Herbert E Ainamani
- Department of Mental Health, Kabale University School of Medicine, Kabale, Uganda, P. O. Box 317
| | - Wilson M Bamwerinde
- Department of Environment and Natural Resources Kabale University, Kabale, Uganda
| | - Godfrey Z Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Sam Tumwesigire
- Department of Pediatrics, Kabale University School of Medicine, Kabale, Uganda
| | | | - Everd M Bikaitwoha
- Department of Pediatrics, Kabale University School of Medicine, Kabale, Uganda
| | - Alexander C Tsai
- Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, United States
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14
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Atim LM, Kaggwa MM, Mamun MA, Ashaba S, Maling S. Prevalence of Severe Neurocognitive Impairment and Its Association with Socio-Demographics and Functionality Among Ugandan Older Persons: A Hospital-Based Study. Clin Interv Aging 2021; 16:1415-1425. [PMID: 34326633 PMCID: PMC8314681 DOI: 10.2147/cia.s319891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/30/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The prevalence of neurocognitive disorders, especially dementia, is rising due to an increase in longevity. Early detection and diagnosis of neurocognitive impairments are important for early interventions and appropriate management of reversible causes, especially by the primary health workers. However, this study aimed to determine the prevalence and associated factors of severe neurocognitive impairment among elderly persons attending a tertiary hospital in Uganda. METHODS This cross-sectional survey was conducted in a Ugandan hospital setting, where older adults go for treatment for their chronic health problems. Following the inclusion criteria, interviews were conducted, where information about socio-demographics was collected, whereas neurocognitive impairment and functionality were assessed by Mini-Mental State Examination and Barthel Index, respectively. Chi-square test, Pearson correlation test, and logistic regression were performed to determine the factors associated with severe neurocognitive impairment. RESULTS A total of 507 elderly persons aged 60 years and above were enrolled in this study (mean age 68.62 ±7.95 years), and the prevalence of severe neurocognitive impairment was 28.01%. Advanced age, female gender, lower education level, and functional dependency were significantly associated with severe neurocognitive impairment. CONCLUSION Severe neurocognitive impairment is prevalent among Ugandan hospital attending elderlies with functional dependency. This suggests a need to routinely screen cognitive disorders among older persons who visit the healthcare facilities with other physical complaints to enable early detection and treatment of reversible causes of neurocognitive impairment, such as depression and delirium to enable better functionality.
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Affiliation(s)
- Letizia Maria Atim
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mark Mohan Kaggwa
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
| | - Mohammed A Mamun
- CHINTA Research Bangladesh (Centre for Health Innovation, Networking, Training, Action and Research – Bangladesh), Savar, Dhaka, 1342, Bangladesh
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Scholastic Ashaba
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Samuel Maling
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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15
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Onyike CU, Shinagawa S, Ellajosyula R. Frontotemporal Dementia: A Cross-Cultural Perspective. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1281:141-150. [PMID: 33433874 DOI: 10.1007/978-3-030-51140-1_10] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
It is predictable that syndromes of frontotemporal dementia (FTD) may have a worldwide distribution; however, data available on their incidence and prevalence are variable. This variability most likely reflects disparities across regions in the distribution of the expertise, technology, and resources available for FTD research and care. Important discoveries have been made regarding FTD's phenotypes, genetics, and cultural influences on the expression of symptoms; however, in many countries, there are barriers posed by a dearth of resources. There are pressing needs to further develop research on FTD: including first, population studies designed to fill the gaps in our knowledge about FTD's frequency and risk factors in developing regions and among minority groups in developed countries. It is also necessary to facilitate the psychometric characterization of contemporary diagnostic criteria and their translation to different languages and cultural contexts. Furthermore, much needed is the analysis of differences in the genetic risk factors for FTD, particularly non-Mendelian susceptibility factors. It is hoped that reflections on FTD from an international perspective will spur an extension of the vibrant multicenter collaborations, that exist in North America and Europe, toward new centers to be established and supported in the developing regions of the world.
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Affiliation(s)
- Chiadi U Onyike
- Division of Geriatric Psychiatry and Neuropsychiatry, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Giebel C. "Current dementia care: what are the difficulties and how can we advance care globally?". BMC Health Serv Res 2020; 20:414. [PMID: 32398073 PMCID: PMC7218536 DOI: 10.1186/s12913-020-05307-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dementia is a growing global public health concern, with post-diagnostic care often very limited. Depending on where people live, both within a country and depending on high-, middle-, and low-income countries, they might also face barriers in accessing the right care at the right time. Therefore, it is important to highlight recent evidence on the facilitators and barriers to dementia care, but also evidence on how to move dementia care forward. MAIN TEXT Current dementia care is subject to several inequalities, including living in rural regions and being from a minority ethnic background. Evidence in this collection highlights the issues that both people living with dementia and unpaid carers are facing in accessing the right care, with evidence from Australia, Canada, Uganda, to the Netherlands, and further afield. Providing improved dementia-specific training to health care professionals and supporting medication and reablement interventions have been identified as possible ways to improve dementia care for all. CONCLUSIONS This special issue focuses on recent evidence on inequalities in dementia care across the globe and how dementia care can be advanced in various areas.
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Affiliation(s)
- Clarissa Giebel
- National Institute of Health Research Applied Research Collaboration North West Coast (NIHR ARC NWC), Liverpool, UK.
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK.
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Niedziela N, Nowak MM, Lis M, Blaszkowska M, Kośmider R, Adamczyk-Sowa M. Atrial fibrillation as an important clinical condition of cognitive decline; diagnosis, comorbidities and severity of symptoms in patients with dementia. Neurol Res 2020; 42:430-438. [DOI: 10.1080/01616412.2020.1738648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Natalia Niedziela
- Faculty of Medical Sciences in Zabrze, Department of Neurology, Medical University of Silesia in Katowice, Poland
| | - Maria Magdalena Nowak
- Faculty of Medical Sciences in Zabrze, Department of Neurology, Medical University of Silesia in Katowice, Poland
| | - Martyna Lis
- Faculty of Medical Sciences in Zabrze, Department of Neurology, Medical University of Silesia in Katowice, Poland
| | - Maria Blaszkowska
- Faculty of Medical Sciences in Zabrze, Department of Neurology, Medical University of Silesia in Katowice, Poland
| | - Rozalia Kośmider
- Faculty of Medical Sciences in Zabrze, Department of Neurology, Medical University of Silesia in Katowice, Poland
| | - Monika Adamczyk-Sowa
- Faculty of Medical Sciences in Zabrze, Department of Neurology, Medical University of Silesia in Katowice, Poland
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18
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Caregiving burden and mental health problems among family caregivers of people with dementia in rural Uganda. Glob Ment Health (Camb) 2020; 7:e13. [PMID: 32742671 PMCID: PMC7379317 DOI: 10.1017/gmh.2020.7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 04/07/2020] [Accepted: 04/26/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Alzheimer's disease and related dementias are associated with increasing health burden in low- and middle-income countries. Less well-recognized is the potential health burden experienced by other affected individuals, such as family caregivers. In this study, we sought to profile the burden of care and its association with symptoms of depression and anxiety among informal caregivers of people living with dementia in rural southwestern Uganda. METHOD We conducted a cross-sectional study of 232 family caregivers of people with dementia. The key measured variables of interest were caregiving burden (Zarit Burden Index) and symptoms of depression and anxiety (Depression Anxiety Stress Scales). We fitted multivariable regression models specifying depression and anxiety symptoms as the primary outcomes of interest and caregiving burden as the primary explanatory variable of interest. RESULTS Family caregivers of people with dementia experience significant caregiving burden, with each item on the Zarit Burden Index endorsed by more than 70% of study participants. Nearly half [108 (47%)] of caregivers had Zarit Burden Interview scores >60, suggestive of severe caregiving burden. In multivariable regression models, we estimated a statistically significant positive association between caregiving burden and symptoms of both depression [b = 0.42; 95% confidence interval (CI) 0.34-0.49] and anxiety (b = 0.37; 95% CI 0.30-0.45). CONCLUSION Family caregivers of people with dementia in rural Uganda experience a high caregiving burden, which is associated with symptoms of depression and anxiety. Interventions aimed at reducing caregiving burden may have important collateral mental health benefits.
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