The Medical School,Newcastle University,Newcastle upon Tyne,UK.
Northumbria Healthcare NHS Foundation Trust,North Tyneside General Hospital,North Shields,UK.
Int Psychogeriatr. 2018 Sep;30(9):1333-1343. doi: 10.1017/S1041610217002861. Epub 2018 Mar 21.
ABSTRACTBackground: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.
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.
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.
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.
摘要
在未来几十年，撒哈拉以南非洲（SSA）的痴呆症患者人数预计将迅速增加。然而，我们对于如何在人群中降低痴呆症风险的了解非常有限。作为在这一环境下制定管理痴呆症风险的干预策略的第一步，我们研究了坦桑尼亚农村人口的认知能力下降速度，并试图确定相关因素。
该研究在坦桑尼亚北部的 Hai 区农村进行。2014 年，邀请居住在六个村庄的 65 岁及以上的社区居民参加认知筛查计划。来自六个村庄中的四个村庄的所有参与者都在两年后进行了随访，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（作为脆弱性的衡量标准）。在随访时，还完成了视力、听力障碍、烟草和酒精使用以及中风临床评估的额外评估。
有 327 人的基线和随访数据可用。50 人在两年后的随访中认知能力明显下降。没有正规教育、基线握力低、女性以及随访时抑郁与认知能力下降独立相关。
这是在 SSA 进行的首批认知能力下降研究之一。两年内的下降速度相对较高。未来的工作应重点确定认知能力下降的具体可改变风险因素，以期制定出适合文化的干预措施。
