INSERM UMR1094, Tropical Neuroepidemiology, University of Limoges, Limoges, France.
Institute of Neuroepidemiology and Tropical Neurology, School of Medicine, University of Limoges, Limoges, France.
Int J Geriatr Psychiatry. 2019 Jan;34(1):169-178. doi: 10.1002/gps.5006. Epub 2018 Nov 9.
Our study aimed at estimating the prevalence of neuropsychiatric symptoms and investigating associated factors among older adults living in two countries in Central Africa (Central African Republic [CAR] and Republic of Congo [ROC]).
The EPIDEMCA multicentre population-based study was carried out in rural and urban areas of CAR and ROC between 2011 and 2012 among people aged 65 and over. After cognitive screening using the Community Screening Interview for Dementia, participants with low performances underwent neurological examination including the brief version of the Neuropsychiatric Inventory Questionnaire (NPI-Q). Multivariate logistic regression analyses were performed to identify factors independently associated with neuropsychiatric symptoms in this population.
NPI-Q data were available for 532 participants. Overall, 333 elderly people (63.7%) reported at least one neuropsychiatric symptom. The prevalence of neuropsychiatric symptoms was 89.9% (95% CI, 84.6-95.1) in participants with dementia, 73.4% (95% CI, 65.1-81.7) in participants with mild cognitive impairment (MCI), and 48.7% (95% CI, 42.9-54.6) in participants with no MCI nor dementia after neurological examination (P < 0.0001). The most common symptoms were depression, anxiety, and irritability. Participants living in Gamboma, with normal hearing and with friends in the community, were less likely to present neuropsychiatric symptoms. Physical disability, difficulties in eating, female sex, and dementia were significantly associated with neuropsychiatric symptoms.
Neuropsychiatric symptoms are common among older people with neurocognitive disorders in CAR and ROC. Our results confirm those from previous studies in Nigeria and Tanzania. Nevertheless, knowledge of these symptoms remains limited in sub-Saharan Africa, hampering their appropriate management.
本研究旨在估计中非法郎区（中非共和国[CAR]和刚果共和国[ROC]）老年人中神经精神症状的流行情况，并探讨其相关因素。
EPIDEMCA 多中心基于人群的研究于 2011 年至 2012 年在 CAR 和 ROC 的农村和城市地区进行，纳入年龄在 65 岁及以上的人群。认知筛查采用社区痴呆筛查访谈后，表现不佳者行神经科检查，包括神经精神疾病问卷简要版（NPI-Q）。采用多变量逻辑回归分析，确定该人群中与神经精神症状独立相关的因素。
NPI-Q 数据可用于 532 名参与者。总体而言，333 名老年人（63.7%）报告至少有一种神经精神症状。在痴呆患者中，神经精神症状的患病率为 89.9%（95%CI，84.6-95.1），在轻度认知障碍（MCI）患者中为 73.4%（95%CI，65.1-81.7），在神经科检查后无 MCI 也无痴呆的患者中为 48.7%（95%CI，42.9-54.6）（P<0.0001）。最常见的症状是抑郁、焦虑和易怒。居住在甘博马、听力正常且在社区中有朋友的参与者不太可能出现神经精神症状。身体残疾、进食困难、女性和痴呆与神经精神症状显著相关。
神经精神症状在 CAR 和 ROC 的神经认知障碍老年人中很常见。我们的结果证实了尼日利亚和坦桑尼亚之前的研究结果。然而，这些症状在撒哈拉以南非洲地区的了解仍然有限，阻碍了它们的适当管理。
