Behavioral disorders among older adults with dementia, Mild Cognitive Impairment and normal cognition living in Central Africa (EPIDEMCA study).

Abstract : Objective: The aim of our study was to estimate the prevalence of behavioral symptoms and associated factors in the elderly in the Central African Republic and the Republic of Congo. Methods: An analysis of baseline data was performed from the EPIDEMCA (Epidemiology of Dementia in Central Africa) multicenter population-based study carried out in rural and urban areas of the Central African Republic and the Republic of Congo between 2011 and 2012 in elderly aged 65 and over. Cognitive disorders were assessed in two phases. The first phase was cognitive screening using the Community Screening Interview in Dementia. Following cognitive screening, in the second phase, participants suspected of dementia underwent clinical assessment based on the abridged version of the neuropsychiatric inventory (NPI) which assesses 12 behavioral disorders in the elderly over the previous 30 days. Results: NPI data were available for 532 out of participants examined in the second phase of EPIDEMCA. Among the 532 elderly included in the analytic sample, 284 were cognitively normal, 130 were demented, 113 had Mild Cognitive Impairment (MCI) and 5 remained without diagnosis. The median age was 75 and most were female. At least one behavioral disorder was reported by 333 elderly (63.7%) with 16.6% reporting 1 or 2 behavioral disorders and 47.1% reporting 3 or more symptoms. In participants with no cognitive impairment, 48.7% reported at least one symptom. The prevalence of behavioral disorders was 73.4% in people with MCI and 89.9% in people with dementia. In our sample, the most frequent symptoms were depression/dysphoria (45.3%), anxiety (28.1%) and irritability (23.7%). Discussion: Behavioral disorders are common in this population. Our data are comparable to those reported in previous population-based studies in Nigeria and Tanzania. It would be important to carry out additional studies to better characterize behavioral disorders in others countries in Africa.