PMID- 31681982 OWN - NLM STAT- MEDLINE DCOM- 20200814 LR - 20200814 IS - 1532-5415 (Electronic) IS - 0002-8614 (Linking) VI - 68 IP - 1 DP - 2020 Jan TI - Severity of Neuropsychiatric Symptoms and Distress in Dementia among Older People in Central Africa (EPIDEMCA Study). PG - 180-185 LID - 10.1111/jgs.16234 [doi] AB - OBJECTIVES: Neuropsychiatric symptoms are common in dementia. Limited data are available concerning their association with dementia in developing countries. Our aim was to describe the severity of neuropsychiatric symptoms among older people, evaluate the distress experienced by caregivers, and assess which neuropsychiatric symptoms were specifically associated with dementia among older adults in Central Africa. DESIGN: This study is part of the EPIDEMCA program, a cross-sectional multicenter population-based study. SETTING: The EPIDEMCA program was conducted from November 2011 to December 2012 in urban and rural areas of the Central African Republic and the Republic of the Congo. PARTICIPANTS: Participants were older people (>/=65 y) included in the EPIDEMCA program who underwent a neuropsychiatric evaluation. The sample included overall 532 participants, of whom 130 participants had dementia. MEASUREMENTS: Neuropsychiatric symptoms were assessed with the brief version of the Neuropsychiatric Inventory including the evaluation of severity and associated distress. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision, criteria were followed to diagnose dementia. A logistic regression model was used to identify associated neuropsychiatric symptoms. RESULTS: The prevalence of neuropsychiatric symptoms was 89.9% (95% confidence interval = 84.6-95.1) among people living with dementia. The overall median severity score for neuropsychiatric symptoms was 9 [interquartile range [IQR] = 6-12], and the overall median distress score was 7 [IQR = 4-10]. Overall median scores of both severity and distress were significantly increased with the number of neuropsychiatric symptoms, the presence of dementia, and dementia severity. Depression, delusions, apathy, disinhibition, and aberrant motor behavior were associated with dementia after multivariate analysis. CONCLUSION: This report is one of the few population-based studies on neuropsychiatric symptoms among older people with dementia in Sub-Saharan Africa and the first one evaluating the severity of those symptoms and distress experienced by caregivers. Individual neuropsychiatric symptoms were strongly associated with dementia in older people and require great attention considering their burden on populations. J Am Geriatr Soc 68:180-185, 2019. CI - (c) 2019 The American Geriatrics Society. FAU - Yoro-Zohoun, Ines AU - Yoro-Zohoun I AUID- ORCID: 0000-0001-7659-2848 AD - INSERM UMR1094, Tropical Neuroepidemiology, University of Limoges, Limoges, France. AD - Institute of Neuroepidemiology and Tropical Neurology, School of Medicine, University of Limoges, GEIST, Limoges, France. AD - Laboratory of Chronic Diseases Epidemiology (LEMACEN), Faculty of Health Sciences, School of Health Sciences, University of Abomey-Calavi (UAC), Cotonou, Benin. FAU - Houinato, Dismand AU - Houinato D AD - INSERM UMR1094, Tropical Neuroepidemiology, University of Limoges, Limoges, France. AD - Institute of Neuroepidemiology and Tropical Neurology, School of Medicine, University of Limoges, GEIST, Limoges, France. AD - Laboratory of Chronic Diseases Epidemiology (LEMACEN), Faculty of Health Sciences, School of Health Sciences, University of Abomey-Calavi (UAC), Cotonou, Benin. FAU - Nubukpo, Philippe AU - Nubukpo P AD - INSERM UMR1094, Tropical Neuroepidemiology, University of Limoges, Limoges, France. AD - Institute of Neuroepidemiology and Tropical Neurology, School of Medicine, University of Limoges, GEIST, Limoges, France. AD - CHS Esquirol, Limoges, France. FAU - Mbelesso, Pascal AU - Mbelesso P AD - INSERM UMR1094, Tropical Neuroepidemiology, University of Limoges, Limoges, France. AD - Institute of Neuroepidemiology and Tropical Neurology, School of Medicine, University of Limoges, GEIST, Limoges, France. AD - Department of Neurology, Amitie Hospital, Bangui, Central African Republic. FAU - Ndamba-Bandzouzi, Bebene AU - Ndamba-Bandzouzi B AD - Department of Neurology, Brazzaville University Hospital, Brazzaville, Republic of the Congo. FAU - Clement, Jean-Pierre AU - Clement JP AD - INSERM UMR1094, Tropical Neuroepidemiology, University of Limoges, Limoges, France. AD - Institute of Neuroepidemiology and Tropical Neurology, School of Medicine, University of Limoges, GEIST, Limoges, France. AD - Hospital and University Federation of Adult and Geriatric Psychiatry, Limoges, France. FAU - Dartigues, Jean-Francois AU - Dartigues JF AUID- ORCID: 0000-0001-9482-5529 AD - Inserm Research Centre U1219 <>, Bordeaux, France. FAU - Preux, Pierre-Marie AU - Preux PM AUID- ORCID: 0000-0002-2171-2977 AD - INSERM UMR1094, Tropical Neuroepidemiology, University of Limoges, Limoges, France. AD - Institute of Neuroepidemiology and Tropical Neurology, School of Medicine, University of Limoges, GEIST, Limoges, France. AD - Department of Medical Information and Evaluation, Clinical Research and Biostatistic Unit, Limoges University Hospital, Limoges, France. FAU - Guerchet, Maelenn AU - Guerchet M AUID- ORCID: 0000-0002-0470-5556 AD - INSERM UMR1094, Tropical Neuroepidemiology, University of Limoges, Limoges, France. AD - Institute of Neuroepidemiology and Tropical Neurology, School of Medicine, University of Limoges, GEIST, Limoges, France. AD - King's College London, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neurosciences, London, United Kingdom. CN - EPIDEMCA Group LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20191104 PL - United States TA - J Am Geriatr Soc JT - Journal of the American Geriatrics Society JID - 7503062 SB - IM MH - Africa, Central/epidemiology MH - Aged, 80 and over MH - Behavioral Symptoms/*epidemiology MH - Caregivers/psychology MH - Dementia/*diagnosis MH - Developing Countries MH - Diagnostic and Statistical Manual of Mental Disorders MH - Female MH - Humans MH - Male MH - Prevalence MH - Severity of Illness Index MH - Stress, Psychological/*psychology OTO - NOTNLM OT - behavioral and psychological symptoms of dementia OT - cognitive disorders OT - dementia OT - neuropsychiatric symptoms OT - older adults EDAT- 2019/11/05 06:00 MHDA- 2020/08/15 06:00 CRDT- 2019/11/05 06:00 PHST- 2019/07/02 00:00 [received] PHST- 2019/09/12 00:00 [revised] PHST- 2019/09/16 00:00 [accepted] PHST- 2019/11/05 06:00 [pubmed] PHST- 2020/08/15 06:00 [medline] PHST- 2019/11/05 06:00 [entrez] AID - 10.1111/jgs.16234 [doi] PST - ppublish SO - J Am Geriatr Soc. 2020 Jan;68(1):180-185. doi: 10.1111/jgs.16234. Epub 2019 Nov 4.