From: Epidemiology of neurodegenerative diseases in sub-Saharan Africa: a systematic review
Author, year of publication | Country/setting | Design/period of study | Population characteristics | Diagnostic criteria | Incidence | Prevalence (%) | Risk factors |
---|---|---|---|---|---|---|---|
Lambo [58], 1966 | Nigeria | Retrospective/Cross-sectional, 1954-1963 | 328 participants (26% ≥60 y.) | Not provided | NA | Senile dementia*: | NA |
Hospital | |||||||
Overall: 26%, Men: 18.9% Women: 30.5% | |||||||
75 cases of dementia (21 men) | |||||||
Ben-Arie [39], 1983 | South Africa | Cross-sectional, 1982 | 139 participants aged ≥65 y. | MMSE/ICD-8 codes | NA | Any (severe) dementia 8.6% (3.6%) | NA |
Community | |||||||
Makanjuola [59], 1985 | Nigeria | Cross-sectional 1979-1982 | 51 (5.2% of new consultations); age ≥60 y. | ICD-9 codes | NA | Dementia 11.2% | NA |
Hospital | |||||||
Gureje [60], 1989 | Nigeria | Cross-sectional, 1984 | 1914 patients; | ICD- 9 codes | NA | No case of dementia | NA |
Community | |||||||
Ogunniyi [40], 1992 | Nigeria | Cross-sectional | 930 participants; age ≥40 y. (293 aged ≥65 y.); No case of dementia | DSM-III-R criteria | NA | No case of dementia | NA |
Community | |||||||
Osuntokun [61], 1994 | Nigeria, hospital Autopsy study | Cross-sectional 1986- 1987 | 111 brains autopsied including 85 patients aged ≤60 y. | Beta A4 amyloid on brain tissues | NA | Heavy/moderate/mild plaque load: 0/6.3/18.9% | NA |
Osuntokun [41], 1995 | Nigeria, community | Cross-sectional | 56 subjects (17 with dementia and 12 with AD); age ≥65 y. | Dementia –CSID | NA | APOE ϵ4 allele in dementia/AD/controls 17.6/16.7/20.5%. | NA |
AD - NINCDS-ADRDA criteria | |||||||
Osuntokun [38], 1995 | Nigeria, hospital Autopsy study | Cross-sectional | 198 brains were autopsied | senile plaque, neurofibrillary tangle, and amyloid vascular degeneration | NA | No evidence of NFT or senile plaque | NA |
1986- 1987 | Including 45 (23%) ≥65 year | ||||||
Hendrie [32], 1995 | Nigeria, community | Cross-sectional | 2494 participants, age ≥65 y., Dementia -28, AD - 18, VaD - 8. | Dementia: CSID/DSM-III-R/ICD-10/AD: NINCDS-ADRDA criteria | NA | Dementia - Overall/65-74/75-84/≥85 y: | |
1992-1993 | 2.3/0 · 9/2.7/9.6; | ||||||
AD - 1.4/0.5/1.7/5.9% | |||||||
Indianapolis-USA, community & nursing home | Cross-sectional | 2212participants, aged ≥65 y. (community) and 106 (nursing home) | Dementia: CSID/DSM-III-R/ICD-10/AD: NINCDS-ADRDA criteria | NA | Dementia Overall/65-74/75-84/≥85 y: | NA | |
1992 - 1993 | |||||||
8.2/2 · 6/11.4/32.4% | |||||||
AD -6.2/1.6/8.0/28.8% | |||||||
Ogeng'o [33], 1996 | Tanzania, hospital | Cross-sectional | 12 Non-demented subjects aged 45–83 y. | senile plaque, neurofibrillary tangle, and cerebral amyloid angiopathy | NA | Amyloid β plaques:17% | NA |
1996 | Autopsy study | ||||||
Neurofibrillary Tangles: 17%; Cerebral Amyloid angiopathy: 17% | |||||||
Kenya, hospital | Cross-sectional Autopsy study | 20 Non-demented subjects aged 45–70 y. | Senile plaque, neurofibrillary tangle, and cerebral amyloid angiopathy | NA | Amyloid β plaques: 15%; Neurofibrillary Tangles: 15%; Cerebral Amyloid angiopathy: 15% | NA | |
USA-Cleveland, Hospital | Cross-sectional/Autopsy study | 20 Non-demented subjects aged 48–84 y. | Senile plaque, neurofibrillary tangle, and cerebral amyloid angiopathy | NA | Amyloid β plaques: 20%; Neurofibrillary: 15%; Cerebral Amyloid angiopathy: 20% | NA | |
Ogunniyi [42], 1997 | Nigeria, community | Cross-sectional | 2494 participants aged >65 y screened, 28 with dementia. | Screening: CSI-D) | NA | Any/ AD/ vascular dementia - 1.1/0.7/0.3% | N A |
1992-1994 | |||||||
Dementia: DSM-III-R and ICD-10 codes | |||||||
AD: NINCDS-ADRDA | |||||||
Sayi [62], 1997 | Tanzania, hospital | Cross-sectional | 24 demented and 286 non-demented participants aged 50–89 y. | Swahili modified MMSE | NA | Prevalence of ϵ4 allele of APOE: Demented - 25%; non demented - 21% | NA |
Kenya, hospital | Cross-sectional | 22 demented and 60 non-demented participants aged ≥65 y. | Swahili modified MMSE | NA | Prevalence of ϵ4 allele of APOE: Demented - 42%, non-demented - 27% | NA | |
Baiyewu [63], 1997 | Nigeria, Nursing home | Cross-sectional | 23 participants (in a nursing home) aged 66–102 y.; 11 women | DSM-III-R/AGECAT | NA | Any dementia (AD) - 47 · 8% (26 · 1%) | NA |
1994 | |||||||
Hall [34],1998 | Nigeria, community | Case–control | 2494 participants; age ≥ 65 y.; | Screening: CSID | NA | 18 cases of possible or probable AD1.4% | age (OR = 1.15; 95% |
423 clinically assessed after screening, | |||||||
CI = 1.12-1.18) and female gender (OR = 13.9; 95% CI = 3.85-50.82) | |||||||
Dementia: DSM-III-R/ICD-10/AD: NINCDS-ADRDA | |||||||
USA–Indianapolis, community | Case–control | 2212 participants; age ≥ 65 y.; | Screening: CSID | NA | Possible/probable AD 6.2% | age, family history of dementia, education; rural residence | |
Dementia: DSM-III-R/ICD-10/AD: NINCDS-ADRDA | |||||||
351 clinically assessed after screening,; 49 (men 17) diagnosed with AD | |||||||
Uwakwe [70], 2000 | Nigeria, Hospital | Cross-sectional | 119 participants; age ≥65 y; 3 had dementia | Geriatric Mental State and/ICD-10 | NA | 2.8% | NA |
1995-1996 | |||||||
Ogunniyi [43], 2000 | Nigeria, community | Cross-sectional 1992-1994 | 2494 participants, age ≥65 y.; 28 with dementia (men: 8) including 18 with AD, 8 with vascular dementia | Screening: CSID | NA | Any dementia 2.3% | Age (OR: 1.15), female gender (13.9), living with others (OR: 0 · 06) |
Dementia: DSM-III-R/ICD-10 | |||||||
AD: NINCDS-ADRDA | AD: 1.4% | ||||||
E4 allele in AD (normal subjects) 34.2% (21.8%) | |||||||
Indianapolis-USA, community | Cross-sectional | 2212 participants, age ≥65 year; 65 with dementia including 49 with AD, 10 with vascular dementia | Screening: CSID | NA | Dementia (AD) overall/65-74/75-84/≥85 y – 8.2 (6.2)/2.62 (1.58)/ 11.4 (8.0)/32 · 4% (28.8%); | Age, rural residence, family history of dementia, education | |
Dementia: DSM-III-R/ICD-10 | |||||||
1992-1994 | |||||||
AD: NINCDS-ADRDA | |||||||
Hendrie [35], 2001 | Nigeria, community | Prospective cohort Baseline survey in 1992-1993 | 2459 participants included after the first visit; 1303 (men 461) completed the follow-up; age ≥65 y. | Screening: CSID | Dementia: 13.5/1,000 | NA | NA |
Dementia: DSM-III-R/ICD-10 | |||||||
AD: NINCDS-ADRDA | AD: 11.5/1000 | ||||||
USA-Indianapolis, community | Prospective cohort | 2147 African-Americans included after the first visit; 1321 (men 417) completed the follow-up; age ≥65 y. | Screening: CSID | Dementia (AD) | NA | NA | |
Baseline survey in 1992-1993 | |||||||
Dementia: DSM-III-R/ICD-10/AD: NINCDS-ADRDA | |||||||
32.4/1,000 (25.2/1,000) | |||||||
Baiyewu [44], 2002 | Nigeria, community | Prospective cohort baseline survey in 1992-1993 | 2487 participants; age ≥65 y.; | Screening: CSID | Conversion from CIND to dementia 16 · 1%; From CIND to normal 25 · 3% | NA | Sex |
Dementia: DSM-III-R/ICD-10 | |||||||
423 clinically assessed after screening; 152 diagnosed with CIND; 28 (men 7) with dementia, 87 followed up for 2 years. | |||||||
Perkins [36], 2002 | Ibadan-Nigeria community | Prospective, 1992-1993 | 2487 participants; age ≥65 y; | Screening: CSID | NA | 1.8% | Dementia associated with mortality |
Dementia: DSM-III-R/ICD-10 | |||||||
423clinically assessed after screening | |||||||
Indianapolis-USA, Community | Prospective Baseline survey in 1992-1993 | 2212 participants; aged ≥65 y.; | Screening: CSID | 4.9% | Dementia associated mortality (adjusted RR: 2 · 05) | ||
342 clinically assessed after screening | |||||||
Dementia: DSM-III-R/ICD-10 | |||||||
Lane [37], 2003 | Nigeria Community | Prospective 8.7 y follow up Baseline 1992-1993 | 968 participants (271 aged ≥75 y.); | Screening: CSID | NA | NA | ApoEϵ4 alleles not associated with increased mortality |
23with dementia at follow-up | |||||||
Dementia: DSM-III-R/ICD-10 | |||||||
Indianapolis-USA, Community | Prospective 9.5 y. Baseline 1992-1993 | 353 participants (17 4 aged ≥75 y.); 17 with dementia at follow-up | Screening: CSID | NA | NA | ApoEϵ4 associated with increased mortality for patient under 75 year | |
Dementia: DSM-III-R/ICD-10 | |||||||
Ogunniyi [45], 2005 | Nigeria, Community | Cross-sectional/1992- 1998 | 98 demented subjects; age ≥65 y. | Screening: CSID | NA | AD: 82% of all cases | NA |
Dementia: DSM-III-R/ICD-10 | |||||||
VaD: 11.1% of all cases | |||||||
Kengne [16], 2006 | Cameroon, | Cross sectional, | 4041 neurologic consultations | Not provided | NA | 0.4% (all neurologic admission), 19% (neurodegenerative diseases) | NA |
Hospital | 1993-2001 | ||||||
145 with neurodegenerative diseases | |||||||
16 (men 14) with dementia, mean age 67.8 y. | |||||||
Gureje [46], 2006 | Nigeria, Community | Cross-sectional, 2003-2004 | 2152 participants at baseline with a respondent rate of 74% (1904 participants). Aged 65 year or older. | adapted 10-Word Delay Recall Test (10-WDRT)10 | NA | Overall: 10.1%; | Female gender, Increasing age, alcohol |
Female: 14.6% | |||||||
Men: 7.0% | |||||||
Gureje [71], 2006 | Nigeria Community | Cross-sectional, | 2245 DNA samples, 830 had a diagnosis | Screening: CSID | NA | Any dementia (16.9% | E4 allele in AD (normal subjects) 26 · 0% (21 · 7%) |
Dementia: DSM-III-R/ICD-10 | |||||||
AD: 14.8% | |||||||
Ogunniyi [72], 2006 | Nigeria, Community | Case–control | 62 participants with AD (Men 16.1%, mean age 82 y) and 461 non demented (men 33.2%, mean age 77 y) | Screening: CSID | NA | Age (OR 1 · 07) | |
Dementia: DSM-III-R/ICD-10/AD: NINCDS-ADRDA | |||||||
Rural to age (OR 2 · 93) Hypertension (OR 0 · 33) | |||||||
Indianapolis-USA, Community | Case–control | 89 participants with AD (men 30.3%, mean age 83 y), mean age 77 y) and 381 non demented (Men 31.2%, mean age 78 y) | Screening: CSID | NA | Age (OR 1.09 | ||
Rural to age (OR 2.08) | |||||||
Dementia: DSM-III-R/ICD-10/AD: NINCDS-ADRDA | Alcohol consumption (OR 0.49) | ||||||
Uwakwe [64], 2006 | Nigeria, Community | Cross-sectional | 30 patients (men 12) with dementia and their caregivers (total 30) | Not provided | NA | N:52; | |
2003-2005 | |||||||
AD: not provided | |||||||
Men: 12 | |||||||
Ochayi [47], 2006 | Nigeria, Community | Cross-sectional 2002 | 280 participants; age ≥65 y.; | CSID | NA | Overall dementia: 6.4% | Female gender, |
Lower body mass index, age, NSAIDS | |||||||
65-74 year old: 5.2% | |||||||
18 (men 2) with dementia | ≥85 year 16%. | ||||||
Hall [48], 2006 | Nigeria, Community | Cross-sectional | 1075 participants; age ≥ 70 y. 29 (men 5) with AD, | NINCDS-ADRDA | NA | NA | Total- or LDL- cholesterol in individuals without the APOE-ϵ4 allele |
Uwakwe [73], 2009 | Nigeria, community | Cross-sectional | 914 (men 432) participants, age ≥65 y; 87 with ≥2 tests memory tests impaired | Memory impairment assessed by MMS, CISD and 10 word list immediate and delayed recall | NA | 9.9% | NA |
Guerchet [50], 2009 | Benin Community | Cross-sectional | 502 (men 156) participants, aged ≥65 y; 52 with cognitive impairment | Screening: CSI-D | NA | Cognitive impairment | Age, current depressive disorder, absence of the APOE ϵ 2 |
Overall: 10.4%; men 7.7 women 11.5% | |||||||
Dementia: DSM-IV | |||||||
AD: NINCDS-ADRDA | Dementia Overall: 2.5%, men 0.6% women 3.4% | ||||||
13 (men 1) with dementia | |||||||
Toure [67], 2009 | Senegal | Cross-sectional | 872 participants; age ≥55 y. | DSM-IV-R | NA | Overall 6.6% | Age, social isolation, history of stroke, epilepsy, family history of dementia, Parkinson’s disease |
Hospital | 2004-2005 | 58 cases of dementia | |||||
Napon [68], 2009 | Burkina Fasso | Cross-sectional | 15815 (2396) out (in) participants; age ≥15 y.; 72 (and 53 inpatients) with dementia; AD: 7; VaD: 19 cases | DSM-IV | NA | outpatients: 0.45% inpatients: 0.22% | NA |
Hospital | |||||||
Guerchet [49], 2010 | Central African Republic Community | Cross-sectional | 509 interviewed; 496 (men 218) included in final sample, age ≥65 y. | Screening: CSID | NA | Overall: 8.1%, men 2.7%, women 12.2% | NA |
2008-2009 | |||||||
Dementia: DSM-IV | |||||||
188 with cognitive impairment and 40 (men 6) with dementia (mean age 76 y.); 33 (men 3) with AD and 7 (men 2) with VaD | AD: NINCDS-ADRDA Hachinski scale, | ||||||
Republic of Congo Community | Cross-sectional | 546 interviewed; 520 (men 198) included in final sample, age ≥65 y. 148 with cognitive impairment and 35 (men 9) with dementia (mean age 79 y.); 24 (men 7) with AD and 11 (men 3) with VaD | CSID/ DSM-IV and NINCDS-ADRDA Hachinski scale | Overall: 6.7%, men 4.5%, women 8.1% | NA | ||
2008-2009 | |||||||
Chen [65], 2010 | Kenya | Cross-sectional | 100 participants; age ≥ 65 y. | CSI-D using a version in Kikuyu. | NA | Apo ϵ4 allele frequency: | NA |
Hospital | |||||||
Demented 31.3%, non-demented 32.2% | |||||||
84 controls (men 38) and 16 with dementia participants (men 7) | |||||||
Ekenze [21], 2010 | Nigeria | Cross-sectional | 8440 admissions; 1249 (men 640) with neurological diseases (age range18-83 y.); 38 (men 23) with dementia | Not specified | NA | 3% | NA |
Hospital | 2003-2007 | ||||||
Siddiqi [69], 2009 | Zambia | Cross-sectional | 443 inpatients (men 219); median age 39 y., 67 with HIV; 368 outpatients (men 168); median age 39 y., 58 with HIV; 36 with dementia | Not specified | NA | Dementia: | Dementia in HIV + patients 8 (13.8%) vs. general population 9 (2.9%) (p = 0.002) |
Overall: 4.4% | |||||||
Hospital | 2006 | ||||||
Yusuf [74], 2011 | Nigeria Community | Cross-sectional | 322 participants (men 128); mean age: 75.5 y | Screening: CSID/CERAD/SDT | NA | Dementia: 2.8% | Age |
AD: 1.9% | |||||||
VaD: 0.6% | |||||||
Dementia: DSM-IV and ICD-10 | |||||||
9 cases of dementia (men 3); mean age: 82.4 y | LBD: McKhan clinical criteria | ||||||
FTD: McKeith clinical criteria | |||||||
Gureje [51], 2011 | Nigeria, Community | Prospective Cohort Baseline 2003-2004 | 2,149 participants at baseline | 10-Word Delayed Recall | 21.80/1,000 | NA | Poor social engagement, rural residence, low economic status, female gender, age. |
Test (cut off of 18) | |||||||
1,408 at 39 months follow-up; 85 (among ≥65 y.) developed dementia | |||||||
Ogunniyi [52], 2011 | Nigeria Community | Cohort study | 1559 participants aged > 65 year without dementia a baseline. 136 (men 33) with dementia (mean age 83.1 y.) at follow-up; 255 with MCI | Dementia: DSM-III-R and ICD-10 | Dementia: 8.72/1,000/year | NA | Low BMI |
1992-2007 | MCI: 16.35/1000/year | ||||||
Ogunniy [53], 2011 | Nigeria Community | prospective cohort baseline 1992 | 2718 participants interviewed | Dementia: DSM-III-R and ICD-10 | Dementia/AD/VaD (per 1,000/year) 11.50/9.50/1.10 | NA | Higher SBP, DBP and PP |
1753 (age ≥65 y.) in the final sample | |||||||
120 (men 30) with dementia (mean age 83.8 y.); 99 with AD; 11 with VaD | |||||||
Paraïso [56], | Benin Community | Cross-sectional | 1,139 (men 523) participants; age ≥65 y.; 42 (men 13) with dementia (mean age 79 · 1 y) | Screening: CSI-D | NA | Dementia Overall 3.7% men 1.1% women: 2.5% | NA |
2011 | |||||||
2008 | |||||||
Dementia: DSM-IV | |||||||
32 with AD, 105 with CIND | |||||||
AD: NINCDS-ADRDA | AD Overall 2.8% | ||||||
VD Overall 0.8% | |||||||
VaD: NINCDS-AIREN | |||||||
Amoo [30], | Nigeria | Cross-sectional | 240,294 participants | Dementia: ICD-10 | NA | Dementia: 45/100,000 | NA |
2011 | |||||||
AD; 25 · 8/100,000 | |||||||
Hospital | 1998-2007 | VaD: 7 · 4/100,000 | |||||
108 (men 51) with dementia (mean age: 70.1); 62 (men 24) with AD; 18 (men 13) with VaD; 4 (men 2) with mixed forms; | ADNINCDS – ADRDA | ||||||
VaD: NINCDS –AIRENS | |||||||
LBD: McKeith criteria, | |||||||
FTD: Lund and Manchester Criteria | |||||||
4 (men 2) with FTD; 3 (men 0) with DLB; 13 (men 2) with unclassified dementia | |||||||
Ndiaye [31], 2011 | Senegal | Cross-sectional | 132 patients seen at a memory clinic (men 41, mean age: 67 y | Screening: “Test du Senegal”/modified HodKinson test | NA | MCI: 14.4% | NA |
Hospital | |||||||
2004-2005 | |||||||
57 with dementia; 37 with AD, 10 with VaD, 5 with FTD and 1 with LBD. | Dementia: 43.2% | ||||||
AD: 64.7% of all cases of dementia | |||||||
MCI: Petersen criteria | |||||||
Dementia: DSM-IV | |||||||
Coume [75], 2012 | Senegal | Cross-sectional | 872 (men 546) participants aged >55 y; mean age 67 · 2 y | Test du Senegal | NA | Cognitive impairment 10.8% | NA |
Hospital | 2004-2005 | 94 (men 65) with cognitive impairment (74 aged > =65 y) | |||||
Baiyewu [54]., 2012 | Nigeria | Cross-sectional/2001 and 2004 | 21 (men 4) participants with normal cognition (mean age 82.8 y.) | Screening: CSID | NA | NA | NA |
Dementia: DSM-III-R/ICD-10 | |||||||
Community | 53 (men 4) with cognitive impairment (mean age 80.9); 34 (men 6) with dementia (mean age 83.3 y) | AD: NINCDS-ADRDA | |||||
Toure [66], 2012 | Senegal | Cross-sectional | 507 participants; age ≥65 y. | Screening: Aging in Senegal Questionnaire | NA | 8.9% | advanced age (Age ≥80 y, OR 4.3, 95% CI 1.4-13), illiteracy, epilepsy, family history of dementia |
45 with dementia | DSM-IV-R | ||||||
Hospital | 2004-2005 | ||||||
Longdon [57], 2012 | Tanzania | Cross-sectional | 1198 (men 525) participants; age ≥70 y; 78 with dementia | Screening: CSI-D | NA | 6.4% | Advanced age |
Community | 2010 | ||||||
DSM-IV-R | |||||||
Onwuekwe [76], 2012 | Nigeria | Cross-sectional | 135 participants (men: 79), aged between 16–76 y | MMSE (cut off of 17 for MCI) | NA | MCI: 5.9% | |
Hospital | 2004 | ||||||
8 with MCI | |||||||
Guerchet [55], 2012 | Central African Republic, Congo | Cross-sectional | 509 interviewed; 496 (men 218) included in final sample; age ≥65 y.; 188 with cognitive impairment | Dementia: DSM-IV-R/AD: NINCDS-ADRDA | NA | Dementia: 7.4% | Hypertension, low BMI, depressive symptoms, change of residence, age (OR 2.59, 95% CI, early death of one parent, female gender |
2008-2009 | |||||||
Community | AD: 5.6% | ||||||
546 interviewed; 520 (men 198) included in final sample; age ≥65 y.; 148 with cognitive impairment | |||||||
Overall 75 (men 15) had dementia 18 with vascular dementia |