O.O. Elugbadebo1, T.H. Farombi2, O.A. Afolabi3, L.A. Adebusoye2
- Department of Psychiatry, College of Medicine, University of Ibadan, Nigeria.
- Department of Psychiatry, College of Medicine, University of Ibadan, Nigeria.
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria.
Abstract
Background: Knowledge on the clinical presentation of dementia is essential for appropriate care, especially in Low-and-Middle-Income Countries where these cases are on a sharp rise and can also aid early detection of other underlying conditions. This study sought to provide a broad and updated socio-demographic, clinical profile, pattern of diagnosis and treatment features of people diagnosed with dementia in this setting.
Method: A retrospective cohort study which reviewed the medical case records of all older adults with dementia receiving treatment at the psychogeriatric and the neurology clinic of the Geriatric Centre (N=192). A proforma was designed to collect information from the case records.
Results: The mean (±SD) age of the participants was 74.0(±7.2) years, 97.9%lived with other persons, 50.0% had at least one comorbidity and 52.6% presented late for treatment. Overall, hypertension (64.1%) and diabetes (22.4%) were the most common comorbidity, 55.2% had complaints bordering on behavioural problems; irrational speech (31.3%) being the most common, while 91.7% had forgetfulness as a cognitive symptom.
Conclusions: A high rate of comorbidities, as well as late presentation was common among the participants. Our findings appraise the clinical importance of detailed knowledge of the patterns and profiles of older adults with dementia for early presentation and treatment.
Keywords: Dementia, Older adults, Clinical profile, Clinical pattern, Comorbidity, Behavioural symptoms
Correspondence:
Dr. O. Elugbadebo
Department of Psychiatry,
College of Medicine,
University of Ibadan,
Ibadan, Nigeria.
E-mail: fisayoelu08@yahoo.com
Submission Date: 16th April, 2023
Date of Acceptance: 1st April, 2024
Publication Date: 30th April, 2024
Introduction
The prevalence of dementia is rising globally with the increasing aging population.1,2 According to a global report in 2019, about 57.4 million people were living with dementia, and this prevalence has been estimated to increase to about 152·8 million cases in 2050.3 In Nigeria, a systematic review conducted by Adeloye et al. in 2019, showed that about 4.9% older adults were living with dementia and projected that by the year 2050, this would have increased to over 1.4 million cases.4 Of no doubt, this will pose some level of care burden. Knowledge on the clinical presentation of the illness is essential for appropriate clinical care especially in Low-and-Middle-Income Countries where dementia cases are on a sharp rise.5,6 Evidences have established that identifying the pattern of presentation of people diagnosed with dementia is crucial in making early diagnosis and developing strategies for effective treatment.7,8 These patterns include the participants’ sociodemographic, clinical and pathologic characteristics.9–11To our knowledge, there is little evidence on the presentation and clinical pattern of dementia in Nigeria. Although, there exists some robust studies on its incidence, prevalence and risk factors,12–14 there is still a dearth of information on the clinical course, pattern of presentation, and specific pointers to diagnosing its subtypes.15,16
Dementia awareness is still relatively low with few specialists available,16,17 leading to a common trend of substantial time lag between identification of symptoms and presentation for treatment among people with dementia (PWD) residing in this setting.18,19 With the growing number of persons with dementia in LMICs,9 late identification, under diagnosis and misdiagnosis could become more challenging without adequate knowledge about dementia. Moreover, dementia is usually accompanied with some medical comorbidities20; explicit knowledge of the profile and presentation of the disease can aid early detection of other underlying conditions.
Therefore, this study sought to provide a broad and updated sociodemographic and clinical profile, patterns of diagnosis and treatment features of the people diagnosed with dementia in this setting.