PROFILE AND PATTERN OF PEOPLE DIAGNOSED WITH YOUNG ONSET DEMENTIA ATTENDING A PSYCHOGERIATRIC CLINIC IN SOUTHWESTERN NIGERIA: A RETROSPECTIVE CASE SERIES

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O.O. Elugbadebo¹, T. Olojugba², C. Okwudiri³, L. Adebusoye⁴, O. Baiyewu¹

1. Department of Psychiatry, College of Medicine, University of Ibadan, Nigeria.
2. Department of Psychiatry, University College Hospital, Nigeria.
3. Department of Data and Information Science, University of Ibadan, Nigeria.
4. Chief Tony Anenih Geriatric Centre, University College Hospital, Ibadan, Nigeria.

Abstract

Background: Accessing data on the profile and pattern of people diagnosed with young onset dementia (YOD) can be challenging, especially in Low-and-Middle-Income Countries. Research focused on the epidemiology of YOD will improve early detection and diagnosis, and the understanding of its impact on individuals and society.

Objective: The study seeks to describe the sociodemographic and clinical characteristics of people diagnosed with YOD in an outpatient memory clinic.

Method: A retrospective quantitative case series to investigate the pattern and characteristics of people diagnosed with YOD attending a Psychogeriatric Clinic in Southwestern Nigeria. Data were collected manually from the medical case records of people with dementia who attended the psychogeriatric clinic.

Results: The subjects’ mean ± SD age was 60.2 ± 4.2 years and 50% were females. The most common medical comorbidity was hypertension (50.0%). Depression (15.8%) was the most common behavioral symptom. Alzheimer’s dementia (50.0%) was the predominant dementia type. There was a significant difference in the age (p=0.001), Boston naming test (p=0.011), based on the educational status of the participants. The neuropsychological profile of the participants showed low scores in some specific domains like memory and language.

Conclusions: Depression and hypertension are major comorbid conditions affecting persons with YOD. Such persons are impaired in some specific domains such as memory and language skills. Early detection and management of both conditions could have a positive impact on the overall management of Young-Onset Dementia

Keywords: Behavioral symptoms, Comorbidity, Dementia, Neuropsychological assessment, Older adults, Young onset dementia.

Introduction

Young-onset dementia (YOD) is a progressive and degenerative condition that predominantly affects adults before 65 years of age.¹ Notably, YOD affects a significant part of the population as about 3.9 million people live with the illness globally² and studies have suggested higher prevalence in Low-and-Middle-Income Countries (LMICs) based on lower life expectancy.³ However, the rates and burdens of YOD in LMICs remain unclear as there exists a substantial literature gap in these regions 2 and a limited understanding of YOD in these regions despite the increasing body of studies on dementia in other regions. Although the diagnosis of dementia at any age is profound, diagnosis in younger persons poses a peculiar challenge with significant psychosocial impact, as they are often in the prime of their lives⁴, and has a fast progression, usually associated with other metabolic co-morbidities and genetic predisposition.

Furthermore, the same diagnostic criteria are commonly used for both late-onset dementia and young-onset dementia despite the observable disparities in clinical features posing barriers to adequate management of the illness.⁵ Additionally, early diagnosis of YOD can be challenging using some existing diagnostic criteria, which require cognitive impairment to be severe enough to impair social and occupational functioning.⁶ However, this level of impairment may take a more extended period to manifest, despite ongoing cognitive decline, with an average delay of up to four years in some cases.^7,8 Moreover, persons diagnosed with YOD may not seek medical help until the symptoms significantly impact their daily functioning or quality of life.^9,10 The situation may be more daunting in developing countries like Nigeria, with limited availability of dementia specialists and YOD identification services.11

Examining the clinical features and presentation of patients diagnosed with YOD in our setting is crucial to obtaining information that can enhance early identification and diagnostic processes and contribute to developing post-diagnostic support and interventions for people diagnosed with YOD in Nigeria. Hence, this present study seeks to obtain relevant information on the characteristics and presentation of patients diagnosed with YOD in this region and its correlates.