Dementia, cognitive impairment in Nigerians aged 90 years or older: A 20-year follow up of survivors of Ibadan study of aging cohort.

Abstract

Objective: Studies of dementia involving the oldest old are few in Sub-Saharan Africa. Survivors of the Ibadan arm of the Indianapolis-Ibadan Dementia Project who were enrolled in 1992 or 2001 were re-examined between 2021 and 2022.

Aim: To revisit these subjects and evaluate them for the presence of cognitive and functional impairment and assign diagnoses as relevant as well as determine factors that mitigate development of dementia and cognitive impairment and thus promote healthy aging.

Design: Evaluation consisted of the CERAD neuropsychological battery, an informant interview, and a clinical examination by physicians with expertise in cognitive disorders of aging. Diagnoses were adjudicated by consensus between psychiatrists and neurologists using ICD-10 and DSM-IV criteria and diagnosis of Mild Cognitive Impairment based on the National Institute of Aging- criteria RESULT: One hundred and thirty-five of the original 4425 persons ever recruited were re-evaluated. Mean age was 93·0±2·8 years (range 89-106 years); 103 (76 %) were females, 29 (21 %) were diagnosed dementia, 25 (18 %) had AD, 44 (32·6 %) had diagnosis of Mild Cognitive Impairment (MCI) and 62 (45·9 %) were cognitively normal. Using logistic regression model for the combined dementia and MCI group with predictor variables collected during the 2001 evaluation wave, we found that cognitive score (Odds Ratio (OR)= 0·94, p = 0·024 (95 % CI:0.09-0.99), diastolic blood pressure (OR=1·04, p = 0·015 (95 % CI:1.01-1.07) and regular alcohol use (OR=0·42, p = 0·041(95 % CI:0.18-0.96) were associated with 20-year prevalence of cognitive impairment after adjusting for age, sex, and education. ApoE4 allele was neither a risk factor for dementia nor Cognitive Impairment in this cohort.

Conclusion: Prevalence of cognitive impairment in this oldest old survivor cohort was associated with cognitive performance, diastolic blood pressure and regular use of alcohol 20 years before.