The burden and determinants of cognitive impairment among individuals with chronic diseases in Ethiopia: A systematic review and meta-analysis

Introduction

Cognitive impairment is a medical condition caused by neurodegeneration, marked by a gradual decline in neurological, motor, psychological, and cognitive domain functions, as well as daily activities. It primarily affects individuals with conditions such as Alzheimer's disease, stroke, HIV/AIDS, diabetes mellitus, cancer, epilepsy, dementia, and other chronic illnesses, as well as older adults. While some individual studies have explored the effects of cognitive impairment, there is a lack of nationwide research to provide a comprehensive understanding of its burden among individuals with chronic diseases.

Objective

To assess the pooled prevalence of cognitive impairment and its associated factors among individuals with chronic diseases in Ethiopia.

Methods

Several databases were examined to find available articles. The data were extracted and sorted in Microsoft Excel before being exported to STATA/MP 17.0 for analysis. A random-effects Der Simonian-Laird model with a 95 % confidence interval was used to pool the data. Cochrane I² statistics and Egger's test were used to evaluate heterogeneity and publication bias, respectively. To determine the cause of heterogeneity, subgroup analysis was performed. A log-odds ratio was utilized to illustrate the association between cognitive impairment and its associated factors. P-values less than 0.05 were considered statistically significant.

Result

This study included 22 individual articles comprising a total of 6818 participants. The overall prevalence of cognitive impairment among individuals with chronic diseases was 44.43 % (95 % CI: 37.76–51.10). Studies conducted in Addis Ababa reported a higher prevalence of 50.89 % (95 % CI: 34.59–67.19). Similarly, research focusing on older adults indicated the highest prevalence, at 57.58 % (95 % CI: 28.78–86.39). Participants who are unable to read and write were 3.82 times more likely to experience cognitive impairment compared to those who had completed primary education (AOR = 3.82; 95 % CI: 2.97–4.91).

Conclusion

This review found a high prevalence of cognitive impairment among Ethiopians with chronic diseases, especially in older adults and those in Addis Ababa. Illiteracy significantly increased the risk. These findings highlight the need for targeted cognitive screening and integration of cognitive care into chronic disease management.