Low education and lack of spousal relationship are associated with dementia in older adults with diabetes mellitus in Nigeria.

BACKGROUND: The relationship between dementia and type 2 diabetes mellitus (T2DM) in older adults is well established in the literature. However, there have been few studies on this relationship in older adults living in low- and middle-income countries, and most demographic projections predict that older adult population will increase substantially in these regions by 2050. METHODS: In this study, older adults with T2DM attending a tertiary health facility were examined and compared with community-dwelling older adults without T2DM. The participants were assessed using the Consortium to Establish Registry for Alzheimer's Disease, the Stick Design Test, the 30-item Geriatric Depression Scale, and the Instrumental Activities of Daily Living Scale. Additionally, all the participants had a physical examination, including assessment of glycated haemoglobin, fasting blood glucose, lipid profile, and HIV status. A consensus diagnosis of dementia was made based on the criteria for dementia in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and the International Classification for Diseases, 10th edition. The data were analyzed using SPSS version 20 for Windows. RESULTS: This study included 224 diabetic patients and 116 controls. A total of 27 diabetic patients (12.1%) had dementia, 19 of whom were women. Of the 27 diabetic patients with dementia, 25 patients (92.6%) had Alzheimer's disease and 2 patients (7.4%) had mixed dementia (vascular dementia and Alzheimer's disease). Only one person among the controls had Alzheimer's type dementia. Dementia in the diabetic patients was significantly associated with advancing age, female gender, education level, duration of diabetes, and absence of a spouse. CONCLUSION: Dementia is common in older adults with T2DM in this low-resource setting, and the risk factors for dementia were similar to those reported in earlier studies in Western societies.

Prevalence of dementia and dementia subtypes among community-dwelling elderly people in northern Nigeria.

BACKGROUND: Dementia has important public health implications. The magnitude of the problem remains largely unknown in the developing countries. METHODS: Three hundred and twenty-two community dwelling elderly persons and their caregivers in Zaria, Northern-Nigeria were enrolled in this study. They were interviewed using Community Screening Interview for Dementia (CSI-D), Consortium to Establish Registry for Alzheimer's disease (CERAD), Stick Design Test (SDT), Blessed Dementia Scale and a sociodemographic questionnaire. The data obtained were analyzed using the Statistical Package for Social Sciences version 15 for Windows. Diagnosis was based on fulfilling criteria for dementia in both the International Classification of Disease, 10th edition and the Diagnostic and Statistical Manual, 4th edition. RESULTS: The mean age of the subjects was 75.5 ± 9.4 years. The prevalence of dementia was 2.79% (CI 1-4.58%). Alzheimer's disease constituted 66.67% of all the cases of dementia in this community. Age was the only demographic factor associated with dementia. CONCLUSION: The prevalence rates of dementia and dementia subtypes in the developing countries are similar using standard diagnostic criteria and methods.