Dementia Prevalence in a Rural Region of South Africa: A Cross-Sectional Community Study

Topic: Risk, prevention and care in population studies

Background Dementia is a growing concern for low- and middle-income countries where longevity is increasing and service provision is poor. Global prevalence estimates vary from 2% to 8.5% for those aged 60 years and older. There have been few dementia studies in sub-Saharan Africa, and prevalence data are lacking for South Africa. Objective To conduct a large dementia prevalence study in a low income rural population in South Africa. Methods 1,394 Xhosa-speaking community dwellers, aged ≥60 y (mean age±sd 71.3±8.3 y), in three clinic catchment areas, were screened at home. Trained community health workers administered the brief Community Screening Instrument for Dementia (CSID) to participants and informants to assess cognitive and functional capacity. Depressive symptoms were assessed with three questions from the EURO-D. Results The prevalence estimate using published CSID sensitivity/specificity values was 0.8 (95% CI: 0.06-0.09). Using CSID cut-off scores the estimated prevalence was 0.12 (95% CI: 0.10-0.13), with 161 screen-positives. Both methods gave a rate of 0.11 (95% CI: 0.09-0.13) for those over 65 years (n = 1051). 68.6% of participants were female and 69.8% had less than 7 years of education. Dementia risk was associated with older age and symptoms of depression, but not with sex. The association with education was not significant when controlled for by age. Conclusions Dementia prevalence estimates were higher than expected for this low-income rural community. There is a need for increased dementia awareness and feasible support interventions. We also need further studies of regional prevalences, dementia subtypes, and modifiable risk factors in South Africa.

Key findings

• Results The prevalence estimate using published CSID sensitivity/specificity values was 0.8 (95% CI: 0.06-0.09).
• Dementia risk was associated with older age and symptoms of depression, but not with sex.
• The association with education was not significant when controlled for by age.

Why it matters

This cross-sectional study estimated how common dementia was in a rural area of South Africa. It found that older age and symptoms of depression were associated with dementia risk, but it does not test any treatment or cure.

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Study details

• Participants1,051
• Effect size8.5%; 68.6%; 69.8%
• Evidence strengthLow

Read the original

• DOI: 10.3233/jad-170325
• PubMed: 28984589
• Original source →
• Free full text: Journal of Alzheimer s Disease →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

@article{dejager2017-28984589,
  author  = {de Jager, C. A. and Msemburi, W. and Pepper, K. and Combrinck, M. I.},
  title   = {{Dementia Prevalence in a Rural Region of South Africa: A Cross-Sectional Community Study}},
  journal = {Journal of Alzheimer's disease : JAD},
  year    = {2017},
  doi     = {10.3233/jad-170325},
  pmid    = {28984589},
  url     = {https://doi.org/10.3233/jad-170325}
}

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• Global prevalence of dementia: a Delphi consensus study Lancet (London, England) · 2005-12-01 · usefulness score 79/100 · How common it is
• The global prevalence of dementia: a systematic review and metaanalysis Alzheimer's & dementia : the journal of the Alzheimer's Association · 2013-01-01 · usefulness score 78/100 · Caregiving
• The protocols for the 10/66 dementia research group population-based research programme BMC public health · 2007-07-20 · usefulness score 69/100 · Caregiving
• Prevalences of dementia and cognitive impairment among older people in sub-Saharan Africa: a systematic review Bulletin of the World Health Organization · 2013-08-20 · usefulness score 67/100 · Disparities
• A Comparison of the Prevalence of Dementia in the United States in 2000 and 2012 JAMA Internal Medicine · 2017-01-01 · usefulness score 65/100 · How common it is
• Dementia diagnosis in developing countries: a cross-cultural validation study Lancet (London, England) · 2003-03-01 · usefulness score 60/100 · Getting a diagnosis
• Prevalence of Alzheimer's disease and other dementias in rural India: the Indo-US study Neurology · 1998-10-01 · usefulness score 57/100 · Disparities
• Dementia in western Europe: epidemiological evidence and implications for policy making The Lancet. Neurology · 2015-08-21 · usefulness score 55/100 · Prevention and risk
• The prevalence of dementia in rural Tanzania: a cross-sectional community-based study International journal of geriatric psychiatry · 2012-09-20 · usefulness score 53/100 · Disparities
• Epidemiology of dementia in Nigeria: results from the Indianapolis-Ibadan study European journal of neurology · 2000-09-01 · usefulness score 44/100 · Disparities

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