title: Association between a low ankle-brachial index and dementia in a general elderly population in Central Africa (Epidemiology of Dementia in Central Africa Study).
abstract: OBJECTIVE
  To investigate the association between peripheral arterial disease (PAD) and dementia in native elderly African populations.
  
  
  METHODS
  Two successive door-to-door cross-sectional surveys in the general population.
  
  
  METHODS
  Representative districts of Bangui (Central African Republic) and Brazzaville (Republic of Congo).
  
  
  METHODS
  Population aged 65 and older.
  
  
  METHODS
  Peripheral arterial disease was defined as an ankle-brachial index (ABI) of 0.90 or less. Cognitive screening was performed using the Community Screening Interview for Dementia and the Five-Word Test. Diagnosis of dementia was confirmed after further neuropsychological tests and neurological examination according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. Multivariate logistic regression models were used to quantify the association between PAD and dementia in those populations, with adjustments for cardiovascular disease (CVD) and other variables.
  
  
  RESULTS
  A significant association was observed between PAD and prevalent dementia (odds ratio (OR) = 2.43, 95% confidence interval (CI) = 1.44-4.13, P = .001), even after adjustment for age, city, sex, CVD risk factors, education, and depressive disorders (OR = 2.37, 95% CI = 1.31-4.26, P = .004). This association was stronger with lower ABI.
  
  
  CONCLUSIONS
  These findings support the hypothesis of a link between atherosclerosis (represented by a low ABI) and cognitive disorders in native Africans and are similar to previous reports in African Americans and other ethnic groups.
authors.affiliation: INSERM UMR1094, Tropical Neuroepidemiology, Limoges, France. maelenn.guerchet@unilim.fr
authors.forename: Maëlenn
authors.initials: M
authors.lastname: Guerchet
authors.forename: Pascal
authors.initials: P
authors.lastname: Mbelesso
authors.forename: Alain M
authors.initials: AM
authors.lastname: Mouanga
authors.forename: André
authors.initials: A
authors.lastname: Tabo
authors.forename: Bébène
authors.initials: B
authors.lastname: Bandzouzi
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Clément
authors.forename: Philippe
authors.initials: P
authors.lastname: Lacroix
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Preux
authors.forename: Victor
authors.initials: V
authors.lastname: Aboyans
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D002488:Central African Republic / Q000453:epidemiology; D016009:Chi-Square Distribution; D003223:Congo / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003704:Dementia / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009483:Neuropsychological Tests; D016491:Peripheral Vascular Diseases / Q000453:epidemiology*; D015995:Prevalence
keywords: Africa; ankle-brachial index; atherosclerosis; dementia; peripheral arterial disease