title: Epidemiology of dementia in Central Africa (EPIDEMCA): protocol for a multicentre population-based study in rural and urban areas of the Central African Republic and the Republic of Congo.
abstract: BACKGROUND
  The worldwide population is ageing and the proportion of elderly aged 60 and over is expected to dramatically rise in Low and Middle Income Countries (LMIC). The epidemic of dementia will not spare those countries, where the largest increases in numbers of people affected are estimated. Besides, dementia is still understudied in sub-Saharan Africa (SSA) compared to other regions. This paper describes the protocol for the 'Epidemiology of Dementia in Central Africa' population-based study, which aims at estimating the prevalence of dementia in two countries of Central Africa and investigating possible risk factors.
  
  
  METHODS
  A multicenter population-based study was carried out in Central African Republic and Republic of Congo between 2011 and 2012 including both urban and rural sites in each country. Around 2000 participants aged ≥65 years old were interviewed in total using the Community Screening Interview for Dementia (CSI-D), the GMS-AGECAT and the CERAD's 10-word list. Elderly with low performance to the cognitive part of the CSI-D (COGSCORE ≤ 24.5) were then clinically assessed by neurologists and underwent further psychometrical tests. DSM-IV and NINCDS-ADRDA criteria were required for dementia and Alzheimer's disease (AD) diagnoses respectively. The algorithmic 10/66 dementia diagnosis was also determined. Petersen's criteria were required for the diagnosis of Mild Cognitive Impairment. Sociodemographic, and environmental factors including vascular, nutritional, biological, psychosocial and lifestyle factors were collected in each setting in order to investigate factors associated with dementia. Blood sampling was realized to investigate genetic variations that could modify the risk of dementia.
  
  
  CONCLUSIONS
  For now, no large epidemiological study has been undertaken to compare the prevalence of dementia in both rural and urban areas within SSA countries. This programme will provide further evidence regarding the prevalence of dementia in SSA, and also the possible rural/urban disparities existing with associated factors. Furthermore, the genetics of AD in those populations will be addressed.
authors.affiliation: Tropical Neuroepidemiology, Faculty of Medicine, INSERM UMR 1094, 2 rue du Docteur Marcland, 87025 Limoges, France ; Institute of Neuroepidemiology and Tropical Neurology, University Limoges, School of Medicine, CNRS FR 3503 GEIST, Limoges, France ; King's College London, Centre for Global Mental Health, Institute of Psychiatry, Health Service and Population Research Department, London, UK.
authors.forename: Maëlenn
authors.initials: M
authors.lastname: Guerchet
authors.affiliation: Tropical Neuroepidemiology, Faculty of Medicine, INSERM UMR 1094, 2 rue du Docteur Marcland, 87025 Limoges, France ; Institute of Neuroepidemiology and Tropical Neurology, University Limoges, School of Medicine, CNRS FR 3503 GEIST, Limoges, France ; Department of Neurology, Brazzaville University Hospital, Brazzaville, Republic of Congo.
authors.forename: Pascal
authors.initials: P
authors.lastname: Mbelesso
authors.affiliation: Department of Neurology, Amitié Hospital, Bangui, Central African Republic.
authors.forename: Bébène
authors.initials: B
authors.lastname: Ndamba-Bandzouzi
authors.affiliation: Tropical Neuroepidemiology, Faculty of Medicine, INSERM UMR 1094, 2 rue du Docteur Marcland, 87025 Limoges, France ; Institute of Neuroepidemiology and Tropical Neurology, University Limoges, School of Medicine, CNRS FR 3503 GEIST, Limoges, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Pilleron
authors.affiliation: Tropical Neuroepidemiology, Faculty of Medicine, INSERM UMR 1094, 2 rue du Docteur Marcland, 87025 Limoges, France ; Institute of Neuroepidemiology and Tropical Neurology, University Limoges, School of Medicine, CNRS FR 3503 GEIST, Limoges, France ; Department of CardioVascular Surgery, CHU, Limoges, France.
authors.forename: Ileana
authors.initials: I
authors.lastname: Desormais
authors.affiliation: Tropical Neuroepidemiology, Faculty of Medicine, INSERM UMR 1094, 2 rue du Docteur Marcland, 87025 Limoges, France ; Institute of Neuroepidemiology and Tropical Neurology, University Limoges, School of Medicine, CNRS FR 3503 GEIST, Limoges, France ; Department of CardioVascular Surgery, CHU, Limoges, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Lacroix
authors.affiliation: Tropical Neuroepidemiology, Faculty of Medicine, INSERM UMR 1094, 2 rue du Docteur Marcland, 87025 Limoges, France ; Institute of Neuroepidemiology and Tropical Neurology, University Limoges, School of Medicine, CNRS FR 3503 GEIST, Limoges, France ; Department of Cardiology, Dupuytren University Hospital, Limoges, France.
authors.forename: Victor
authors.initials: V
authors.lastname: Aboyans
authors.affiliation: Tropical Neuroepidemiology, Faculty of Medicine, INSERM UMR 1094, 2 rue du Docteur Marcland, 87025 Limoges, France ; Institute of Neuroepidemiology and Tropical Neurology, University Limoges, School of Medicine, CNRS FR 3503 GEIST, Limoges, France ; Department of Nutrition, CHU, Limoges, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Jésus
authors.affiliation: Tropical Neuroepidemiology, Faculty of Medicine, INSERM UMR 1094, 2 rue du Docteur Marcland, 87025 Limoges, France ; Institute of Neuroepidemiology and Tropical Neurology, University Limoges, School of Medicine, CNRS FR 3503 GEIST, Limoges, France ; Department of Nutrition, CHU, Limoges, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Desport
authors.affiliation: EA 6310, Disability, Activity, Aging, Autonomy and the Environment (HAVAE), Limoges, France.
authors.forename: Achille E
authors.initials: AE
authors.lastname: Tchalla
authors.affiliation: Tropical Neuroepidemiology, Faculty of Medicine, INSERM UMR 1094, 2 rue du Docteur Marcland, 87025 Limoges, France ; Institute of Neuroepidemiology and Tropical Neurology, University Limoges, School of Medicine, CNRS FR 3503 GEIST, Limoges, France ; CHU, Department of Medical Information & Evaluation, Clinical Research and Biostatistic Unit, Limoges, France.
authors.forename: Benoît
authors.initials: B
authors.lastname: Marin
authors.affiliation: INSERM U744, Institut Pasteur de Lille, Lille, France.
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Lambert
authors.affiliation: Tropical Neuroepidemiology, Faculty of Medicine, INSERM UMR 1094, 2 rue du Docteur Marcland, 87025 Limoges, France ; Institute of Neuroepidemiology and Tropical Neurology, University Limoges, School of Medicine, CNRS FR 3503 GEIST, Limoges, France ; Hospital and University Federation of Adult and Geriatric Psychiatry, Limoges, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Clément
authors.affiliation: INSERM U897, Victor Segalen Bordeaux II University, Bordeaux, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Dartigues
authors.affiliation: Tropical Neuroepidemiology, Faculty of Medicine, INSERM UMR 1094, 2 rue du Docteur Marcland, 87025 Limoges, France ; Institute of Neuroepidemiology and Tropical Neurology, University Limoges, School of Medicine, CNRS FR 3503 GEIST, Limoges, France ; CHU, Department of Medical Information & Evaluation, Clinical Research and Biostatistic Unit, Limoges, France.
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Preux
keywords: Ageing; Alzheimer’s Disease; Dementia; Prevalence; Risk Factors; sub-Saharan Africa