title: The prevalence and burden of behavioural and psychological symptoms of dementia in rural Tanzania.
abstract: OBJECTIVE
  Behavioural and psychological symptoms (BPS) in dementia are common in high-income countries, but there are few data from sub-Saharan Africa. Our aim was to estimate the prevalence and pattern of BPS and associated caregiver distress in rural Tanzania.
  
  
  METHODS
  Prevalent cases of dementia (aged 70 and over) were identified during a community-based door-to-door study in six rural villages in Tanzania. Following cognitive screening, a stratified sample (over-sampled for people with dementia) of cases underwent a detailed clinical assessment including the brief 12 item neuropsychiatric inventory (NPI-Q), which assesses BPS and associated caregiver distress over the preceding 30 days.
  
  
  RESULTS
  Of 78 people with dementia, at least one current BPS was reported by 69 (88.4%), with 40 (51.3%) reporting 3 or more symptoms. In 172 people with no cognitive impairment, 110 (64.0%) reported at least one symptom and 48 (27.9%) reported 3 or more. In dementia cases, the most frequent symptoms reported were anxiety (47.4%), agitation/aggression (38.5%), night-time behavioural disturbance (34.6%), irritability (33.3%) and depression (33.3%).
  
  
  CONCLUSIONS
  The frequency of BPS in dementia in this rural Tanzanian population is high and comparable to that reported in prevalence studies from high income countries. Symptoms were also common, although to a lesser degree, amongst cognitively intact subjects. BPS are likely to have a significant impact on quality of life for elderly persons and their carers in low-income settings. Low-cost interventions, such as community-based therapy and education, are needed.
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, North Shields, UK.|Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK.
authors.forename: S-M
authors.initials: SM
authors.lastname: Paddick
authors.affiliation: Hai District Hospital, Boma'ngombe, Tanzania.
authors.forename: A
authors.initials: A
authors.lastname: Kisoli
authors.affiliation: South Devon Healthcare Trust, Torquay, UK.
authors.forename: A
authors.initials: A
authors.lastname: Longdon
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, North Shields, UK.|Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: C
authors.initials: C
authors.lastname: Dotchin
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, North Shields, UK.
authors.forename: W K
authors.initials: WK
authors.lastname: Gray
authors.affiliation: Hai District Hospital, Boma'ngombe, Tanzania.
authors.forename: P
authors.initials: P
authors.lastname: Chaote
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK.|Northumberland, Tyne and Wear NHS Trust, Newcastle Upon Tyne, UK.
authors.forename: A
authors.initials: A
authors.lastname: Teodorczuk
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, North Shields, UK.|Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: R
authors.initials: R
authors.lastname: Walker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression; D001007:Anxiety / Q000453:epidemiology; D017028:Caregivers / Q000523:psychology*; D003072:Cognition Disorders / Q000453:epidemiology; D003704:Dementia / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000453:epidemiology; D011788:Quality of Life; D012424:Rural Population / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000209:etiology; D013636:Tanzania / Q000453:epidemiology
keywords: Africa; behavioural symptoms; dementia; neuropsychiatric inventory; psychological symptoms