title: The nutritional status of older people with and without dementia living in an urban setting in Central Africa: the EDAC study.
abstract: OBJECTIVE
  To determine the nutritional status of elderly African people and to investigate the association between undernutrition and dementia.
  
  
  METHODS
  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 over 65 years.
  
  
  METHODS
  Undernutrition was defined as a body mass index <18.5. Anthropometric parameters (arm circumference, waist circumference and triceps skinfold thickness) were measured, and information was gathered on nutritional habits. PARTICIPANTS underwent cognitive screening using the Community Screening Interview for Dementia (CSI-D) and the Five-Word Test. After further neuropsychological testing and neurological examination, the diagnosis of dementia was confirmed according to DSM-IV criteria. Multivariate logistic regression models were applied in order to identify factors associated with undernutrition in populations with or without dementia.
  
  
  RESULTS
  1016 people were included. In the general population, the prevalence of undernutrition was 19.2%. Dementia was found in 7.4% of elderly people. Compared with healthy people, patients with dementia had an increased prevalence of undernutrition (32.0% vs. 17.7%; p = 0.002), lower weight (49.3 ± 10.5 kg vs. 58.4 ± 13.5 kg ; p < 0.001), and lower BMI (20.8 ± 4.1 vs. 22.9 ± 4.8 ; p < 0.001); they were less likely to eat their fill (38.9% vs. 45.9% ; p = 0.001), had more dietary restrictions (36.1% vs. 24.3% ; p = 0.03) and ate less often with their family (66.7% vs. 90.6% ; p < 0.0001). Eating only one meal per day was the sole factor associated with undernutrition in dementia (OR: 7.23 [CI: 1.65-31.7]; p = 0.03).
  
  
  CONCLUSIONS
  The prevalence of undernutrition is high in the older population. The nutritional status of patients with dementia is more impaired than that of healthy patients. However, they are less often malnourished than in French home care settings. This study is the first to look at the nutritional status of at-home patients with dementia in Africa. These comparative data will eventually be used in the development of new nutritional intervention strategies.
authors.affiliation: Dr Jésus Pierre, Unité de Nutrition, CHU Dupuytren, 2 Avenue Martin Luther King, 87042 Limoges Cedex, France, Phone : (33) 5 55 05 66 21, Mail : pierre.jesus@chu-limoges.fr.
authors.forename: C
authors.initials: C
authors.lastname: De Rouvray
authors.forename: P
authors.initials: P
authors.lastname: Jésus
authors.forename: M
authors.initials: M
authors.lastname: Guerchet
authors.forename: P
authors.initials: P
authors.lastname: Fayemendy
authors.forename: A M
authors.initials: AM
authors.lastname: Mouanga
authors.forename: P
authors.initials: P
authors.lastname: Mbelesso
authors.forename: J P
authors.initials: JP
authors.lastname: Clément
authors.forename: P M
authors.initials: PM
authors.lastname: Preux
authors.forename: J C
authors.initials: JC
authors.lastname: Desport
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001835:Body Weight; D002488:Central African Republic / Q000453:epidemiology; D003223:Congo / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003704:Dementia / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000453:epidemiology; D009483:Neuropsychological Tests; D009752:Nutritional Status; D015995:Prevalence; D014504:Urban Health; D014505:Urban Population