title: Mild Cognitive Impairment in Rural Tanzania: Prevalence, Profile, and Outcomes at 4-Year Follow-up.
abstract: OBJECTIVE
  Mild cognitive impairment (MCI) is recognized as a high-risk condition for conversion to dementia, although data on outcomes of MCI in sub-Saharan Africa are scarce. We investigated outcomes of MCI over a 4-year period in Tanzania and considered risk factors for conversion to dementia.
  
  
  METHODS
  In a longitudinal cohort study in the Hai district, Tanzania, patients with MCI were identified during a two-phase prevalence study carried out in 2010. Of 1,198 people aged 70 years and over screened in phase I, a stratified sample of 296 were fully assessed in phase II. MCI was defined according to international consensus criteria. DSM-IV criteria were used for dementia diagnosis. Background demographic and risk factor data were collected, and neuropsychiatric symptoms were assessed using the neuropsychiatric inventory. Patients were followed-up in 2011, 2012 and 2014.
  
  
  RESULTS
  Forty-six MCI patients were identified. After adjusting for stratification, the crude prevalence of MCI was 7.0% (95% CI: 3.6-10.4). Over a 4-year period, 15 patients (32.6%) progressed to dementia, 2 patients (4.3%) returned to normal cognition, 1 developed late-onset schizophrenia, 8 patients (17.4%) had stable MCI, 19 patients (41.3%) died, and 1 refused assessment. Age, sex, education levels, body mass index, hypertension, and comorbidity were not associated with progression to dementia.
  
  
  CONCLUSIONS
  In this rural Tanzanian population, rates of conversion from MCI to DSM-IV dementia were similar to those reported in high-income countries. Over a third of all patients had died at the 4-year follow-up.
authors.affiliation: Northumbria Healthcare National Health Service Foundation Trust, Department of Medicine, North Tyneside General Hospital, North Shields, United Kingdom; Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom. Electronic address: stellamaria@doctors.org.uk.
authors.forename: Stella-Maria
authors.initials: SM
authors.lastname: Paddick
authors.affiliation: Hai District Hospital, Boma'ngombe, Kilimanjaro, Tanzania.
authors.forename: Aloyce
authors.initials: A
authors.lastname: Kisoli
authors.affiliation: Northumbria Healthcare National Health Service Foundation Trust, Department of Medicine, North Tyneside General Hospital, North Shields, United Kingdom.
authors.forename: Maria
authors.initials: M
authors.lastname: Samuel
authors.affiliation: Health Education North East, Newcastle upon Tyne, United Kingdom.
authors.forename: Janice
authors.initials: J
authors.lastname: Higginson
authors.affiliation: Northumbria Healthcare National Health Service Foundation Trust, Department of Medicine, North Tyneside General Hospital, North Shields, United Kingdom.
authors.forename: William K
authors.initials: WK
authors.lastname: Gray
authors.affiliation: Northumbria Healthcare National Health Service Foundation Trust, Department of Medicine, North Tyneside General Hospital, North Shields, United Kingdom; Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Dotchin
authors.affiliation: South Devon National Health Service Foundation Trust, Department of Medicine, Torbay Hospital, Torquay, United Kingdom.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Longdon
authors.affiliation: Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom; Northumberland, Tyne and Wear National Health Service Foundation Trust, St Nicholas Hospital, Newcastle upon Tyne, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Teodorczuk
authors.affiliation: Hai District Hospital, Boma'ngombe, Kilimanjaro, Tanzania.
authors.forename: Paul
authors.initials: P
authors.lastname: Chaote
authors.affiliation: Northumbria Healthcare National Health Service Foundation Trust, Department of Medicine, North Tyneside General Hospital, North Shields, United Kingdom; Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Walker
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D060825:Cognitive Dysfunction / Q000150:complications / Q000453:epidemiology*; D015897:Comorbidity; D003704:Dementia / Q000150:complications / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D013636:Tanzania / Q000453:epidemiology
keywords: Africa; Dementia; MCI; Tanzania; mild cognitive impairment