title: The association between disability and cognitive impairment in an elderly Tanzanian population.
abstract: Cognitive impairment is thought to be a major cause of disability worldwide, though data from sub-Saharan Africa (SSA) are sparse. This study aimed to investigate the association between cognitive impairment and disability in a cohort of community-dwelling older adults living in Tanzania. The study cohort of 296 people aged 70years and over was recruited as part of a dementia prevalence study. Subjects were diagnosed as having dementia or mild cognitive impairment according to the DSM-IV criteria. Disability level was assessed according to the WHO Disability Assessment Schedule, version 2.0 (WHODAS). A higher WHODAS score indicates greater disability. The median WHODAS in the background population was 25.0; in those with dementia and in those with mild cognitive impairment, 72 of 78 (92.3%) and 41 of 46 (89.1%), respectively, had a WHODAS score above this level. The presence of dementia, mild cognitive impairment, hearing impairment, being unable to walk without an aid and not having attended school were independent predictors of having a WHODAS score above 25.0, though age and gender were not. In summary, cognitive impairment is a significant predictor of disability in elderly Tanzanians. Screening for early signs of cognitive decline would allow management strategies to be put in place that may reduce the associated disability burden.
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK; Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK. Electronic address: Catherine.dotchin@nhct.nhs.uk.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Dotchin
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK; Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Stella-Maria
authors.initials: SM
authors.lastname: Paddick
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK.
authors.forename: William K
authors.initials: WK
authors.lastname: Gray
authors.affiliation: District Medical Office, Hai District Hospital, Boman'gombe, Hai, Tanzania.
authors.forename: Aloyce
authors.initials: A
authors.lastname: Kisoli
authors.affiliation: Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
authors.forename: Golda
authors.initials: G
authors.lastname: Orega
authors.affiliation: South Devon Healthcare NHS Foundation Trust, Toruay, UK.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Longdon
authors.affiliation: District Medical Office, Hai District Hospital, Boman'gombe, Hai, Tanzania.
authors.forename: Paul
authors.initials: P
authors.lastname: Chaote
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK.
authors.forename: Felicity
authors.initials: F
authors.lastname: Dewhurst
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Dewhurst
authors.affiliation: Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK; Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Walker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D006233:Persons with Disabilities / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015995:Prevalence; D013636:Tanzania / Q000453:epidemiology
keywords: Dementia; Disability; Elderly; Sub-Saharan Africa; WHODAS