Prevalence of dementia among community-dwelling older adults in rural Uganda: findings from DEPEND Uganda (Dementia Epidemiology, unmet need and co-developing solutions in Uganda)

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INTRODUCTION The number of people living with dementia in many African countries is anticipated to treble by 2050. However, data from Uganda are scarce, with no published prevalence studies using a comprehensive approach to dementia diagnosis. We used methods developed by the 10/66 Dementia Research Group to estimate dementia prevalence in rural South-West Uganda, and its association with socio-demographics and functional status. METHODS The study was nested within the General Population Cohort in Kalungu District. In Phase 1, all cohort participants aged 60+ underwent cognitive screening. In Phase 2, we invited all those with impaired cognition, 50% with mildly impaired cognition, and 15% with unimpaired cognition for assessment. We also assessed functional status using WHODAS-12, IDEA-IADL and reported care needs. RESULTS Over 80% of eligible participants underwent screening, and of those sampled, over 90% were assessed. Dementia prevalence was 18.6%, and most cases were mild or very mild. Dementia was associated with increased age and lower educational attainment. People with dementia had lower performance at IADLs, but similar levels of disability and care needs. DISCUSSION Dementia prevalence in Uganda is high, affecting nearly 1 in 5 people aged 60 and over. This is higher than most other estimates from the region, particularly others that have used two-phase approaches and clinical DSM diagnoses, which may under-estimate dementia prevalence due to attrition between study phases and cultural variations in reporting functional impairment by informants. Any planned health and social care services for older people should include support for people with dementia and their families.

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