Prevalence, Factors Associated and Knowledge of Dementia in a Sample of Older Ugandans

Abstract Introduction:Dementia is on the rise due to increasing proportion of old people in Sub-Saharan Africa (SSA). Although dementia is misattributed to normal ageing or supernatural causes in SSA, it is a brain disease with well-established etiologies. Limited knowledge and understanding of dementia means that many older people are suffering without seeking help and are undiagnosed and untreated. The aim of this study was to determine the prevalence and factors associated with dementia and to describe the knowledge of the disease among older adults attending ROTOM Health Center-Mukono, Central Uganda. Methods: This was a cross-sectional study using quantitative methods. A total of 267 older adults attending ROTOM health center-Mukono were interviewed between 1 April to 15 May 2022. Using interviewer administered Early Dementia Questionnaire (EDQ) and Dementia Knowledge Assessment Scale (DKAS), data was collected, entered into EpiData version 3.1 and analysed using SPSS version 12.0. Bivariate and multivariable analyses using logistic regression were done. Results: Dementia was 46.2% in the sample. The most common symptoms of dementia in the order of their severity were memory symptoms, 6.1% (n =16); physical symptoms, 1.9% (n = 5); and concentration symptoms, 1.1% (n = 3). Bivariate analysis showed that dementia was significantly associated with age >85 years (prevalence ratio, PR=2.42, p < .001), being married (PR=0.70, p < .026), secondary/tertiary level of education (PR=0.54, p < .004), occasional/non-believer (PR=1.85, p < .001), smoker/ex-smoker (PR=1.46, p < .013), occasional/no exercise (PR=3.28, p < .001) and hypertension (PR=0.70, p < .019). The final degree of association as determined by adjusted PR in the multivariable model revealed that only older age (aPR=1.88, p < .001) and occasional/non-believer (aPR=1.61, p =.001) remained significantly related to dementia. The study also found that 8.0% of the participants had optimal knowledge of dementia. Conclusion: There is high burden of dementia among older persons attending ROTOM health center-Mukono. Factors associated with dementia are older age and being an occasional/non-believer. Knowledge of dementia among older adults is low. There is need to promote integrated early dementia screening, care and educational program in primary care to reduce the disease burden. Spiritual support would be a rewarding investment in the lives of the ageing population.