Title: Challenges of diagnosing dementia among elderly patients in a rural Referral Hospital, South-Western Uganda

Biography:

Patrick Orikiriza has just completed his PhD from University of Montpellier, France. He is a junior lecturer in Microbiology and a research fellow at Mbarara University of Science and Technology. He has published more than 20 papers in reputed journals

Abstract

Background: Dementia, is a common disease among elderly persons and is characterized by progressive decline of cognitive functioning. Uganda is one of the countries grappling with high fertility rates and 4% elderly population. Most low resource settings lack capacity to screen and diagnose dementia because of limited testing options. We evaluated the impact of Montreal Cognitive Assessment (MOCA) tool in screening dementia among elderly patients in a low resource setting.

Methods: A cross-sectional study was conducted in a Regional Referral Hospital in Uganda. We enrolled 90 elderly patients (≥60 years) admitted in medical, surgical, emergency, obstetrics and gynaecological, and psychiatry wards. All participants had standardized screening using the MOCA tool in order to establish the relevance of the checklist in the management of dementia within a low resource setting.

Results: Overall, 46/90 (51%) were females with median age of 72 years. Of these, 41/90 (46%) had no formal education while 48/90 (53%) were married. Most patients; 25/90 (28%) were admitted with respiratory problems while 41/90 (46%) had a cognitive disorder; 18/90(20%) mild, 11/90 (12%) moderate, 12/90 (13%) severe, that was not screened at admission. Moreover, 12/90 (13%) had a history of a family member presenting with memory loss. The MOCA checklist was highly subjective with scores more likely to increase with level of education and age.

We affirm that in its current form, the MOCA checklist is not suitable to screen dementia in low resource settings where majority of presumptive elderly patients lack basic education. We propose a modified checklist capturing more relevant aspects in such populations.