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Levels of functional disability in elderly people in Tanzania with dementia, stroke and Parkinson’s disease

Published online by Cambridge University Press:  17 March 2015

Aloyce Kisoli ,
William K. Gray ,
Catherine L. Dotchin ,
Golda Orega ,
Felicity Dewhurst ,
Stella-Maria Paddick ,
Anna Longdon ,
Paul Chaote ,
Matthew Dewhurst  and
Richard W. Walker
Aloyce Kisoli*
Affiliation:
Hai District Hospital, Boman’gombe, Kilimanjaro, Tanzania
William K. Gray
Affiliation:
Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
Catherine L. Dotchin
Affiliation:
Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK
Golda Orega
Affiliation:
Kilimanjaro Christian Medical Centre, Moshi, Tanzania
Felicity Dewhurst
Affiliation:
Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
Stella-Maria Paddick
Affiliation:
Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK
Anna Longdon
Affiliation:
South Devon Healthcare NHS Foundation Trust, Torquay, UK
Paul Chaote
Affiliation:
Hai District Hospital, Boman’gombe, Kilimanjaro, Tanzania
Matthew Dewhurst
Affiliation:
Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
Richard W. Walker
Affiliation:
Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
*
Aloyce Kisoli, Hai District Hospital, Boman’gombe, Kilimanjaro, Tanzania. Tel: 027 275 7039; Fax: 027 275 7039; E-mail: kisolialoyce@yahoo.com
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Abstract

Background

Disability is associated with increasing age and poverty, yet there are few reliable data regarding disability amongst the elderly in low-income countries. The aim of this study was to compare disability levels for three of the most common neurological, non-communicable diseases: dementia, stroke and Parkinson’s disease (PD).

Methods

We performed a community-based study of people aged 70 years and over in 12 randomly selected villages in the rural Hai district of Tanzania. Participants underwent disability assessment using the Barthel Index, and clinical assessment for dementia, stroke and PD.

Results

In a representative cohort of 2232 people aged 70 years and over, there were 54 cases of stroke, 12 cases of PD and estimated (by extrapolation from a sub-sample of 1198 people) to be 112 cases of dementia. People with stroke were the most disabled, with 62.9% having moderate or severe disability. Levels of moderate or severe disability were 41.2% in people with dementia and 50.0% in people with PD. However, the higher prevalence of dementia meant that, at a population level, it was associated with similar levels of disability as stroke, with 18.5% of 249 people identified as having moderate or severe disability having dementia, compared to 13.7% for stroke and 2.4% for PD.

Conclusions

Levels of disability from these conditions is high and is likely to increase with demographic ageing. Innovative, community-based strategies to reduce disability levels should be investigated.

Keywords

AfricadementiadisabilityParkinson’s diseasestrokeTanzania
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 27 , Issue 4 , August 2015 , pp. 206 - 212
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Copyright
© Scandinavian College of Neuropsychopharmacology 2015 

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