Prevalence of cognitive impairment among elderly patients at university teaching hospitals in Rwanda

Abstract

B a c k g r o u nd

Cognitive impairment is a global challenge among elderly patients. It is associated with increased hospital stay, morbidity and mortality. Moreover, it affects short and long-term patients’ functional capacity and negatively impact their activities of daily living and may increase the rate of readmission. We conducted this first study in Rwanda to determine the prevalence of cognitive impairment among elderly patients at two main university teaching hospitals in Rwanda.

M e t ho ds It was a cross sectional study among elderly patients: aged 60s and above who attended the department of internal medicine at two main university teaching hospitals in Rwanda: CHUB and CHUK. Their cognitive function and health autonomy status were assessed using Mini-Mental State Examination (MMSE) and Activities of Daily Living (ADL) scales respectively. Probable precipitating factors were evaluated. One-time physical contact data were collected including biodemographic profile and clinical background as well as their scores on MMSE and ADL all compiled in one questionnaire through a consecutive recruitment over 6 months. Data analysis was done using the statistical package for the social science (SPSS) application.

Res ul ts 200 participants were recruited among which the females predominated 105(52.5%). The majority was aged between [60-65] years: 69(34.5%), followed by [66-70] years: 46(23%) and nearly similar from [71-80] years: around 15%. Continuous negative skewed representation of ages with a limited number of the participants with [81-90]:10% and above 90s: only represented by 3%. The overall prevalence of cognitive impairment revealed by our study was 61.5%. Its severity was distributed as: mild: 19%, moderate: 23% and severe: 19.5%. Mild cognitive impairment was more prevalent among females, 13.5% versus 5.5% of males, p<0.001. The overall top risk factors were: cardiovascular diseases (36.5%) followed by malignancies (14.5%), viral hepatitis C (10%), chronic lung diseases (9%) and diabetes mellitus (5.5%). Stroke (8.5%) was the leading cause of severe cognitive impairment as shown by the MMSE ≤ 10 among other medical conditions, followed by hypertension (8%) and malignancies (5%). 44% of the studied population was dependent as revealed by their low score on ADL scale. The associated risk factors were found to be similar to those of cognitive impairment where malignancies (33%), cardiovascular diseases (31%) and viral hepatitis C infection (6.5%), chronic lung diseases (5.5%) and diabetes mellitus (4.5%) were significantly associated with dependency among others.

C o n cl us i o n

The prevalence of cognitive impairment among elderly patients at our university teaching hospitals is significantly elevated with impaired health autonomy status. The main risk factors include, cardiovascular diseases, malignancies, viral hepatitis C infection, chronic lung diseases and diabetes mellitus.