Epidemiology of dementia in Central Africa (EPIDEMCA): protocol for a multicentre population-based study in rural and urban areas of the Central African Republic and the Republic of Congo

Guerchet, Maëlenn; M’Belesso, Pascal; Ndamba-Bandzouzi, Bébène; Pilleron, Sophie; Desormais, Iléana; Lacroix, Philippe; Aboyans, Victor; Jésus, Pierre; Desport, Jean‐Claude; Tchalla, Achille; Marin, Benoît; Lambert, Jean‐Charles; Clément, Jean‐Pierre; Dartigues, Jean‐François; Preux, Pierre‐Marie

doi:10.1186/2193-1801-3-338

Cited by 50 publications

(73 citation statements)

References 69 publications

(99 reference statements)

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“…In addition, we performed Sanger sequencing of the whole APP 3'UTR of 175 supplemental controls of the same ethnic origin (Sub-Saharan Africa) as the patient carrying the c.*331_*332del variant. 14 …”

Section: Controlsmentioning

confidence: 99%

Mutation in the 3’untranslated region of APP as a genetic determinant of cerebral amyloid angiopathy

et al. 2015

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Aβ-related cerebral amyloid angiopathy (CAA) is a major cause of primary non-traumatic brain hemorrhage. In families with an early onset of the disease, CAA can be due to amyloid precursor protein (APP) pathogenic variants or duplications. APP duplications lead to a~1.5-fold increased APP expression, resulting in Aβ overproduction and deposition in the walls of leptomeningeal vessels. We hypothesized that rare variants in the 3'untranslated region (UTR) of APP might lead to APP overexpression in patients with CAA and no APP pathogenic variant or duplication. We performed direct sequencing of the whole APP 3'UTR in 90 patients with CAA and explored the functional consequences of one previously unreported variant. We identified three sequence variants in four patients, of which a two-base pair deletion (c.*331_*332del) was previously unannotated and absent from 175 controls of same ethnicity. This latter variant was associated with increased APP expression in vivo and in vitro. Bioinformatics and functional assays showed that the APP c.*331_*332del variant affected APP messenger RNA (mRNA) structure and binding of two microRNAs (miR-582-3p and miR-892b), providing a mechanism for the observed effects on APP expression. These results identify APP 3'UTR sequence variants as genetic determinants of Aβ-CAA.

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Section: Controlsmentioning

confidence: 99%

Mutation in the 3’untranslated region of APP as a genetic determinant of cerebral amyloid angiopathy

et al. 2015

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“…While understanding this prevalence is important, this research overlooks the wide range of cognitive abilities in the older population, the social determinants of CH in SSA, and the implications of variability in CH for day-to-day activities and well-being among older individuals. Moreover, the survey instruments used in these studies are designed mainly to capture clinical dementia (Guerchet et al, 2014; Paddick et al, 2015; Prince et al, 2011), rather than population-level variability of CH. Dementia represents only a small subset of this population-level distribution of CH, and our measures of CH have therefore been designed to capture the full range of CH present among older individuals in a SSA LIC.…”

Section: Introductionmentioning

confidence: 99%

Cognition, Health, and Well-Being in a Rural Sub-Saharan African Population

et al. 2017

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Cognitive health is an important dimension of well-being in older ages, but few studies have investigated the demography of cognitive health in sub-Saharan Africa’s (SSA) growing population of mature adults (= persons age 45+). We use data from the Malawi Longitudinal Study of Families and Health (MLSFH) to document the age and gender patterns of cognitive health, the contextual and life-course correlates of poor cognitive health, and the understudied linkages between cognitive and physical/mental well-being. Surprisingly, the age-pattern of decline in cognitive health is broadly similar to that observed in the U.S. We also find that women have substantially worse cognitive health than men, and experience a steeper age-gradient in cognitive ability. Strong social ties and exposure to socially complex environments are associated with higher cognitive health, as is higher socioeconomic status. Poor cognitive health is associated with adverse social and economic well-being outcomes such as less nutrition intake, lower income, and reduced work efforts even in this subsistence agriculture context. Lower levels of cognitive health are also strongly associated with increased levels of depression and anxiety, and are associated with worse physical health measured through both self-reports and physical performance. Our findings suggest that cognition plays a key—but understudied—role in shaping late-life well-being in low-income populations.

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“…In rural areas, exhaustive sampling using a door-to-door approach was used due to logistic and financial constraints. The detailed methodology is described in an open-access publication [20]. France.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

Prevalence, awareness, treatment, and control of hypertension in older people in Central Africa: the EPIDEMCA study

Pilleron

Aboyans

M’Belesso

et al. 2017

Journal of the American Society of Hypertension

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Hypertension represents a major global health burden. While older individuals of African descent are at higher risk of hypertension in western countries, epidemiological data on hypertension in older native Africans are scarce. We assessed the prevalence and the level of awareness and control of hypertension among older adults in Central Africa. A total of 1990 individuals 65 years of age and older from the Republic of Congo and the Central African Republic participated into a cross-sectional population-based survey. Hypertension was defined by self-reporting of on-going treatment and/or systolic (SBP)/diastolic (DBP) blood pressures at rest being ≥140 and/or 90 mmHg. Controlled hypertension was defined as treated hypertension with SBP <140 mmHg and DBP <90 mmHg. The overall prevalence of hypertension was 61.1%. Among hypertensive people, 46.7% were aware of their condition and 17.3% were treated. Among the latter 23.8% had their hypertension controlled.Correlates of hypertension were increasing age and body mass index, living in the Republic of Congo, occupation other than employee, no tobacco use, sedentary lifestyle and ≥ 3 meals a day. Our findings indicate a need for the implementation of public health policies to reduce hypertension in older Africans, and to prevent the subsequent burden of cardiovascular diseases.Keywords: Hypertension, epidemiology, elderly, Central Africa M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 3According to the United Nations, the number of persons 65 years of age and older is expected to more than double by 2035, from 608 million in 2015 to 1.2 billion in 2035 [1]. Almost a quarter (23%) of the total global burden of disease is attributable to disorders in people aged 60 years of age and older, among whom cardiovascular diseases (CVDs) are the leading contributors to the burden of disease.Among CVDs, hypertension is the leading cause of mortality and morbidity [2]. one of the global non-communicable disease targets of the World Health Organization is to lower the prevalence of raised blood pressure by 25% by 2025 [4]. However, a global increase in the prevalence of hypertension in low-income countries is now being observed, notably in Sub-Saharan Africa [3].In the United States, the prevalence of hypertension is more than 60% among older people and is higher in older African-Americans when compared to non-Hispanic whites [5]. Ethnic differences cannot be explained solely in terms of socio-economic status [5], suggesting the involvement of other factors. It is therefore important to know more about the epidemiology of hypertension in older native Africans.Several community-based epidemiological studies on hypertension were conducted in Africa [6].Most were carried out in adults and reported prevalence for the ≥65 age group [7][8][9][10][11][12][13][14][15][16][17][18][19]. Only one study in rural Tanzania was specifically conducted on the elderly and reported a prevalence of hypertension of 70% in people over 70 years of age [17]. To our knowledge, no data from ...

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Epidemiology of dementia in Central Africa (EPIDEMCA): protocol for a multicentre population-based study in rural and urban areas of the Central African Republic and the Republic of Congo

Cited by 50 publications

References 69 publications

Mutation in the 3’untranslated region of APP as a genetic determinant of cerebral amyloid angiopathy

Mutation in the 3’untranslated region of APP as a genetic determinant of cerebral amyloid angiopathy

Cognition, Health, and Well-Being in a Rural Sub-Saharan African Population

Prevalence, awareness, treatment, and control of hypertension in older people in Central Africa: the EPIDEMCA study

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