Association Between a Low Ankle–Brachial Index and Dementia in a General Elderly Population in Central Africa (Epidemiology of Dementia in Central Africa Study)

Authors

  • Maëlenn Guerchet PhD,

    Corresponding author
    1. University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
    • INSERM UMR1094, Tropical Neuroepidemiology, Limoges, France
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  • Pascal Mbelesso MD,

    1. INSERM UMR1094, Tropical Neuroepidemiology, Limoges, France
    2. University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
    3. Neurology Department, Amitié Hospital, Bangui, Central African Republic
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  • Alain M. Mouanga MD,

    1. INSERM UMR1094, Tropical Neuroepidemiology, Limoges, France
    2. University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
    3. Psychiatry Department, Brazzaville University Hospital, Brazzaville, Congo
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  • André Tabo MD,

    1. Psychiatry Department, Bangui National Hospital, Bangui, Central African Republic
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  • Bébène Bandzouzi MD,

    1. Neurology Department, Brazzaville University Hospital, Brazzaville, Congo
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  • Jean-Pierre Clément MD, PhD,

    1. INSERM UMR1094, Tropical Neuroepidemiology, Limoges, France
    2. University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
    3. Hospital and University Federation of Adult and Geriatric Psychiatry, Limoges, France
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  • Philippe Lacroix MD,

    1. INSERM UMR1094, Tropical Neuroepidemiology, Limoges, France
    2. University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
    3. Department of Thoracic and Cardiovascular Surgery and Vascular Medicine, Dupuytren University Hospital, Limoges, France
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  • Pierre-Marie Preux MD, PhD,

    1. INSERM UMR1094, Tropical Neuroepidemiology, Limoges, France
    2. University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
    3. Department of Medical Information and Evaluation, Clinical Research and Biostatistic Unit, Dupuytren University Hospital, Limoges, France
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  • Victor Aboyans MD, PhD

    1. INSERM UMR1094, Tropical Neuroepidemiology, Limoges, France
    2. University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
    3. Department of Cardiology, Dupuytren University Hospital, Limoges, France
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Address correspondence to Maëlenn Guerchet, UMR Inserm 1094 NET, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, Faculté de Médecine, 2 rue du Docteur Marcland, 87025 Limoges, France.E-mail: maelenn.guerchet@unilim.fr

Abstract

Objectives

To investigate the association between peripheral arterial disease (PAD) and dementia in native elderly African populations.

Design

Two successive door-to-door cross-sectional surveys in the general population.

Settings

Representative districts of Bangui (Central African Republic) and Brazzaville (Republic of Congo).

Participants

Population aged 65 and older.

Measurements

Peripheral arterial disease was defined as an ankle–brachial index (ABI) of 0.90 or less. Cognitive screening was performed using the Community Screening Interview for Dementia and the Five-Word Test. Diagnosis of dementia was confirmed after further neuropsychological tests and neurological examination according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. Multivariate logistic regression models were used to quantify the association between PAD and dementia in those populations, with adjustments for cardiovascular disease (CVD) and other variables.

Results

A significant association was observed between PAD and prevalent dementia (odds ratio (OR) = 2.43, 95% confidence interval (CI) = 1.44–4.13, = .001), even after adjustment for age, city, sex, CVD risk factors, education, and depressive disorders (OR = 2.37, 95% CI = 1.31–4.26, = .004). This association was stronger with lower ABI.

Conclusion

These findings support the hypothesis of a link between atherosclerosis (represented by a low ABI) and cognitive disorders in native Africans and are similar to previous reports in African Americans and other ethnic groups.

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