Cohort Profile Update: Cognition and dementia in the Health and Aging in Africa Longitudinal Study of an INDEPTH community in South Africa (HAALSI dementia).
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SUBMITTER: Bassil DT
PROVIDER: S-EPMC9365629 | biostudies-literature | 2022 Aug
REPOSITORIES: biostudies-literature
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Cohort Profile Update: Cognition and dementia in the Health and Aging in Africa Longitudinal Study of an INDEPTH community in South Africa (HAALSI dementia).
Bassil Darina T DT Farrell Meagan T MT Wagner Ryan G RG Brickman Adam M AM Glymour M Maria MM Langa Kenneth M KM Manly Jennifer J JJ Salinas Joel J Tipping Brent B Tollman Stephen S Berkman Lisa F LF
International journal of epidemiology 20220801 4
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Project description:ObjectivesTo characterize the cardiovascular disease (CVD) profile of individuals aged 80 and older in rural South Africa.DesignFirst wave of population-based longitudinal cohort.SettingAgincourt subdistrict (Mpumalanga Province) in rural South Africa.ParticipantsAdults residents (N = 5,059).MeasurementsIn-person interviews were conducted to obtain social, behavioral, economic, and clinical data. Prevalence of hypertension, diabetes, dyslipidemia, high waist-to-hip ratio, overweight and obesity, high-risk high-sensitivity C-reactive protein, smoking, stroke, myocardial infarction, angina pectoris, and heart failure in individuals younger than 65, aged 65 to 79, and aged 80 and older were compared. Associations between self-reported treatments and determinants of hypertension treatment in those aged 80 and older were assessed using multivariable regression.ResultsOf 5,059 individuals included, 549 (10.8%) were aged 80 and older, and their CVD prevalence was 17.9% (stroke 3.8%, myocardial infarction 0.5%, angina pectoris 13.5%, heart failure 0.7%). Hypertension prevalence in this group was 73.8%, and along with angina pectoris, it increased with age (p<.001), whereas overweight and obesity (46.4%), dyslipidemia (39.1%), and smoking prevalences (3.1%) decreased (p<.001). Hypertension treatment was significantly associated with being aged 80 and older (odds ratio (OR)=1.48; 95% confidence interval (CI)=1.14-1.92, p=.003). Male sex (OR=0.73, 95% CI=0.66-0.88, p=.001), being an immigrant (OR=0.80, 95% CI=0.65-0.98; p=.03), higher socioeconomic status (OR=1.28, 95% CI=1.06-1.53, p=.009), and higher depression score (OR=1.12, 95% CI=1.05-1.19, p<.001) were associated with hypertension treatment in those aged 80 and older.ConclusionThis is the first study to characterize the CVD profile of individuals aged 80 and older in sub-Saharan Africa and provides baseline data for comparison with future studies in this rapidly growing age group. J Am Geriatr Soc 66:2151-2157, 2018.
| S-EPMC6417425 | biostudies-literature
Project description:Dyslipidemia is a primary driver for chronic cardiovascular conditions and there is no comprehensive literature about its management in South Africa. The objective of this study was to assess the prevalence, awareness, treatment, and control of dyslipidemia in rural South Africa and how they are impacted by different behaviors and non-modifiable factors. To fulfill this objective we recruited for this cohort study adults aged ≥40 years residing in the Agincourt sub-district of Mpumalanga Province. Data collection included socioeconomic and clinical data, anthropometric measures, blood pressure (BP), HIV-status, point-of-care glucose and lipid levels. Framingham CVD Risk Score was ascribed to patients based upon categories for 10 year cardiovascular risk of low (<3%), moderate (≥3% and <15%), high (≥15% and <30%), and very high (≥30%).LDL cholesterol control by risk category was defined according to South African Guidelines. Multivariable logistic regression models were built to identify factors that were significantly associated with dyslipidemia and awareness of dyslipidemia From 5,059 respondents a total of 4247 subjects (83.9%) had their cholesterol levels measured and were included in our analysis. Overall, 67.3% (2860) of these met criteria for dyslipidemia, only 30 (1.05%) were aware of their condition, and only 21 subjects (0.73%) were on treatment. The majority have abnormalities in triglycerides (59.3%). As cardiovascular risk increased the rates of lipid control according to LDL level dropped. Multivariate logistic regression analyses showed that being overweight was predictive of dyslipidemia (OR 1.76; 95%CI 1.51-2.05, p<0.001) and dyslipidemia awareness (OR 2.58; 95%CI 1.19-5.58; p = 0.017). In conclusion, the very low awareness and treatment of dyslipidemia in this cohort indicate a greater need for systematic screening and education within the population and demonstrate that there are multiple opportunities to allay this burden.
| S-EPMC5659770 | biostudies-literature
Project description:Social network analysis depends on how social ties to others are elicited during interviews, a process easily affected by respondent and interviewer behaviors. We investigate how the number of self-reported important social contacts varied within a single data collection round. Our data come from HAALSI, a comprehensive population-based survey of individuals aged 40 years and older conducted over thirteen months at the Agincourt health and demographic surveillance site in rural South Africa. As part of HAALSI, interviewers elicited detailed egocentric network data. The average number of contacts reported by the 5059 respondents both varied significantly across interviewers and fell over time as the data collection progressed, even after adjusting for respondent, interviewer and respondent-interviewer dyad characteristics. Contact numbers rose substantially after a targeted interviewer intervention. We conclude that checking (and adjusting) for interviewer effects, even within one data collection round, is critical to valid and reliable social network analysis.
| S-EPMC6320223 | biostudies-literature
Project description:Objectives1. Assess validity of the Oxford Cognitive Screen (OCS-Plus), a domain-specific cognitive assessment designed for low-literacy settings, especially in low- and middle-income countries (LMIC); 2. Advance theoretical contributions in cognitive neuroscience in domain-specific cognitive function and cognitive reserve, especially related to dementia.MethodIn a cross-sectional study of a sample of 1,402 men and women aged 40-79 in the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), we administered OCS-Plus along with health and sociodemographic assessments. HAALSI is a representative sample of older adults in Agincourt, South Africa contributing to normative understanding of cognition in LMIC. We report measure distributions, construct and external validity of the OCS-Plus.ResultsOCS-Plus has excellent construct and external validity. Intra-class correlations between similar basic measures of orientation in OCS-Plus and in HAALSI assessments was 0.79, and groups of people performing well on the OCS-Plus verbal memory also showed superior performance on HAALSI verbal memory. The OCS-Plus scores showed consistent associations with age and education and domain-specific associations with alcohol and depression. Younger respondents and the more educated did better on all assessments.DiscussionThe OCS-Plus represents a major methodological advance in dementia studies in LMICs, and enhances understanding of cognitive aging.
| S-EPMC5156498 | biostudies-literature
Project description:Background/aimsWe aimed to estimate the prevalence of cognitive impairment, and the sociodemographic and comorbid predictors of cognitive function among older, rural South African adults.MethodsData were from a population-based study of 5,059 adults aged ≥40 years in rural South Africa in 2015. Cognitive impairment was defined as scoring ≤1.5 SDs below the mean composite time orientation and memory score, or requiring a proxy interview with "fair" or "poor" proxy-reported memory. Multiple linear regression estimated the sociodemographic and comorbid predictors of cognitive score, with multiplicative statistical interactions between each of age and sex with education.ResultsCognitive impairment increased with age, from 2% of those aged 40-44 (11/516) to 24% of those aged ≥75 years (214/899). The independent predictors of lower cognitive score were being older, female, unmarried, not working, having low education, low household wealth, and a history of cardiovascular conditions. Education modified the negative associations between female sex, older age, and cognitive function score.ConclusionsThe prevalence of cognitive impairment increased with age and is comparable to rates of dementia reported in other sub-Saharan African countries. Age and sex differences in cognitive function scores were minimized as education increased, potentially reflecting the power of even poor-quality education to improve cognitive reserve.
| S-EPMC6531856 | biostudies-literature
Project description:IntroductionDespite rapid population aging, there are currently limited data on the incidence of aging-related cognitive impairment in sub-Saharan Africa. We aimed to determine the incidence of cognitive impairment and its distribution across key demographic, social, and health-related factors among older adults in rural South Africa.MethodsData were from in-person interviews with 3,856 adults aged ≥40 who were free from cognitive impairment at baseline in the population-representative cohort, "Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community in South Africa" (HAALSI), in Agincourt sub-district, Mpumalanga province, South Africa (2014-19). Cognitive impairment was defined as scoring <1.5 standard deviations below the mean of the baseline distribution of orientation and episodic memory scores. Incidence rates and rate ratios for cognitive impairment were estimated according to key demographic, social, and health-related factors, adjusted for age, sex/gender, and country of birth.ResultsThe incidence of cognitive impairment was 25.7/1,000 person-years (PY; 95% confidence interval [CI]: 23.0-28.8), weighted for mortality (12%) and attrition (6%) over the 3.5-year mean follow-up (range: 1.5-4.8 years). Incidence increased with age, from 8.9/1,000 PY (95% CI: 5.2-16.8) among those aged 40-44 to 93.5/1,000 PY (95% CI: 75.9-116.3) among those aged 80+, and age-specific risks were similar by sex/gender. Incidence was strongly associated with formal education and literacy, as well as marital status, household assets, employment, and alcohol consumption but not with history of smoking, hypertension, stroke, angina, heart attack, diabetes, or prevalent HIV.ConclusionsThis study presents some of the first incidence rate estimates for aging-related cognitive impairment in rural South Africa. Social disparities in incident cognitive impairment rates were apparent in patterns similar to those observed in many high-income countries.
| S-EPMC8058235 | biostudies-literature
Project description:BackgroundThe Center for Epidemiologic Studies-Depression (CES-D) scale is a widely used measure of depressive symptoms, but its construct validity has not been adequately assessed in sub-Saharan Africa. This study validates the CES-D among an aging Shangaan-speaking and predominantly Black African sample in rural South Africa, with a special emphasis on gender differences.MethodsAn 8-item CES-D scale was administered in Shangaan to 5059 respondents, aged 40+ years, residing in Agincourt, South Africa. We used Cronbach's alpha and exploratory and confirmatory factor analysis to examine and confirm dimensionality of the CES-D scale. Differential endorsement of CES-D items by gender were assessed using the Mantel-Haenszel (MH) odds ratio test.ResultsReliability of the CES-D scale differed by gender with women reporting higher internal consistency on items than men. A two-factor solution was retained and confirmed representing two latent factors: (1) Negative Affect (six items) and (2) Diminished Positive Affect (two items). MH results showed that men exhibited significantly higher odds of putting an effort in everything that they did (OR: 1.33, 95% CI: 1.15-1.54) and lower odds of feeling depressed (OR: 0.71, 95% CI: 0.56-0.89) and having restless sleep (OR: 0.67, 95% CI:0.58-0.77) than women.LimitationsAnalyses were limited to a dichotomous, short form of the CES-D, a self-reported population-based measure.ConclusionAging Black Africans differ in endorsing affective and somatic items on the CES-D scale by gender, which may lead to skewed population-level estimates of depression in key subpopulations. These findings highlight the importance of continued research disentangling cross-cultural and gendered nuances of depression measurements.
| S-EPMC7575820 | biostudies-literature
Project description:ObjectivesWe use recently-collected data from the Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) cohort from Agincourt, South Africa, to describe physical functioning in this aging population, and place the overall level and age-trajectories of physical health in the context of other Health and Retirement Study (HRS) sister studies in low- and middle-income countries (LMICs).MethodWe conduct multiple regression to estimate associations of physical functioning assessed from both self-report (activities of daily living [ADL] limitation, self-reported health) and performance (grip strength, gait speed) with socio-demographic and health characteristics in HAALSI, and use fully-interacted regression models to compare age-patterns of physical functioning outcomes cross-nationally.ResultsGender differences in self-reported health are minimal, and men had 30% higher odds of being ADL limited controlling for socio-demographic and health characteristics. Measured physical performance is closely tied with socioeconomic conditions, but self-reported measures have a much smaller or weaker socioeconomic gradient. In international age-adjusted comparisons, the HAALSI sample had lower physical performance outcomes than most comparison populations.DiscussionAs the first HRS sister study undertaken in Africa, HAALSI adds vital information on population aging and health in the region. Continuing waves of HAALSI data will be a key resource for understanding differences in the complex processes of disability across LMIC contexts.
| S-EPMC6075193 | biostudies-literature
Project description:Time-course expression analysis profiling whole blood samples collected from healthy South African adolescents while monitoring their potential acquisition of a Mycobacterium tuberculosis infection.
2018-08-18 | GSE116014 | GEO
Project description:ObjectivesTo test whether a relatively complex model of human cognitive abilities based on Cattell-Horn-Carroll (CHC) theory, developed mainly in English-speaking samples, adequately describes correlations among tests in the Longitudinal Aging Study in India-Diagnostic Assessment of Dementia (LASI-DAD), and to develop accurate measures of cognition for older individuals in India.DesignLASI-DAD participants were recruited from participants aged 60 years and older from 14 states in the core LASI survey, with a stratified sampling design.SettingParticipants were interviewed at home or in a participating hospital, according to their preferences.ParticipantsCommunity-residing older adults aged 60 years and older (N = 3,224).MeasurementsA variety of cognitive tests were administered during two pretests and chosen for their appropriateness for measuring cognition in older adults in India and suitability for calibration with the core LASI survey and the Harmonized Cognitive Assessment Protocol.ResultsWe evaluated the factor structure of the test battery and its conformity with a classical CHC factor model that incorporated measurement models for general cognition, five broad domains (orientation, executive functioning, language/fluency, memory, and visuospatial), and five narrow domains (reasoning, attention/speed, immediate memory, delayed memory, and recognition memory) of cognitive performance. Model fit was adequate (root mean square error of approximation = 0.051; comparative fit index = 0.916; standardized root mean squared residual = 0.060).ConclusionWe demonstrated configural factorial invariance of a cognitive battery in the Indian LASI-DAD using CHC theory. Broad domain factors may be used in future research to rank individuals with respect to cognitive performance and classify cognitive impairment. J Am Geriatr Soc 68:S11-S19, 2020.
| S-EPMC7513554 | biostudies-literature