Prevalence of dementia and mild cognitive impairment among older
Albanian patients detected by different screening tools
Abstract
Rationale, aims and objectives: Recent studies have identified
significant gaps in dementia´s epidemiology, especially regarding low-
and middle-income countries. The aim of our study was to estimate the
prevalence of mild cognitive impairment (MCI) and dementia by applying
different tests among older Albanian patients and to find correlates
with socio-demographic and medical factors. Method: Study population
consisted of older people (60 years or more) who visited primary
healthcare centers in two Albanian cities (Shkoder and Tirana). The MoCA
(Montreal Cognitive Assessment), MoCA B (Basic) and the mini-cog were
translated and applied by two trained pharmacists. A predictive
multivariate logistic regression analysis was conducted. Degree of
agreement between the MoCA and mini-cog tools was assessed using Kappa
statistic. Results: A total of 206 participants with a mean age of 68,8
years old (SD 5.65), almost equally distributed among the two cities,
were included in our study. A high prevalence of dementia and MCI was
detected with MoCA, respectively 19,42 % and 93,20 %. The latter was
20,39 % with mini-cog. Multivariate regression analysis showed that men
had an elevated risk for MCI (OR 5,31; 95% CI 1,40 – 20,15), as well
as patients from Shkoder (OR 14,48; 95% CI 1,11 – 4,53), when MoCA
detected MCI. According to mini-cog, more than 7 years of education
acted as a protective factor for MCI (OR 0,12; 95% CI, 0,05 – 0,33),
whereas having 1 to 6 years of education was a risk factor. For each
year increase of age the risk of MCI was 1,16 times higher. The degree
of agreement between the two tools was poor with Kappa 2.38 (SD 1,87).
Conclusion: The results of these tests may help in selecting individuals
for more specialised examination, in order to facilitate early diagnosis
of dementia and MCI among Albanian older patients.