Dementia screening in rural Kenya: The prevalence and impact of screening positive for dementia.

Abstract

In Kenya, there is a lack of data on the number of people with dementia. In this article, we aim to estimate the number of community-dwelling older adults (aged 60 years and above) that are potentially living with dementia in rural Kenya. Recruitment of older adults occurred through adopting a convenience approach based on the catchment areas served by trained ten Community Health Workers (CHWs). Screening was conducted using the Brief Community Screening Instrument for Dementia (CSI-D), in which prevalence ratios were reported. Regression analyses were run to understand the association between screening outcome and wellbeing, social isolation, and employment status (adjusted for age, sex, literacy, geography, and social status). Of the 3,546 older adults who were screened for dementia, 652 screened positive (PR = 0.18, 95%CIs 0.17 to 0.20). Back estimating screen positives based on established sensitivity and specificity of the tool against a gold standard (clinical diagnosis), yielded a prevalence of 9.4% (0.09, 95%CIs 0.08 to 0.11). Screening positive for dementia was associated with poorer quality of life (B =-0.17, p<0.001) and loneliness (B= 0.28, p<0.001). There is potentially 258,000 older adults living with dementia in Kenya, who likely have poorer outcomes. We need to encourage a timely diagnosis and develop better ways to support people living with dementia in Kenya and other resource-limited settings.