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Lookup NU author(s): Dr Stella-Maria Paddick, Professor Raj KalariaORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2025 The Alzheimer's Association. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association. BACKGROUND: BPSD are common in persons living with dementia and are often associated with disease severity and caregivers' distress. In Low- and Middle-Income Countries, they are often the symptom complex that compel family to seek medical help. However, the association of BPSD with dementia severity and specific cognitive domains is underexplored in African populations. This study aims to evaluate BPSD among indigenous Africans and the association with specific cognitive domains. METHOD: This cross-sectional study analyzes data collected from nine African countries (Nigeria, Benin, Ghana, Cameroon, Ethiopia, Kenya, Uganda, Tanzania, and Mozambique) participating in the Recruitment and Retention for Alzheimer's Disease Diversity Cohorts in the Alzheimer's Disease Sequencing Project (READD-ADSP) project, from June 2023 to December 2024. Data on neurocognitive factors were collected using the Uniform Data Set (UDS), Neuropsychiatric Inventory Questionnaire (NPI-Q) for BPSD, and the Clinical Dementia Rating (CDR) scale for dementia severity. Data was managed on REDCap and analysis was performed using STATA (v16). Descriptive statistics were employed for symptom prevalence, and Spearman's rank correlation was used to analyze the relationship between NPI-Q and CDR scores. Association between cognitive domains and behavioral symptoms was examined using hierarchical linear model adjusting for covariates such as age, gender, education, and illness duration. RESULT: A total of 641 Africans with dementia (61% female, mean age 76.7±10.1 years) were included. The mean (±SD) NPI and CDR scores were 4.91 (±6.25) and 1.84 (±1.25), respectively. The most prevalent BPSD symptoms were apathy (32%), agitation/aggression (28.7%), and depression (28.1%). Spearman's correlation revealed a weak but significant positive association between NPI-Q severity scores and CDR scores (rho = 0.264, p < 0.001). Behavioral symptoms were significantly associated with dementia severity (β = 1.59, CI: 1.15-2.03) as well as specific cognitive domains, particularly memory (digit span backward: β = -0.38, CI: -0.64 to -0.13). However, the duration of illness was not a significant predictor of behavioral symptoms in this cohort. CONCLUSION: The findings suggest that BPSD are both an indicator and consequence of dementia severity, particularly in memory function. This study posits the need for targeted management of BPSD and improvement in overall patient care in LMICs.
Author(s): Elugbadebo OO, Ogunronbi M, Ogunniyi A, Akinyemi RO, Ogunde GO, Akinyemi JO, Farombi TH, Kunkle BW, Adams LD, Inciute JD, Griswold AJ, Adams LD, Whitehead PG, Umuojine J-P, Ogundele A, Zewde YZ, Osaigbovo G, Mutiso V, Olowoyo P, Ibuchim A, Boshe J, Lwere K, Ndetei D, Akpalu A, Nichols M, Mlaki DA, Sarfo FS, Nwani P, Njamnshi AK, Damasceno A, Wahab K, Whitehead PG, Griswold AJ, McCauley JL, Vance JM, Pericak-Vance M, Obiako R, Logvinsky I, Okubadejo NU, Paddick S-M, Kalaria RN, Arulogun O, Baiyewu O, Byrd GS, Pericak-Vance M
Publication type: Article
Publication status: Published
Journal: Alzheimer's & Dementia
Year: 2025
Volume: 21
Issue: S3
Online publication date: 26/12/2025
Acceptance date: 02/04/2018
Date deposited: 08/01/2026
ISSN (print): 1552-5260
ISSN (electronic): 1552-5279
Publisher: John Wiley and Sons Inc.
URL: https://doi.org/10.1002/alz70857_106579
DOI: 10.1002/alz70857_106579
PubMed id: 41451924
Notes: Supplement: Clinical Manifestations
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