Objective: Community dwelling older persons diagnosed with dementia from the Indianapolis-Ibadan Research Project were followed in 1999, 2000, and 2001. The aim was to assess cognition, functioning, and behavioral symptoms over time.
Method: Subjects in this cohort were assessed each year using the Mini Mental State Examination (MMSE), Blessed Dementia Scale (BDS), and Neuropsychiatry Inventory (NPI). The questionnaires had been back translated and harmonized into the Yoruba language. The MMSE was administered to the demented subjects while their principal caregivers were administered the BDS and NPI. Odds ratios and p-values were derived from generalized estimating equations (GEE) applied to the logistic regression models of the association between MMSE and BDS with NPI scores. Demographic characteristics were compared between subjects completing and not completing all three follow-ups using t-tests and Fisher’s exact tests.
Result: Of 40 persons seen in 1999, 29 were also seen in 2000, and 22 were seen on all 3 occasions. Analysis of data from the 22 subjects who completed all three follow ups (completers) showed that the presence of the symptoms of delusion, depression, and night–time behavior increased over the years, while the presence of other NPI symptoms was more variable. Mean MMSE scores were stable over the years, but mean BDS and NPI scores deteriorated. The GEE results of MMSE and BDS on the NPI individual items showed that better MMSE correlated significantly with decreased presence of delusion and anxiety, while BDS correlated with presence of depression, anxiety, and irritability. From comparing the completers with the 18 persons who were lost to follow-up, we found that the lost to follow-up had significantly more males and worse mean BDS and NPI total scores at baseline. Night-time behavior was the only NPI symptom more frequently reported at baseline by the lost to follow-up group. 78% of those lost to follow-up died.
Conclusion: Functioning and behavioral symptoms became worse over time. In addition, those lost to follow-up tended to be males and had significantly worse performance at baseline.
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