Epidemiologic and clinical features of Alzheimer's disease: a hospital study based on the memory clinic in Abidjan, Côte D'ivoire, Sub-Saharan Africa.

This is a retrospective 4 year, cross-sectional hospital based study describing the main epidemiological and clinical characteristics in a cohort of 36 patients with Alzheimer’s disease. The AD patients were identified out of a series of 295 patients attending a Specialized Memory clinic. The main epidemiolocal findings were a mean time to consultation of 3.3 years, equal M/F sex ratio, mean age 70.5 years, ≥ 65 years 72.3%, and had a higher overall level of education 52%. The main clinical findings as assessed by a Mean Montreal Cognitive Assessment score of 10.9, report a mean loss of memory capacity of 89.2%, loss of visuospatial and executive functions of 64% and of attention of 61.5%. The main radiological finding on MRI investigation was bilateral hippocampal atrophy (63.9%) with radiologic lesions significantly more pronounced in the elderly than in the young. On univariate analysis, moderate Alzheimer’s disease was associated with age < 75 years, higher education and cortical atrophy. A history of diabetes and cortico-subcortical atrophy were associated with severe AD. In conclusion, this study provides an initial database on this disease in Côte d’Ivoire, but also enriches the existing database in sub-Saharan Africa. The authors state that the main findings of the study are similar to those described in the literature. However, they note the predominance in young subjects < 65 years old (27.7%) and the strong association with higher education (university) of 52%. Furthermore, the authors highlight a diagnostic delay and difficulties in diagnostic management related to the costs of paraclinical investigations for this disease. Government interventions to better characterize this disease using larger sample sizes.