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Disease surveillance is the systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice. This process integrates data dissemination to entities responsible for preventing and controlling disease, injury, and disability. Surveillance systems provide crucial information for action, helping public health authorities make informed decisions to manage and prevent outbreaks, ensure public safety, optimize...
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Public Health.

Stephen Asiimwe1,2, Moses Acan1, Samuel Maling1

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Summary
This summary is machine-generated.

The Uganda Dementia Cohort Study investigates Alzheimer's disease and related dementias (ADRDs) in older adults with and without HIV in sub-Saharan Africa. This research aims to identify risk factors and improve understanding of ADRDs in this vulnerable population.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Infectious Diseases

Background:

  • Antiretroviral therapy (ART) enables over 25 million people with HIV (PWH) in sub-Saharan Africa (sSA) to age.
  • Older PWH may face a higher burden of Alzheimer's disease and related dementias (ADRDs) due to chronic inflammation and increased risk factors.
  • Limited data exist on ADRD prevalence, progression, and predictors in sSA, especially among PWH.

Purpose of the Study:

  • To address the gaps in understanding ADRDs among older adults in Uganda, particularly those with HIV.
  • To establish a prospective cohort study (Uganda Dementia Cohort Study - UDCS) for in-depth research.
  • To investigate risk and protective factors, clinical characteristics, diagnostic tools, and societal impacts of ADRDs.

Main Methods:

  • The UDCS builds upon a 10-year quality of life study, enrolling PWH on suppressive ART and age/sex-similar controls without HIV.
  • Participants undergo phenotyping for 15 modifiable ADRD risk factors and annual cognitive testing.
  • The cohort includes approximately 600 older adults (mean age 62) with and without HIV, with similar demographics apart from marital status.

Main Results:

  • Established ADRD risk factors like hypertension (20%), smoking (41%), frailty (60%), and depression (40%) are prevalent in the cohort.
  • Prevalence rates of these risk factors are similar between participants with and without HIV.
  • Demographic characteristics are largely similar between HIV-positive and HIV-negative participants, with a higher frequency of married individuals in the HIV-negative group.

Conclusions:

  • The UDCS will significantly advance the understanding of ADRDs, including risk factors, phenotypes, diagnostics, and societal effects in Uganda.
  • The study is expanding to include deep phenotyping via cognitive assessments, biomarkers, and brain imaging.
  • Data and specimens will be collected to create a biobank, fostering harmonized cross-national research on ADRDs in Africa and globally.