Late life depression among elderly hypertensive patients.

AIMS AND OBJECTIVES: To determine the correlates of late life depression among elderly hypertensive patients as seen in Zaria Northern Nigeria. SUBJECTS AND METHODS: Elderly hypertensive patients attending the cardiac clinic of Ahmadu Bello University Teaching Hospital Zaria were recruited for the study. They were interviewed using socio-demographic Questionnaire, Consortium to Establish Registry for Alzheimer's Disease (CERAD), Geriatric Depression Scale-30 and Stick Design Test. Patients that had a score of 11 and above in the GDS-30 were further interviewed using the Geriatric Mental State Schedule (GMSS) AGECAT. Data obtained from the study was analyzed using Statistical Package for Social Sciences windows version 15. All tests of significance were carried out at 5% level of probability. RESULTS: A total of 179 patients participated in the study out of which 110 (65.1%) were females. The mean age of the subject was 68.23±5.72 years. The rate of late life depression based on International Classification of Diseases (ICD), 10th edition and Geriatric Mental State Schedule AGECAT (GMSS-AGECAT) diagnoses were 17. 88% (32) and 20.11 % (36) respectively. There was very good agreement between diagnoses based on ICD-10 criteria and GMSS-AGECAT (kappa=0.82, p<.001). Late life depression was significantly associated with recent bereavement (OR=11.04, p=.001), poverty (OR=4.39, p=.036) and lower diastolic blood pressure (7.04, p=.008). CONCLUSION: The rate of late life depression in this study is comparable to that of other studies reported in the literature. Poverty and bereavement but not high blood pressure, are important factors associated with depression in the elderly.

Male urinary incontinence and dementia in Zaria, Nigeria.

BACKGROUND: Ageing population in all parts of the world has make dementia in the elderly an important public health issue. Behavioural and Psychological symptom of dementia like urinary incontinence seldom attract the attention of clinicians providing care for the elderly. OBJECTIVE: To determine the prevalence of dementia among elderly male patients presenting with urinary incontinence to a urology clinic. SUBJECTS AND METHOD: We recruited consecutive elderly patients and their caregivers presenting to the urology clinic of Ahmadu Bello University Teaching Hospital for the treatment of urinary incontinence. The patients were assessed using Socio-demographic data collecting sheet, Consortium to Establish Registry for Alzheimer's Disease (CERAD), Stick Design Test and physical examination. While the caregivers were interviewed using the Blessed Dementia Scale. A consensus diagnosis was made for each of the patients based on criteria for dementia in both Diagnostic and Statistical Manual 4th edition (DSM-IV) and International Classification for Diseases 10 edition( ICD-10). All test of statistics were carried out at 5%level of probability. RESULTS: A total of 121 patients participated in the study. The mean age of the patients was 70.58 ± 5.47 years (95% CI=69.10-71.55). A total of 11 patients (9.10%, 95% CI=3.98-14.22) have dementia based on the consensus diagnosis. Dementia among this cohort is significantly associated with advancing age and enuresis. CONCLUSION: Dementia is common among elderly patients with urinary incontinence in Africa but remains large undetected and unrecognised.