Cognitive Dysfunction in Patient with Chronic Medical Condition in Sub-Saharan Africa
Taofiki Ajao Sunmonu*, Adebimpe Funmilola Ogunmodede,
Olubumin Akindele Ogunrin
1Neurology Unit Department of Internal Medicine, Federal Medical Centre Owo,
2Department of Neurology, University Hospitals of North Midlands, NHS Trust,
Stoke on Tent, United Kingdom
*Corresponding Author:Taofiki Ajao Sunmonu, Neurology Unit, Department of
Medicine, Federal Medical Centre, Owo, Ondo state, Nigeria.
May 18, 2023; Published: July 10, 2023
Chronic Medical Condition is a condition that last longer than one year or more, requires ongoing medical attention and limit activities of daily living. Among these conditions in sub-Saharan Africa (SSA) are epilepsy, diabetes mellitus, Human Immunodeficiency Virus infections bronchial asthma, chronic liver disease and others. Cognitive decline could be present in about 60% of patients with chronic medical conditions especially older adults and those with multiple comorbidities. These chronic medical conditions could have heterogenous patterns of presentation and may have different underlying pathophysiological mechanisms. Various instruments used for neuropsychological assessment of cognition in these conditions and treatment is basically through pharmacologic and non-pharmacologic therapies including cognitive behavioural therapy.
This review is an attempt to describe the specific patterns of presentations of cognitive dysfunctions in patients living with common chronic medical conditions in sub-Saharan Africa such as memory, information processing, attention/concentration, learning, visual spatial skills and other executive functions. We also highlighted recent advances of possible pathophysiological mechanism and management of this conditions. Furthermore, well conducted large scale trials to explore the peculiar pathophysiological mechanisms of cognitive decline in patients with chronic medical conditions in sub-Saharan Africa in the near future.
Keywords: Cognition; Cognitive Dysfunctions; Neuropsychology; Chronic Medical Conditions; Africa
- Centre for disease control, National Centre for Disease Prevention and Health Promotion (2023).
- Megari K. “Quality of life in chronic disease patients”. Health Psychology Research3 (2013).
- Ibekwe Rc., et al. “Academic performance of School Children with epilepsy”. West African Journal of Medicine2 (2008): 74-77.
- International league against Epilepsy (ILAE) “The 2014 definition of Epilepsy Perspective of patients and caregivers” (2023).
- Njamnshi AK., et al. “Risk factors associated with epilepsy in a rural area in Cameroon A preminary study”. African Journal of Neurologiled Sciences 2 (2007): 18-26.
- Sunmonu TA., et al. “Seizure viatables and cognitive performance in patients with epilepsy”. African Journal of Neurologiled Sciences 2 (2008): 86-94
- Arinzach Ed., et al. “A community based case-control study of prevalence and patterns of cognitive impairments in patients with epilepsy residing in South Eastern Nigeria”. Journal of Neuroscience in Rural Practice3 (2016): 405-411.
- Ogunrin OA and Adamolekun B. “Cognitive neuro assessment in Africans - predictive validity of a computerized testing”. Annals of Biomedical Sciences 1 (2007): 28-144.
- Ogunrin OA., et al. “Cognitive functions in Nigerian with newly diagnosed epilepsy”. Canadian Journal of Neurological Sciences 2 (2000): 148-151.
- Nau Al., et al. “Cognitive impairment and quality of life of people with epilepsy and cysticercosis in Zambia”. Epilepsy and Behavior 80 (2018): 354-359.
- Imam I and Oguniyi A. “The value of mini-mental State examination in Nigeria epileptic”. Tropical Doctor2 (2019): 108-109.
- Sunmonu TA., et al. “Cognitive assessment inpatient with epilepsy using community screening interview for dementia”. Epilepsy and Behavior 3 (2009): 525-530.
- Ogunjimi L., et al. “Cognitive dysfunction in Nigerian women with epilepsy on cartamazepine Leviteracetam monotherapy”. Brain and Behaviour47 (2021): e02038.
- Hammed SA. “The aspects and mechanism of cognitive operations and epilepsy”. The role of antiepileptic mechanism”. CNS Neuroscience and their Therapeutic 18 (2009): 134-156.
- Ogunrin O., et al. “Cognitive effect of antiepileptic drugs in Nigerians with epilepsy”. African Journal of Neurological Sciences 1 (2005).
- Ogunrin O. “Effect of Vinpoceutine (Cognitol) on cognitive performances of a nigerian population”. Annals of Medical and Health Sciences Research4 (2014).
- Sunmonu TA., et al. “Intellectual impairment in patients with epilepsy in ile-ife, Nigeria”. Acta Neurologica Scandinavica 6 (2008): 395-401.
- Bascum J., et al. “Dyadic Short forms of the Wechsler Adult intelligent scale IV”. Systematic Review Psychology Society and Education3 (2020): 187.
- Ryan J., et al. “Scormg reliability of WAIS-R”. Journal of Consulting and Clinical Psychology1 (1983): 149-150.
- Albert WCJ and Aldenkamp AP. “Neuropsychological assessment of cognitive functioning in children with epilepsy”. Epilepsia 4 (1990): s35-s40.
- Wu Q Zhao CW., et al. “Anatomy based network and topology alteration in seizure related cognitive outcomes”. Frontiers in Neuroanatomy 6 (2018): 12-25.
- Heaton RK., et al. “The HNRC 500 et al. The neuro psychology of HIV infection at different stages of the diseases. AV neurobehavioral research centre”. International Journal of Neuropsychopharmacology 3 (1995): 231-251.
- Mugendi AG Kubo MN Nyamu DG., et al. “Prevalence and correlates of neurocognitive disorder among HIV patients on Antitroviral therapy at Kenyan hospital”. Nuerology Research International (2019): e5173289.
- Asemkomeh GE., et al. “The burden of HIV - associated the mental is in acquired immunodeficiency syndrome; a case-control study”. Journal of Neurology and Epidemiology13 (2013): 39-47.
- Sunmonu TA., et al. “Cognitive functions in new diagnostic patients with HIV infection in a tertiary health facility stop assessment using community screening interview for dementia”. eNeurologicalSci 9 (2017): 8-13.
- Yusuf AJ., et al. “Prevalence of hiv-associated neurocognitive disorder (HAND) among patients attending health facility in northern Nigeria”. International Association of Providers of AIDS Care 1 (2017): 48-55.
- Odiase F., et al. “Effect of progression of diseases on cognitive performance in HIV/AIDS”. Journal of the National Medical Association8 (2006): 1260-1262.
- Odiase FE and Oguniyi A. “Memory performance in HIV/AIDs. A prospective case-control study”. Journal of Neurological Sciences2 (2009): 154-159.
- Sunmonu TA., et al. “Intellectual impairment in patients with newly diagnosed HIV infection in southwestern Nigeria”. BioMed ResearchInt (2015): 185891.
- Royal W., et al. “Clinical features and preliminary studies of virological correlates of neuro cognitive impairment and not a Chevy infected individuals in Nigeria”. Journal of NeuroVirology 18 (2012): 191-199.
- Obimakinde AM., et al. “Neuro cognitive impairments in aging people living with HIV. A comparative study of elderly patients attending the University college hospital ibadan Nigeria”. African Journal of Neurological Sciences 21 (2021): 110-119.
- Oshinaike OO., et al. “Composition of mini-mental state examination scales an international HIV dementia scale in assessing cognitive functioning in Nigeria patients on antiretroviral therapy”. AIDS Research and Treatment (2015): e581531.
- Yakassai AM., et al. “Prevalence and correlates of HIV-associated neurocognitive disorder (HANDS) the northwestern Nigeria”. Neurology Research International (2015): e486960.
- Sunmonu TA., et al. “Cognitive function in patients with newly diagnosed HIV infection in a child health facility in Southwestern Nigeria; assessment using computer instead neuropsychological test battery”. eNeurologicalsci 3 (2016): 54-59.
- Thompson PM., et al. “Thining of the cerebral Cortex visualized in HIV/AIDS reflects CD4 T hymphkcyte decline”. Proceedings of the National Academy of Sciences43 (2005): 15647-15652.
- Herold CJ., et al. “Nuerological soft signs and brain morphology in people living with HIV”. Journal of Neurovirology 28 (2022): 238-247.
- Moore JW., et al. “Orphological MRI brain scans abnormalities in apparently healthy non - encephalopathic patient with liver cirrhosis; a control study”. Journal of Hepatology3 (1989): 319-325.
- Rathi S., et al. “Prevalence of minimal Hepatic encephalopathy in patients with liver cirrhosis: a cross-sectional chico epidemiological multi centre, national study in India: The PREDICT study”. Journal of Clinical and Experimental Hepatology4 (2019): 476-483.
- Faccioli J., et al. “Minimal Hepatic encephalopathy affects daily life of cirrhotic patients. Viewpoints on clinical consequences and therapeutic opportunities”. Chinese Medical Journal 23 (2022): 7246.
- Bamidele OF., et al. “Prevalence of minimal hepatic encephalopathy among patients with chronic liver diseases in Nigeria cost of Ghana mad. J4 (2019): 299 - 303
- Sunmonu TA., et al. “Cognitive functions in patients with liver cirrhosis without overt hepatic encephalopathy. Assessment using an automated neuropsychological test battery”. Arab Journal of Gastroenterology1 (2012): 4-8.
- Gracias - Gracias R., et al. “Learning a memory impairment in patients with minimal apothic encephalopathy associated with function connectivity operation in hippocampus”. Scientific Report 8 (2018): e9664.
- American Diabetes Association (2022).
- Bashir J and Yarube IU. “Occurrence of mild cognitive impairment with hyperinsulinemia in African with advanced type diabetes mellitus”. IBRO Neuroscience Reports 12 (2022): 182-187.
- Eze Co., et al. “The prevalence of cognitive impairment amongst type 2 diabetes mellitus patience art abakaliki southeast Nigeria”. Journal of Diabetes and Metabolic Disorder 2 (2015): 003.
- Adetayo RY., et al. “Body mass, index, blood pressure and cognitive impairment among type 2 diabetic patients in primary Care setting in North Central, Nigeria”. Annals of African Medical Research 1 (2022): 158.
- Yarube IU and Gwarzo FM. “Cognitive impairment and reduced antioxidant capacity in patient with type 2 diabetes”. Sahel Medical Journal 4 (2019): 171-178.
- Moran C., et al. “Alzheimer's Disease neuroimaging initiative; type 2 diabetes mellitus; atrophy and cognitive decline”. Neurology8 (2019).
- Erhabor GE., et al. “Asthma: psychosocial impact among sample of southwestern Nigerians”. Journal of National Medical Association 11 (2002): 981-993.
- Sunmonu TA., et al. “Cognitive function in clinically stable (mild to moderate) asthma in southwest Nigeria; assessment Using automated neuropsychological test battery”. West African Journal Medicine2 (2019): 158-164.
- Li S., et al. “Cerebral regional and network characteristics in asthmatic patients; a resting MRI FMRI Study”. Frontier in Medicine 14 (2020): 792-801.
- Blan R., et al. “White matter integrity destruction in patients with need cognitive impairment and dementia. A sampling review”. The American Journal of Geriatric Psychiatry 2 (2019): 188-197.
- Imarhiagbe F., et al. “Cognitive performance of hypertensive elderly in Nigerian; a case-control study”. African Journal of Medicine and Medical Sciences 3 (2015): 269-273.
- Egbi OG., et al. “Prevalence determinants of cognitive impairment in patients with chronic kidney disease: A cross-sectional study in Benin City Nigeria”. Annals of African Medicine 2 (2015): 75-81.
- Owolabi LF., et al. “Cognitive functions assessment in patients with end stage renal diseases in Nigeria; a single centre experience”. Annals of African Medicine3 (2016): 138-144.
- Drew DA., et al. “Cognitive impairment in CRD. Pathophysiology management and prevention”. American Journal of Kidney Diseases 6 (2019): 782-790.
- Ben M., et al. “Allergic Asthma induced cognitive impairment is alleviated by dexamethasone”. Frontiers in Pharmacology 12 (2021): e0680815.
- Simoniene D and Vehickene D. “The relationship between exogenous insulin and cognitive function in type 2 diabetes mellitus”. Medicina (Kaines)9 (2021): 943.
- Fischer RS., et al. “A pilot study of donezil for memory problem in epilepsy”. Epilepsy and Behavior 4 (2001): 330-334.
- Yang X., et al. “The role of butyryl cholinesterase in the regulation of cognitive function in minimal hepatic encephalopathy”. Frontiers in Neurology 13 (2022): 900-997.
- Binan LA., et al. “Neurocognitive changes following kidney transplant: A prospective study”. Kidney Medicine 12 (2022): e100560.
- Osman MA., et al. “Reversibility of hepatic encephalopathy following transplantation in Egyptian Cirrhotic patients”. World Journal of Hepatology30 (2016): 1279-1286.
- Stinton LM and Iayakumar S. “Minimal Hepatic encephalopathy”. Canadian Journal of Gastroenterology 10 (2013): 572-574.
- Leeman - Markowski BA and Schaecter Sc. “Cognitive and behavioral intervention in epilepsy”. Current Neurology and Neuroscience Reports 5 (2007): 42.
- Kew Km., et al. “Okay completive behavioral therapy for adults and adolescents with asthma”. The Cochrane Publication 9 (2016): CD011818.
- Brence GA., et al. “The effective of yoga on patients with mild cognitive impairment and dementia. A scoping review”. The American Journal of Geriatric Psychiatry 2 (2019): 188-197.