Includes bibliographical references. / Do any validated dementia screening tools exist for use in palliative care populations in sub-Saharan Africa? Around the world populations have increased life expectancies. The tendency to develop dementia increases with age. By 2040, it is projected that more than 80 million people worldwide will suffer from dementia. Effective and validated dementia screening tools are used for screening and identifying people with dementia at an early stage, allowing for the possibility of earlier intervention. Validated tools are used internationally, but there is a need to determine if such tools have been validated for use in a sub-Saharan African palliative care population, which presents with the distinct challenges of literacy, language and culture. There is also a high incidence of HIV in sub-Saharan Africa, with a concomitant high prevalence of HIV-associated dementia. Sub-Saharan Africa therefore needs a unique, validated dementia screening tool for use in a palliative care population. Dementia causes a high burden of suffering for patients, their families, and communities. There is a similarity between many of the symptoms of cancer and dementia, although patients with dementia have a longer life expectancy. Palliative care is the cornerstone in the management of cancer patients and is therefore clearly ideal for people suffering from dementia. The World Health Organization, in their publication: "Palliative Care for Older People: Better Practices", state that people who suffer from dementia are in urgent need of improved palliative care services 2.2. Aim The aim of this systematic review was to identify validated dementia screening tools, and of those tools, to determine, specifically, whether they had been validated in a palliative care population in sub-Saharan Africa. This was done by following 3 objectives: Page 14 1. To identify which validated dementia screening tools are available. 2. To identify and isolate those tools which have been validated in sub-Saharan Africa. 3. To determine from those tools validated in sub-Saharan Africa, which have been validated in a palliative care population. To clarify, the aim of the study was to identify the validated tools, for dementia screening in sub-Saharan Africa, in a palliative care population. This study did not endeavor to conduct an in-depth analysis of the psychometric properties of the identified tools. 2.3. Methods The EBSCO, PUBMED, SCOPUS, Medline, Psych INFO, CINAHL and Africa-Wide Information databases were searched to identify dementia screening tools. The comprehensive search strategy focused on search terms in the categories of dementia, screening tools and subSaharan Africa. Included were all tools used to screen dementia in an adult population, provided the tools met one of the following validity criteria: face validity, or content validity, or concurrent validity as well as internal consistency. An abstract had to be available. The tool had to be peer reviewed, for use with human subjects, and in English. Exclusion criteria for the validated tools were: grey literature and the screening of children. 2.4. Results Stage 1 was to identify validated dementia screening tools internationally using the electronic databases listed above under methods. This search identified 116 articles written on global dementia screening tools. Stage 2 was performed on the same electronic databases to determine if any tools had been validated in sub-Saharan Africa. This search identified 8 articles on dementia screening tools validated in sub-Saharan Africa. The 3rd stage was to determine if any of the dementia screening tools from stage 2 had been validated in a palliative care population. In stage 3, 3 articles were identified all pertaining to the same dementia screening tool. The International HIV Dementia Scale (IHDS) was the only validated dementia r a g " I s screening tool found that had been validated in sub-Saharan Africa in an HIV population but not in a palliative care population. HIV can be seen as being included in a palliative care population. 2.5. Conclusion No validated tool was identified for the broad-based screening of dementia in sub-Saharan Africa in a palliative care population. The IHDS has been validated for use in screening for HIV-associated dementia in this region. This tool can still be used in the HIV population, but the author is of the opinion that the IHDS, as a screening tool for dementia, is not adequate in the general palliative care population. In the current clinical setting, the international gold standard tool for dementia screening, the Mini Mental State Examination (MMSE), is regularly used, and despite certain limitations associated with its use in the sub-Saharan Africa setting, the author recommends its continued use. The author recommends that the MMSE be revalidated for use in the sub-Saharan Africa palliative care population.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uct/oai:localhost:11427/13290 |
| Date | January 2014 |
| Creators | Schneider, Suzanne Eva |
| Contributors | Harding, Richard |
| Publisher | University of Cape Town, Faculty of Health Sciences, Department of Public Health and Family Medicine |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Master Thesis, Masters, MPhil |
| Format | application/pdf |
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