Overview
Cognitive function is important for conducting many activities in daily life, ranging from simple activities such as household chores to complex ones such as financial matters. Neurodegenerative disorders that cause dementia are a major cause of cognitive decline, and are increasingly being recognized as a public health issue in low and middle-income countries (LMICs), as infectious diseases come under better control. One of the most important characteristics of LMICs is extreme poverty, defined by the World Bank Group as those living on less than $2.15/day (purchasing power). In the Democratic Republic of Congo (DRC), where this project will be conducted, 62.7 % of residents fit that definition. Over the last few decades, there has been a growing awareness that poverty is associated with non-monetary factors that also contribute to poor health conditions. This new approach aligns with the United Nations Agenda 2030 toward ending poverty in all its forms everywhere as targeted explicitly in the first Sustainable Development Goal.
Project Details
The proposed study will measure cognitive function in 300 Congolese adults aged 70 or older living in Kinshasa to better understand how the risk for dementia differs for urban and rural dwellers. We will collect all information needed to quantify multidimensional poverty using a previously published measure (education, disability due to poor health status, living standards, employment, social participation, and psychological well-being), and also collect additional information to comprehensively evaluate health risks across individuals, including health literacy, access to health care, comorbid health conditions, and physical activity. We will then examine the relationship between these factors and cognition, in the context of place of residence.
This study will provide important information about health risks across individuals in LMICs, while specifically providing data on what types of interventions could be most effective for protecting cognitive health in urban and rural residents in the DRC. We expect that specific risks for cognitive decline, including low levels of physical activity, being overweight, low social participation, and higher burden of comorbid chronic health conditions, will be worse in urban dwellers, while factors including low level of education, low health literacy, low access to health care, malnutrition, and poor standard of living will be worse in rural dwellers.
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