Cognitive function in people with Parkinson’s disease in northern Tanzania.

Background: Cognitive impairment (CI) is a common non-motor symptom of Parkinson’s Disease (PD), but little is known about its profile and assessment in Sub-Saharan Africa (SSA). This study aims to characterise cognitive function in a cohort of people with PD (PwP) in northern Tanzania, and evaluate the feasibility and acceptability of cognitive screening tools in a low-resource, community setting. 

Methods: Twenty-eight PwP identified in a previous door-to-door survey were followed up. Cognitive function was assessed using the Identification and Intervention for Dementia in Elderly Africans (IDEA) screen, extended matchstick task (EMT), Luria’s test, cup task, and neuromotor pen (NMP). Age- and sex matched controls were recruited for comparison. Relationships between cognitive scores and disease stage, age, mood, and education were examined. 

Results: Executive and visuospatial impairments were the most prominent cognitive deficits. A moderate negative correlation was found between disease stage and IDEA screen scores (ρ = -0.471, p < 0.05). Significant differences were observed between PwP and controls on the EMT (p = 0.010). The NMP showed potential as a scalable and objective tool but faced technical and cultural challenges. The EMT was the most liked tool, while the IDEA screen was least preferred. 

Conclusions: This cohort of PwP demonstrated impaired cognitive function, with executive and visuospatial dysfunction being dominant features. Cognitive screening in rural SSA is feasible and acceptable, though tools must be culturally adapted. Larger, longitudinal studies are needed to validate tools and guide future care of PD related CI.