Objective: To critically appraise and synthesize evidence on the prevalence and clinical correlates of cognitive impairment and neuropsychiatric manifestations among patients with Parkinson’s disease in Africa.

Background: Cognitive impairment and neuropsychiatric manifestations are common disabling non-motor symptoms that can negatively impact quality of life in Parkinson’s disease (PD). Data on these non-motor symptoms from African populations remains sparse.

Method: We conducted a systematic review of observational studies reporting cognitive and neuropsychiatric outcomes among individuals with Parkinson’s disease in African populations. We searched PubMed, ScienceDirect, African Journals Online, Google Scholar, Cochrane Library, and Sabinet Journals for eligible studies. This review was done following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We used the Critical Appraisal Skills Program (CASP) checklist to determine the quality of the included studies. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to estimate the certainty of the evidence.

Results: A total of 32 studies were included, representing 3,687 patients with Parkinson’s disease from North, West, East, Central, and Southern Africa. The prevalence of cognitive impairment was high across studies, ranging from approximately 20% to over 90%. Studies using more sensitive tools, such as the Montreal Cognitive Assessment, reported higher detection rates. Neuropsychiatric manifestations were also frequently reported, with depression being the most common, followed by anxiety, apathy, hallucinations, and behavioral disturbances. A high prevalence of depression (up to 81.4%) was reported in some studies. Cognitive impairment and neuropsychiatric symptoms were significantly associated with older age, longer disease duration, and greater motor severity, as well as poor quality of life. Significant associations of cognitive impairment with genetic mutations, and metabolic abnormalities were reported in some studies.

Conclusion: Cognitive impairment and neuropsychiatric manifestations are highly prevalent among people with PD in African populations, echoing a critical need for systematic screening and management to improve quality of life for people with PD in this setting.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-impairment-and-neuropsychiatric-manifestations-in-parkinsons-disease-in-africa-a-systematic-review-of-evidence/