Predictors of Neurocognitive Disorders among Patients with Substance Use Disorders in Kiambu County, Kenya
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Date
2025-09
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Kenyatta University
Abstract
Mental, neurological and substance use disorders have become widespread with 25% of all people affected during their lifetime. Drug abuse has diverse impacts on individuals cognitive functioning, differ across substances affecting adherence to treatment. Cognitive impairments induced by substance use contributes to poorer treatment and outcomes among patients with substance use disorder (SUD). However, neuropsychological assessment is usually not included in patient evaluation in SUD treatment programs because it is extensively time and resource consuming. Kenya identifies that alcohol and drug abuse are a major threat to the community and national development. However, in the Kenyan context there is limited data on the prevalence and predictors of neurocognitive disorders among patients with substance use disorders. The study sought to attain three core objectives, namely establish the prevalence of neurocognitive disorders among patients of substance abuse disorders; to identify drug abuse risk factors associated with neurocognitive disorders among SUD patients; and to identify the socio-economic and demographic factors associated with neurocognitive disorders among substance abuse disorder patients in Kiambu County. Montreal Cognitive Assessment tool (MoCA) was used to screen for cognitive impairment. Clinicians and psychosocial counsellors offering treatment services administered the data collection tool. Descriptive and inferential data analysis was conducted using STATA 18 statistical software. A total of 250 patients aged 18-58 years were enrolled in the study through consecutive sampling method. Prevalence of neurocognitive disorders was 34.8%. Significant cognitive disorders concerned delayed recall, attention, and visuospatial/executive functioning. Prevalence of cognitive impairment per primary substance was 37% for alcohol, 27% for cannabis and 22% for khat. Age was negatively associated while education was positively associated with cognitive impairment (P<0.05). There was no statistical difference between males and females (P>0.05) on the MoCA score. Multivariate analysis was conducted to identify predictors of neurocognitive disorders at (P<0.05). The analysis revealed that anxiety disorder was significantly associated with neurocognitive disorder. This study showed that age >35 years was associated with presence of neurocognitive disorder among SUD patients. Other socio-economic and demographic characteristics were not associated with cognitive disorders among SUD patients (P>0.05). It is important to screen for cognitive impairments during early treatment stages considering the high prevalence rate. This will enhance the choice of treatment course and maximize on treatment outcomes.
Description
A Research Thesis Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Public Health (Epidemiology and Disease Control) in the School of Health Sciences of Kenyatta University, September, 2025
Supervisor;
1.Isaac Mwanzo
2.Eunice Githae