Predictors of cognitive impairment in patients with substance use disorder in Kiambu County, Kenya

Abstract

Cognitive impairments induced by substance use contribute to poorer treatment outcomes among patients with substance use disorder (SUD). Neuropsychological assessments are often neglected during patient evaluation in SUD treatment programs owing to the fact that they require extensive time for evaluation and are resource intensive. This inattention is likely to compromise comprehensive treatments which would offer better prognosis for such patients undergoing treatment for SUD. The main objective of this study was to determine predictors of neuro cognitive disorders (NCD) in patients with substance use disorders enrolled in rehabilitation centres in Kiambu County, Kenya. A cross-sectional design was adopted and data collected between Oct-23 to Jan 2024, covering a total of 250 patients aged 18-65 years that consented to participate in the study. Consecutive non-probability sampling technique was deployed in the recruitment of the respondents into the study. A self-rated questionnaire was developed for data collection whereas the Montreal Cognitive Assessment (MoCA) Tool was employed in the screening for cognitive impairment. The prevalence of cognitive impairment was 34.8% (Prevalence per primary substance showed alcohol=37%, cannabis=22%, and khat=22%). Age (Coefficient=0.0852, P=0.013 CI= 0.018-0.152), education (Coefficient=0.0783, P<0.008 CI= 0.021-0.139), and anxiety disorder (Coefficient=0.4286, P<0.001 CI= 0.317-0.540) were found to be significantly associated with neurocognitive disorders at multivariate analysis. This shows that 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.