Prevalence of and Factors Associated with Cognitive Impairment Among Adults in Central Sudan: A Community-Based Cross-Sectional Study

Background: Cognitive impairment is a major global public health challenge; however, data from sub-Saharan Africa, particularly Sudan, remain scarce. This study investigated the prevalence of cognitive impairment and the factors associated with it among adults in East Gezira, central Sudan. Methods: This community-based cross-sectional study was conducted from April to June 2025. Using multistage stratified random sampling, 336 adults aged ≥ 18 years were recruited. Cognitive status was assessed using the Montreal Cognitive Assessment (MoCA), with a score of < 26 indicating cognitive impairment. Depression and anxiety were assessed using the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7) scales, respectively. Multivariable binary logistic regression was used to identify independent factors associated with cognitive impairment. Results: Of the 336 adults, 227 (67.6%) were men and 109 (32.4%) were women. Their median (interquartile range) age and body mass index were 42.0 (30.0‒55.0) years and 22.6 (19.3‒27.0) kg/m 2 , respectively. The overall prevalence of cognitive impairment (MoCA score < 26) was 73.5%. The prevalence of mild, moderate, and severe cognitive impairment was 51.5%, 21.7%, and 0.3%, respectively. In multivariate binary analysis, factors independently associated with cognitive impairment were older age (adjusted odds ratio [AOR], 1.02; 95% confidence interval [CI]: 1.004– 1.05), low education level (AOR: 5.22; 95% CI: 2.70– 10.09), unemployment (AOR: 2.46; 95% CI: 1.03– 5.91), and depression (AOR: 2.98; 95% CI: 1.30– 6.83). Conclusion: The prevalence of cognitive impairment in this central Sudan community is remarkably high. Age, low education, unemployment, and depression are significant risk factors. These findings underscore the urgent need for public health interventions to detect and manage cognitive impairment early in this population. Keywords: cognitive impairment, depression, age, education, employment, Sudan