Dementia in Africa: Current evidence, knowledge gaps and future directions
Epidemiology and Risk Factors:
Dementia prevalence in Africa ranges from 2.3% to 20.0%, with an incidence rate of 13.3 per 1000 person-years. Lower dementia rates in Africa may stem from shorter life expectancies, varied diets, and less cardiovascular risk exposure. Risk factors include age, genetic predispositions, HIV, cardiovascular conditions, and education levels. APOE ε4’s role shows variability between African populations and other ethnic groups.
Challenges:
- There is a lack of longitudinal, high-quality studies and regionally representative data.
- Cognitive assessment tools often fail to account for cultural and educational differences, leading to under-diagnosis.
- The high cost and limited availability of advanced diagnostic tools and care infrastructure impede early detection and management.
Dementia Care:
- Traditional multigenerational care systems are eroding due to globalization and urbanization.
- Formal care systems are limited by financial constraints and societal stigmas around dementia.
Research Gaps:
- Limited neuropathological studies restrict understanding of dementia subtypes.
Few genome-wide association studies have explored genetic predispositions unique to African populations. - Minimal data exist on the economic cost and biomarker utilization in Africa.
African Dementia Consortium (AfDC):
- A proposed initiative to unify African researchers for multidisciplinary studies on dementia.
- Goals include enhancing epidemiological data, genomic studies, biomarker discovery, clinical trials, and capacity building.
Future Directions:
- Develop culturally sensitive diagnostic tools with validated normative data.
Address stigma through community education. - Expand research infrastructure and capacity, focusing on longitudinal studies and integrative transomics.
*Data sourced from Pub Med Central