We all envision ourselves ageing gracefully, spending our twilight years surrounded by loved ones. However, the looming dementia health crisis is threatening to upend this vision for millions of people across Africa.
Dementia is a term for several diseases that affect memory, thinking and the ability to perform daily activities.
As the continent’s elderly population surges, the threat of cognitive decline grows, yet we remain dangerously unprepared to tackle it.
The World Health Organization (WHO) projects that by 2050, the number of people aged 60 and above in Sub-Saharan Africa will triple, adding immense strain to already fragile healthcare systems.
Dementia, which disproportionately affects older populations, is poised to become one of the most pressing public health challenges in the region. Yet, much of our current understanding of dementia is based on research conducted in Western countries, where the environments, lifestyles and healthcare systems are vastly different from those in Africa. The Western focus overlooks critical factors like genetic diversity, cultural perceptions of ageing, access to healthcare and social support systems that are unique to African populations.
Without data specific to Africa, how can we develop interventions that truly meet the needs of its people? This is a question we can no longer afford to ignore.
While existing global data provide valuable insights, they fail to fully address the unique cultural, genetic and environmental factors influencing dementia in African populations. For example, dietary habits, physical activity levels, vascular health factors and access to healthcare vary widely across the continent, significantly impacting both the risk and progression of dementia.
Moreover, we do not fully understand how genetic factors contribute to dementia in African populations. A key gene linked to dementia is called APOE ε4. In research mostly conducted in the Global North, this gene has been found to increase the risk of developing Alzheimer’s disease, which is the most common type of dementia; yet studies in people of African ancestry in these regions suggest that this gene may not be a significant predictor of Alzheimer’s disease in this population. Importantly, we don’t have enough information about how common this gene is in Africa or how it affects people there. Without this knowledge, it becomes challenging to identify people who might be at higher risk of dementia and to develop effective prevention strategies.
We urgently need research tailored to Africa’s unique contexts to create effective strategies for our communities. Without such data, millions of older Africans could be left vulnerable to a condition that not only affects individuals but also places a heavy burden on families and healthcare systems. It is crucial that we act now before dementia becomes a full-blown crisis in Africa.
Addressing this gap is essential to reducing the risk of cognitive decline and dementia across the continent. To do this, we need studies that shed light on the genetic, cultural, and environmental factors unique to African populations to enable us to develop innovative brain health programmes that will safeguard the well-being of our communities.
A recent Lancet report identified 14 modifiable risk factors that could prevent or delay up to 40 per cent of dementia cases globally. These include education, engaging in physical, social, and cognitive activities, managing blood pressure and cholesterol levels, maintaining a healthy diet, correcting vision and hearing problems, reducing exposure to pollution, ceasing smoking, and reducing alcohol intake. Understanding how these factors interact within African communities can offer valuable insights into effective strategies for preventing dementia.
Africa stands on the brink of a potential dementia crisis, and we must act decisively to avert it. Investments in research specific to our populations are urgently needed to help us develop the knowledge and tools required to protect future generations from the devastating impacts of dementia. This research is not just about understanding a disease—it is about ensuring that our aging population can live with dignity, health and resilience.
At the Brain and Mind Institute at Aga Khan University, we are addressing these gaps. The Brain Resilience Kenya project exemplifies the critical need for such studies as it aims to fully characterise bio-mechanistic pathways and identify unique contextual stressors that will inform the development of culturally appropriate strategies to boost resilience, such as the planned Africa FINGERS intervention trial.
The future of dementia in Africa is not predetermined. With the right research, we can change the narrative and bring hope to millions of older Africans and their families. The time to act is now, and the path forward is clear: we must bridge the dementia data gap and create solutions tailored to the unique needs of our continent.
Dr Udeh-Momoh, PhD, FHEA, is a translational neuroscientist at Aga Khan University’s Brain & Mind Institute
