Dementia in Sub-Saharan Africa: Risk factors, public perception, and management approaches

Dementia is becoming a major public health problem in Sub-Saharan Africa (SSA), with prevalence increasing due to demographic transitions, increasing life expectancy, and increasing prevalence of non-communicable diseases. This commentary synthesizes the latest data on the epidemiology, risk factors, public perception, and management approaches for dementia in SSA, noting that although worldwide rates of dementia are increasing, SSA will experience the highest growth, which, with the current rate of increase, is projected to triple by 2050. SSA prevalence rates vary widely from 2.3% to as high as 20%, predominantly because of methodological discrepancies, lack of identification, and limited access to medical care. Incidence figures are also weak and mostly restricted to a few countries, thus potentially underestimating the true regional burden. The identified risk factors include age, gender, low educational attainment, untreated hypertension, diabetes, infectious diseases, including causes of HIV and cerebral malaria, and specific genetic predispositions, with low educational status being the most powerful modifiable factor. Stigma and misconceptions often delay diagnosis and contribute to under-reporting, compounding the burden on affected families. The sub-optimal healthcare system, lack of culturally appropriate diagnostics, and national fragmentation of epidemiological data make the situation of SSA more complex. The commentary emphasizes the importance of raising awareness, data collection method refinement, and culturally informed approaches to guide policy-making, promote research, and enhance the prevention and management of dementia in SSA, to develop locally-suited interventions to address the growing dementia epidemic.