Epidemiology of Dementia among the Elderly in Sub-Saharan Africa

Abstract

Objectives. To review epidemiologic studies on the prevalence, incidence, and risk factors of dementia in sub-Saharan Africa (SSA). Methods. A MEDLINE search (from January 1992 to December 31, 2013) of epidemiologic studies, with no language restriction, was conducted using the keywords “dementia” or “Alzheimer's” and “Africa.” We selected for review population and hospital-based studies that reported the prevalence, incidence, or risk factors of dementia in SSA in people aged 60 years and above. References of selected articles were reviewed to identify additional relevant articles that met our selection criteria. Results. Of a total of 522 articles, 41 were selected and reviewed. The reported prevalence of dementia in SSA varied widely (range: 2.29%–21.60%); Alzheimer's disease was the most prevalent type of dementia. Only two studies conducted in Nigeria reported incidence data. Major risk factors identified include older age, female gender, cardiovascular disease, and illiteracy. Conclusion. Data on the epidemiology of dementia in SSA is limited. While earlier studies reported a lower prevalence of dementia in older persons, recent studies have put these findings into question suggesting that dementia prevalence rates in SSA in fact parallel data from Western countries.

Dementia in rural South Africa: A pressing need for epidemiological studies

“…[8] A survey of individuals aged >60 years in residential homes found 7.9% with dementia; this was not, however, a population prevalence study. The University of the Free State, with the 10/66 Group, investigated dementia in an urban black community and reported a higher than expected preliminary prevalence of approximately 6% in a small sample of 200 older persons.…”

Dementia in Indigenous Populations

“…A 2014 review found prevalence rates of 2.29% to 21.6% [5]. Most of the studies reviewed reported a lower prevalence of dementia compared to developed countries; however a few of the most recent studies reported prevalence rates similar to Western countries [5].…”

“…A 2014 review found prevalence rates of 2.29% to 21.6% [5]. Most of the studies reviewed reported a lower prevalence of dementia compared to developed countries; however a few of the most recent studies reported prevalence rates similar to Western countries [5]. This may be due to newer, more accurate methods of assessment or the evolution of the disease in Africa as the population becomes exposed to greater risk factors, or, most likely, a combination of the two.…”

“…This may be due to newer, more accurate methods of assessment or the evolution of the disease in Africa as the population becomes exposed to greater risk factors, or, most likely, a combination of the two. The authors discussed some of the inherent difficulties in measuring prevalence as that many of the studies to date have been in single communities, which may not be representative of the specific country and that the variety of languages and cultures that exist between and within countries make assessment of cognition difficult [5]. When examining dementia and health more broadly and from the perspective of indigenous studies, we may need to take a different perspective and assess and address the needs of individual groups within a country on their own merits, rather than attempting to develop a one-size-fits-all approach, which is preferred in more culturally homogenous Western countries.…”

[P2–506]: Exploring the Lived Experience of the Individual of Black Ethnicity Living With Dementia: A Phenomenological Study

“…Awareness and understanding of dementia among the sample was very low, which had important implications for individuals' likelihood to seek dementia support, as this may have put them at risk of harm related to the conflation of dementia symptoms with witchcraft (Benade, 2012;De Jager et al 2015; Khonje et al 2015). Therefore, my close encounter with an early onset diagnosis of dementia would certainly be viewed as 'witchcraft', without the label of ageing.Data on the epidemiology of dementia in Sub-Sahara Africa is limited, as few studies to determine the prevalence of dementia have been conducted in sub-Saharan Africa (GeorgeCarey et al 2012;Prince et al 2013;Olayinka and Mbuyi, 2014). It is estimated that 2.13 million people were living with dementia in sub-Saharan Africa in 2015, with numbers projected to nearly double every 20 years, increasing to 3.48 million by 2030 and 7.62 million by 2050 (ADI, 2017).…”