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.
Highlights
According to a recent survey conducted by Harvard School of Public Health and Alzheimer’s Europe consortium on Alzheimer’s disease (AD), dementia of the Alzheimer’s type is a major cause of health concern in adults [1]
Most of the population-based studies had study participants ranging from 184 persons in a Kenyan study (84 controls versus 100 demented persons) to 4,706 persons in the IndianapolisIbadan epidemiological study of dementia (2,494 NigeriaYoruba versus 2,212 African Americans in Indianapolis), while the range for hospital-based studies was 23 to 240,294 participants (Tables 1 and 2)
The reported age-adjusted prevalence of dementia for the population-based studies we reviewed varied widely ranging from 2.29% (AD = 1.41%) in Nigeria-Yoruba, aged 65 years and above, who lived in the Idikan community in Ibadan city [8], to 21.60% (AD prevalence not reported) in the rural Hai district of Tanzania [6]
Summary
According to a recent survey conducted by Harvard School of Public Health and Alzheimer’s Europe consortium on Alzheimer’s disease (AD), dementia of the Alzheimer’s type is a major cause of health concern in adults [1]. A variety of reasons may account for the varying reported prevalence rates of dementia in SSA. This is a vast territory with a population of 1.1 billion people [13, 14], and the number of people aged 60 years and above is projected to rise to over 67 million by 2030 [15]. The objective of this paper is to identify the prevalence, incidence, and risk factors of dementia in SSA in order to gain a clearer view of this major public health concern
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