Dementia in Africa: Current evidence, knowledge gaps, and future directions

Rufus Akinyemi (1, 2) , Joseph Yaria (2) , Akin Ojagbemi (2) , Maëlenn Guerchet (3) , Njideka Okubadejo (4) , Alfred Njamnshi (5) , Fred Sarfo (6) , Albert Akpalu (7) , Godwin Ogbole (2) , Temitayo Ayantayo (1) , Thierry Adokonou (3, 8) , Stella‐maria Paddick (9) , David Ndetei (10) , Judith Bosche , Biniyam Ayele (11) , Andrea Damas (12) , Motunrayo Coker (1) , Lingani Mbakile‐mahlanza (13) , Kirti Ranchod , Kirsten Bobrow (14) , Udunna Anazodo (15) , Albertino Damasceno (16) , Sudha Seshadri (17) , Margaret Pericak‐vance (18) , Brian Lawlor (19) , Bruce Miller (20) , Mayowa Owolabi (1) , Olusegun Baiyewu (2) , Richard Walker (2) , Oye Gureje (2) , Rajesh Kalaria (1) , Adesola Ogunniyi (1, 2)

1 University of Ibadan
2 University College Hospital [Ibadan, Nigeria]
3 NET - Neuroépidémiologie Tropicale
4 Université de Lagos
5 Université de Yaoundé I
6 KNUST - Kwame Nkrumah University of Science and Technology
7 Korle-BU Teaching Hospital [Accra, Ghana]
8 UP - Université de Parakou
9 Newcastle University [Newcastle]
10 University of Nairobi
11 Department of Earth Sciences [Addis Ababa]
12 UDOM - University of Dodoma [Tanzanie]
13 Université du Botswana
14 Department of Medicine - Division of Clinical Pharmacology [Cape Town, South Africa]
15 Lawson Health Research Institute [London (ON) Canada]
16 Faculty of Medicine, Eduardo Mondlane University, Maputo
17 University of Texas Health Science Center at San Antonio [San Antonio, Tx, USA]
18 John P. Hussman Institute for Human Genomics
19 Trinity College Dublin
20 UC San Francisco - University of California [San Francisco]

In tandem with the ever-increasing aging population in low and middle-income countries, the burden of dementia is rising on the African continent. Dementia prevalence varies from 2.3% to 20.0% and incidence rates are 13.3 per 1000 person-years with increasing mortality in parts of rapidly transforming Africa. Differences in nutrition, cardiovascular factors, comorbidities, infections, mortality, and detection likely contribute to lower incidence. Alzheimer's disease, vascular dementia, and human immunodeficiency virus/acquired immunodeficiency syndrome-associated neurocognitive disorders are the most common dementia subtypes. Comprehensive longitudinal studies with robust methodology and regional coverage would provide more reliable information. The apolipoprotein E (APOE) ε4 allele is most studied but has shown differential effects within African ancestry compared to Caucasian. More candidate gene and genome-wide association studies are needed to relate to dementia phenotypes. Validated culture-sensitive cognitive tools not influenced by education and language differences are critically needed for implementation across multidisciplinary groupings such as the proposed African Dementia Consortium.

Mots clés: Africa; Alzheimer's disease; consortium; dementia; epidemiology; genetics; neuropathology; biomarkers; precision medicine; vascular dementia

Domaines: Santé publique et épidémiologie

Rufus Akinyemi, Joseph Yaria, Akin Ojagbemi, Maëlenn Guerchet, Njideka Okubadejo, et al.. Dementia in Africa: Current evidence, knowledge gaps, and future directions. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, 2021, ⟨10.1002/alz.12432⟩. ⟨hal-03414090⟩