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Dementia could become one of Africa’s biggest health crises unless urgent interventions are introduced to counter the continent’s disproportionate incidence of the 14 changeable risk factors.1
Unexplained vision loss, and high LDL cholesterol, are the latest risk factors on the list,2 which included low education levels, smoking, obesity, diabetes, and physical inactivity. Africa contributes almost one-fifth to the global incidence of vision loss,3 while high LDL cholesterol in the general population is estimated at about 30%.4
Led by 27 dementia experts, the 2024 update of the Lancet Commission on Dementia builds on the list of risk factors, providing an updated analysis of the best evidence on dementia prevention.
“The number of people with dementia continues to rise, even as the age-specific incidence decreases in high-income countries, emphasising the need to identify and implement prevention approaches,” lead author, Gill Livingston, of University College London, writes in The Lancet.
“Evidence is now stronger than before that tackling the many risk factors for dementia that we modelled previously reduces the risk of developing dementia,” she says.
Current projections suggest that 153 million people could have dementia by 2050, according to the report. It says that targeted prevention and treatment of risk factors throughout a life’s course could reduce incidence by half.
Within Africa, the report stresses there is more potential for risk reduction in low- and middle-income countries, and among “minoritized and lower socioeconomic groups”. It is in these populations, which often have a higher burden of modifiable risk, that dementia is more likely to develop at an earlier age, it says.
Sholto de Wet, of the Neurology Research Group at Stellenbosch University, South Africa, agreed that the high prevalence of modifiable risk factors in African countries provides fertile ground for local scientists.
“Given the high prevalence of these modifiable risk factors, African scientists have ample opportunity and reason to study and address these factors and offer future means of detection and information as a means of serving their communities,” he said.
The World Health Organization estimates that the African region is home to about 24 million people who have diabetes, a figure projected to more than double to 55 million in the next two decades – the highest projected increase worldwide. WHO says that only about 50% of people diagnosed with diabetes on the continent are receiving adequate treatment.5
Similarly, WHO estimates that fewer than a third of people living with hypertension in the African Region are on treatment, and only about 12% have the life-threatening condition under control.6
Kirti Ranchod, co-founder and chair of the Africa Brain Health Network, said resource limitations, affordability and accessibility are compounding the threat. Targeted interventions were therefore critical, informed by locally relevant research. “The problem is complex and requires a strategic vision that includes supporting communities, supporting universities, enhancing research infrastructure, and ultimately implementing research findings in an appropriate and accessible way that mandates affordability,” she says.
