Ojagbemi, A, Okekunle, AP and Babatunde, O (2021) Dominant and Modifiable Risk Factors for Dementia in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. Frontiers in Neurology, 12. ISSN 1664-2295

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Background: Sub-Saharan Africa (SSA) is projected to have a rapid increase in the number of people living with dementia by 2050. Yet, there is currently no robust evidence on the risk factors for dementia in the sub-region that could inform context specific interventions.

Methods: We conducted a systematic review and meta-analysis of observational studies to determine the dominant and modifiable risk factors for dementia in SSA. We searched MEDLINE, EMBASE, PsychINFO, and African Journals Online using keywords for dementia and Alzheimer's disease as well as the.mp operator for all 47 SSA countries or regions. We included peer-reviewed original studies with epidemiological designs, conducted random effect meta-analysis and determined the dominant and modifiable risk factors for dementia using the inverse of variance method.

Results: A total of 44 studies out of 2,848 met criteria for syntheses. The pooled annual incidence of dementia from 5,200 cohort risk years was 2.0% [(95% Confidence Interval (CI) = 1.0–4.0%)]. The pooled prevalence was 5.0% (95% CI = 2.0–7.0%). Older age was the dominant risk factor for both prevalent [(Standard error (S.E = 0.3, weight = 25.2%)] and incident dementia (S.E = 0.02, weight = 95.8%), while low educational attainment (S.E = 0.19, weight = 32.6%) and poor predementia cognitive functioning at baseline (S.E = 0.2, weight = 20.5%) were the best ranked modifiable risk factor for incident dementia.

Conclusion: Low formal educational attainment which, in SSA, may represent a stable index of low socioeconomic position and health disadvantage over the life course, was the most prominent modifiable risk factor for incident dementia. Findings have implications for deliberate policies targeted at access to education across the life course as a primary prevention strategy against dementia in SSA.

Item Type: Article
Additional Information: This is the final published version (version of record). It was first published online via Frontiers Media at http://doi.org/10.3389/fneur.2021.627761 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: low-and middle-income countries, Sub-Saharan Africa, dementia prevalence, dementia incidence, risk factors
Subjects: R Medicine > RC Internal medicine > RC346 Neurology. Diseases of the nervous system, including speech disorders
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Depositing User: Symplectic
Date Deposited: 06 May 2021 12:57
Last Modified: 06 May 2021 12:57
URI: https://eprints.keele.ac.uk/id/eprint/9527

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