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Dementia in Africa: Current evidence, knowledge gaps, and future directions
Alzheimer's & Dementia ( IF 14.0 ) Pub Date : 2021-09-27 , DOI: 10.1002/alz.12432
Rufus O Akinyemi 1, 2, 3 , Joseph Yaria 3 , Akin Ojagbemi 4 , Maëlenn Guerchet 5 , Njideka Okubadejo 6 , Alfred K Njamnshi 7, 8 , Fred S Sarfo 9 , Albert Akpalu 10 , Godwin Ogbole 11 , Temitayo Ayantayo 1 , Thierry Adokonou 12 , Stella-Maria Paddick 13 , David Ndetei 14 , Judith Bosche 15 , Biniyam Ayele 16 , Andrea Damas 17 , Motunrayo Coker 1 , Lingani Mbakile-Mahlanza 18 , Kirti Ranchod 19 , Kirsten Bobrow 20 , Udunna Anazodo 21 , Albertino Damasceno 22 , Sudha Seshadri 23 , Margaret Pericak-Vance 24 , Brian Lawlor 25 , Bruce L Miller 26 , Mayowa Owolabi 1, 2, 3 , Olusegun Baiyewu 4 , Richard Walker 1, 27 , Oye Gureje 4 , Rajesh N Kalaria 1, 28 , Adesola Ogunniyi 1, 3 ,
Affiliation  

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.

中文翻译:

非洲痴呆症:当前证据、知识差距和未来方向

随着低收入和中等收入国家人口老龄化的加剧,非洲大陆的痴呆症负担正在上升。痴呆症患病率从 2.3% 到 20.0% 不等,发病率为每 1000 人年 13.3 例,在快速转型的非洲部分地区死亡率不断上升。营养、心血管因素、合并症、感染、死亡率和检测方面的差异可能导致较低的发病率。阿尔茨海默病、血管性痴呆和人类免疫缺陷病毒/获得性免疫缺陷综合征相关的神经认知障碍是最常见的痴呆亚型。具有稳健方法和区域覆盖面的全面纵向研究将提供更可靠的信息。载脂蛋白E(APOE) ε4 等位基因研究最多,但与高加索人相比,在非洲血统中显示出不同的影响。需要更多的候选基因和全基因组关联研究来与痴呆表型相关。跨多学科小组(例如拟议的非洲痴呆症联合会)的实施迫切需要经过验证的不受教育和语言差异影响的文化敏感认知工具。
更新日期:2021-09-27
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