Alzheimer's disease, a relentless adversary of memory and cognition, has silently gripped the global population, emerging as the most prevalent form of dementia. Its impact is staggering, not only as the fifth leading cause of death and disability but as a quiet indicator of societal change. Nowhere is this more evident than in sub-Saharan Africa, where this neurological battlefront is reshaping lives, communities and the narrative of aging.
This is an area of concern given that most sub-Saharan Africa countries, including Kenya are now experiencing aging populations, in part due to rising life expectancy. While age has always been a co-conspirator in this ailment, sub-Saharan Africa countries, Kenya among them, stand at the crossroads of a demographic transformation. The surge in life expectancy has ushered in an era of unprecedented aging, illuminating the urgent need to confront Alzheimer's head-on.
In medical journals, a stark reality looms: the research spotlight has often bypassed the African continent, leaving sub-Saharan Africa in the shadows of dementia studies. A recent report by Alzheimer's Disease International sheds light on the scarcity of knowledge regarding Alzheimer's and its companions in this region.
The bulk of dementia research has gravitated toward the Global North societies. At this point, we do not know the true prevalence and incidence of dementia in places like Kenya, which remains a puzzle to be solved.
The key to rewriting this narrative lies in deciphering the societal lens through which dementia is viewed. Understanding community perceptions, attitudes and practices of dementias in countries like Kenya is critical for effective diagnosis, treatment and care. Further, early identification of risk factors for Alzheimer’s disease and other associated Dementias is key in timely management of the diseases.
In March 2023, we conducted a rapid ethnographic study in Kilifi county in Kenya to understand people’s knowledge, attitudes and perceptions of dementias in the region. This entailed conducting in-depth qualitative interviews and focus group discussions with different stakeholders including community members, faith and traditional healers, community health volunteers, local leaders, healthcare providers and policy makers in the county.
Majority of community members lacked knowledge about dementia. However, they described some behavioural aspects of elderly populations in their communities such as ‘being forgetful’ ‘behaving like a child’ or ‘decline in reasoning capacity’.
Moreover, elderly individuals with neurocognitive disorders were tragically perceived as witches, resulting in targeted violence and loss of lives. These vulnerable individuals, often grappling with dementia, were accused of practising witchcraft. The issue of violence and lynching directed towards this aging demographic, as highlighted by the policymakers we engaged with, emerged as a pressing concern.
A few participants, especially the educated or those working in the healthcare system were able to describe dementia. They also reported that they see such patients in hospitals.
Some of the mentioned perceived causes of dementia were stress, depression, hallucination and cultural-related causes such as curses. The consequences are dire a cocktail of stigma and neglect that renders the vulnerable even more defenceless.
Medical Anthropologist and Implementation Scientist at the Aga Khan University’s Brain and Mind Institute. Any opinions expressed are solely those of the writer