A perspective on the disparities in Alzheimer’s disease treatment and rehabilitation in Africa
摘要
Alzheimer’s disease (AD) is an increasingly prevalent neurodegenerative disorder and a growing public health challenge across Africa, with significant consequences for individuals, families, and health systems. This article examines disparities in AD diagnosis, treatment, and rehabilitation across Africa. We synthesized evidence on the health system, socioeconomic, and cultural barriers to equitable care. Limited diagnostic capacity, specialist shortages, and cultural misconceptions drive delayed recognition and management of AD. Socioeconomic constraints, urban–rural service inequities, and high, inconsistent medication costs further restrict treatment access. Non-pharmacological interventions including cognitive stimulation, occupational therapy, and caregiver training remain scarce and are largely confined to urban tertiary facilities with minimal multidisciplinary coordination. Consequently, informal family-based care predominates, increasing caregiver burden and worsening outcomes relative to high-income settings. African populations are also underrepresented in epidemiological studies and clinical trials. Reducing AD disparities in Africa requires integrating AD into national non-communicable disease strategies, strengthening primary care via task-shifting, and expanding affordable pharmacologic and rehabilitation services. Scalable, low-cost approaches such as community-based cognitive stimulation, physical exercise programs, and caregiver education delivered by community health workers and digital platforms show promise for low-resource settings. Coordinated policy, research, and service delivery reforms are essential to improve equity and outcomes for people living with AD in Africa.