article · BMC Psychiatry
Dementia is an escalating public health challenge across Africa, yet comprehensive evidence regarding its management in primary healthcare remains scarce. A scoping review synthesising sixteen eligible studies examined screening practices, risk reduction approaches, and care barriers across the continent. Nine of the identified studies addressed screening methods, most frequently relying on the Brief Community Screening Instrument for Dementia and the Mini-Mental State Examination. However, this screening occurred predominantly within research projects rather than routine clinical primary care. Six studies detailed substantial implementation obstacles, encompassing healthcare workforce shortages, inadequate infrastructure and funding, deficient clinical training, low policy prioritisation, sociocultural stigma, and poor public awareness. Furthermore, only one study investigated the implementation of dementia risk reduction strategies. Overall, routine service integration remains severely limited, necessitating targeted implementation research into culturally appropriate dementia prevention and detection.
Dementia represents an expanding public health concern across Africa, yet primary healthcare systems are currently under-equipped to manage it. By mapping the significant absence of routine screening, preventive interventions, and infrastructure, this research reveals where frontline services fall short. It offers clear evidence for policymakers, healthcare organisations, and funders seeking to address critical workforce gaps, community stigma, and resource limitations in dementia care.
This work is an early-stage evidence synthesis that indicates potential future applications for digital screening tools, clinical training packages, and healthcare workflow solutions. Primary care clinics, community health workers, and public health authorities would be the ultimate users. However, because current screening is largely confined to research and risk reduction is scarcely tested, practical solutions remain distant from commercial deployment and require extensive implementation research and field testing.
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Introduction Dementia is a growing public health challenge worldwide, particularly in Africa. Although various screening tools have been used across different settings in the region, evidence on dementia screening practices, risk reduction strategies, and barriers to evidence-based dementia care has not been systematically mapped. This scoping review aimed to map the available evidence on dementia screening practices, risk reduction approaches, and barriers to dementia care across Africa. Methods This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. The review protocol was prospectively registered on the Open Science Framework (OSF). A comprehensive search of major databases (PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, Google Scholar) and grey literature was conducted. Eligible studies focused on dementia screening, risk reduction strategies, and barriers to evidence-based dementia care in primary healthcare settings across Africa. Study selection and data extraction were independently performed by three reviewers, and findings were synthesized using descriptive mapping. Results Of the 3,102 records identified, 16 studies met the inclusion criteria. Nine studies reported dementia screening practices using a range of screening tools, most commonly the Brief Community Screening Instrument for Dementia (CSID) and the Mini-Mental State Examination (MMSE). The available evidence suggests that dementia screening was largely conducted within research settings rather than as part of routine primary healthcare. Six studies identified barriers to evidence-based dementia screening and care, including workforce shortages, limited infrastructure and funding, inadequate training, low policy prioritization, sociocultural stigma, and limited public awareness. Only one study evaluated the implementation of dementia risk reduction strategies in an African context, highlighting an important evidence gap. Conclusions Evidence on dementia screening, risk reduction, and care integration in African primary healthcare remains limited. Key barriers include health system constraints, workforce shortages, inadequate infrastructure and funding, and sociocultural challenges. Future implementation research should evaluate culturally appropriate strategies to strengthen dementia detection, prevention, and integration of dementia services into primary healthcare across Africa.
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DOI: 10.1186/s12888-026-08528-6
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