NAIROBI – Africa can harness community care, traditional health, exercise and digital tools to treat dementia as its population ages, according to experts on the second day of Nature’s “Future of Dementia in Africa” conference,.

The conference, the first of its kind in Africa, was presented in conjunction with the Davos Alzheimer’s Collaborative and Aga Khan University and ran from 11-12 September in Nairobi.

A key focus of the two-day event was the use of traditional, complementary, and alternative medicine in Africa and how it could be integrated with modern healthcare practices.

Razak Gyasi, an associate research scientist at the African Population and Health Research Centre, pointed out that by 2050, 2.1 billion people worldwide will be over the age of 60, with 80% of them living in Africa.

Ageing populations face numerous challenges, including financial loss, social isolation, and decreased mental and cognitive capacity, including dementia.

But addressing mental health in older adults doesn’t have to rely solely on Western medicine, said Gyasi.  Physical activity, for example, can improve mental health in old age, social inclusion increases a sense of belonging, and good sleep quality benefits brain function.

In his study on Ghanaians’ perceptions of traditional medicine, Gyasi showed that community members already use various alternative methods to support healthcare, from physical activity and social inclusion to massage therapy, herbal remedies, prayer, music, and aromatherapy.

The study focused on how people in the Sekyere South District of Ashanti in Ghana, perceive traditional medicine and its role compared to modern medicine. It explored key factors such as the accessibility of traditional medicine, the conditions it treats, its safety, effectiveness, and how it interacts with modern medical systems.

Gyasi’s research used a descriptive cross-sectional survey, collecting data at a single point from 120 participants: 70 traditional medicine practitioners, 30 healthcare users, and 20 modern practitioners.

Data was gathered through questionnaires, interviews, and observations of practitioners’ work environments in nine communities. Both qualitative (interviews and observations) and quantitative (survey) methods were used for data analysis.

The results show that alternative medicine has been effective in treating numerous medical conditions, including malaria, typhoid fever, arthritis, jaundice, infertility, strokes, broken bones, boils, piles, HIV/AIDS, and mental illness. However, there are risks due to the lack of formalised, coordinated interactions between allopathic and traditional healthcare providers.

Gyasi identified what he called “pull factors” that draw people toward traditional medicine and “push factors” that keep them away from modern healthcare.

People are drawn to alternative medicine because it takes a holistic approach and treats the “entire human system,” Gyasi showed. Traditional methods are also deeply rooted in people’s cultural upbringing. Many people believe in the spiritual connection between health’s physical and mental aspects, which draws people toward alternative care.

As one study participant asked, “How can I be cured with a treatment regimen that I do not understand?”

Allopathic deterrents

There are also deterrents within the mainstream health system. Some participants reported that they felt doctors lacked professionalism or embarrassed them during treatment.

Others cited the stigma associated with visiting “White man’s” practitioners. Additionally, many allopathic therapies have side effects that people are unwilling to endure, even if the treatment is effective. Finally, the cost of care is often prohibitive, making modern treatments inaccessible for many.

“The traditional system of medical practice is embedded in our culture and tradition,” Gyasi said. “If you ask any older African, whether from an urban or rural setting, this is what they grew up with. Trying to separate family traditions from the Western system isn’t right. Cooperation should be encouraged.”

He suggested that Africans should be able to benefit from both systems. For example, they might visit a clinic for a diagnosis but rely on traditional remedies within their communities for treatment.

“All of us need to come together and address these issues holistically,” he said.

Care for the Caregiver

Another significant aspect is the unique role of caregivers in Africa. Wambui Karanja, a project manager at the Brain and Mind Institute at Aga Khan University, said that almost all those with dementia in low- and middle-income countries (96%) live at home.

This places a heavy burden on caregivers and greatly impacts the global distribution of caregiving time, particularly for women who contribute 71% of the global hours of informal care, with the highest proportion in low-income countries. These caregivers need better tools and support to care for those they look after.

Karanja highlighted the efforts of the Alzheimer’s Dementia Organisation of Kenya, which has been working to build caregiver capacity at all levels and equip them with the skills to provide basic care for people with dementia.

During the COVID-19 pandemic, the organisation partnered with the Alzheimer’s Society of Ireland to offer online support from both peers and professionals. A training program helped caregivers improve their understanding of dementia patients, practice self-care, and enhance communication.

Feedback from the program was overwhelmingly positive. Caregivers expressed relief that they finally had someone to listen to them and provide support, making them feel less isolated. The program also provided better insight into what to expect for those caring for loved ones in the early stages of dementia.

While some other African local organisations offer similar programs, Karanja emphasised that there aren’t enough resources or partnerships to adequately support caregivers, particularly in Kenya. She said more investment and collaboration are needed to provide the necessary assistance.

Digital tools

Edem Adzogenu, vice chair of the Nigeria Digital Health Initiative, discussed how digital tools could support the dementia community in general.

“A low-resource continent like Africa, where the kinds of investments that are required to go into clinical trials, etc., might not be available, early diagnosis and intervention is the smartest strategy,” Adzogenu said.

He explained that in Africa, dementia diagnosis typically begins only after significant memory loss but digital tools have the potential to change this.

As many people have access to smartphones, Adzogenu stressed that promoting digital health is more about education than training. He noted that digital tools can collect basic health information and conduct simple screenings to help identify early signs of dementia.

Even if elderly individuals struggle with the tests, younger caregivers or relatives can assist, he said.

During the COVID-19 pandemic, a digital health wallet was implemented in 22 African countries to ensure care continuity. Kenya was the first country to adopt it.

“With that platform, we can now build many other things on top of it, and we are using it for brain health as well,” Adzogenu said.

He again highlighted the widespread use of digital tools in Africa, particularly in areas like fintech and social media.

“It would be remiss to say the valuable aspect of our existence on this planet, our health, is not taking advantage of digital tools,” he concluded. “The question is … how do we create the frameworks to make it possible in health?”

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