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Background Over 55 million people worldwide live with dementia, with more than 60% residing in low‐ and middle‐income countries. Alzheimer's disease, the most common form of dementia, accounts for 60–70% of cases. Early and accurate diagnosis remains a global challenge, necessitating novel approaches to mitigate the disease burden. Biomarkers hold significant promise in improving diagnostic accuracy and predicting disease progression. Validated biomarkers for the preclinical stages of dementia are crucial for advancing diagnosis and therapeutic strategies. We aimed to identify potential clinical markers for early dementia detection and assess their predictive accuracy in identifying high‐risk individuals. Method We analyzed blood samples from dementia cases (n = 30) and controls (n = 75) for clinical parameters, including renal and liver function tests, lipid profiles, thyroid function tests, glomerular filtration rate (GFR), vitamin B12, and fasting glucose. Result Dementia cases showed significantly elevated high‐density lipoprotein (HDL), free thyroxine (FT4), and vitamin B‐12 (P = 0.0002, P = 0.015, and P = 0.004, respectively) compared to controls. We also observed significant reductions in GFR, free triiodothyronine (FT3), and the cholesterol‐to‐HDL ratio (P = 0.003, P = 0.0002, and P = 0.05, respectively). Logistic regression confirmed associations between HDL (Odds: 10.8, 95% CI: 0.34–5.01, P = 0.04) and FT4 (Odds: 33.78, 95% CI: 0.64–7.20, P = 0.028) with dementia after adjusting for age and sex. Vitamin B‐12, FT3, GFR, and the cholesterol‐to‐HDL ratio were not significantly associated with dementia (P > 0.05). Predictive models demonstrated strong performance (R2 = 0.47–0.52). Conclusion Our findings demonstrated the potential of HDL and FT4 as blood‐based clinical markers for early detection of cognitive impairment and dementia.

Over 55 million people worldwide live with dementia, with more than 60% residing in low- and middle-income countries. Alzheimer's disease, the most common form of dementia, accounts for 60-70% of cases. Early and accurate diagnosis remains a global challenge, necessitating novel approaches to mitigate the disease burden. Biomarkers hold significant promise in improving diagnostic accuracy and predicting disease progression. Validated biomarkers for the preclinical stages of dementia are crucial for advancing diagnosis and therapeutic strategies. We aimed to identify potential clinical markers for early dementia detection and assess their predictive accuracy in identifying high-risk individuals. We analyzed blood samples from dementia cases (n = 30) and controls (n = 75) for clinical parameters, including renal and liver function tests, lipid profiles, thyroid function tests, glomerular filtration rate (GFR), vitamin B12, and fasting glucose. Dementia cases showed significantly elevated high-density lipoprotein (HDL), free thyroxine (FT4), and vitamin B-12 (P = 0.0002, P = 0.015, and P = 0.004, respectively) compared to controls. We also observed significant reductions in GFR, free triiodothyronine (FT3), and the cholesterol-to-HDL ratio (P = 0.003, P = 0.0002, and P = 0.05, respectively). Logistic regression confirmed associations between HDL (Odds: 10.8, 95% CI: 0.34-5.01, P = 0.04) and FT4 (Odds: 33.78, 95% CI: 0.64-7.20, P = 0.028) with dementia after adjusting for age and sex. Vitamin B-12, FT3, GFR, and the cholesterol-to-HDL ratio were not significantly associated with dementia (P > 0.05). Predictive models demonstrated strong performance (R  = 0.47-0.52). Our findings demonstrated the potential of HDL and FT4 as blood-based clinical markers for early detection of cognitive impairment and dementia.

Dementia research accounts for only 0.1% of all research in Africa, making it the lowest among all low- and middle-income country (LMIC) regions. The development and adaptation of biological and psychosocial measures in ethnically and culturally diverse populations remain limited but are essential for culturally informed research. This is particularly critical for examining sex- and gender-based vulnerabilities to Alzheimer's disease and related dementias (ADRD), including factors such as reproductive health and fertility. We conducted a thorough review of our clinical and health questionnaires for cultural relevance and sensitivity through a series (n = 3) of focus groups discussions. These focus groups included a diverse range of participants, such as expert clinical and academic stakeholders, local community members, health promoters, community leaders, and representatives, ensuring a well-rounded and inclusive approach. Certain questions about sexual behavior, sexually transmitted diseases, biological and adopted children, and fertility were deemed culturally inappropriate and required rephrasing for sensitivity. To build rapport, these questions were strategically placed after less sensitive topics. Additionally, gaps were identified, including missing questions on traditional fertility practices (e.g., herbal remedies), male puberty characteristics, and partner support during and after childbirth. Addressing these gaps by incorporating local beliefs and traditions will enable a more holistic understanding of reproductive health behaviors. Furthermore, translations overlooked subtle linguistic nuances, highlighting the need for more detailed explanations or alternative concepts in Swahili to ensure clarity and accuracy. The Fember-Africa study aims to bridge a critical gap in understanding sex- and gender-specific differences in Africa, shedding light on the disproportionately higher prevalence of dementia among women of African ancestry. Through the culturally sensitive adaptation of reproductive health assessment tool, the study seeks to generate valuable insights that can inform the prevention and management of Alzheimer's disease and related dementias (ADRD) in this underrepresented population.

Background Cardiometabolic risk factors (CMRFs), such as hypertension and diabetes, are modifiable contributors to dementia risk. However, these conditions are often underdiagnosed or undertreated, particularly in African populations. This study aimed to examine discrepancies between self‐reported and objectively measured CMRFs across multiple indigenous African and African diaspora cohorts, investigate sex‐specific patterns of underdiagnosis, and explore their implications for dementia risk and brain health equity. Methods Data were analyzed from three cohorts: (1) the African American (AA) and rural Nigerian Indianapolis‐Ibadan Dementia Study cohort (n = 4,353; mean age 74 years; 66% female), (2) the East African (EA) AD‐Detect Kenya project (n = 51; mean age 55 years; 51% female), and (3) the EA Brain Resilience Kenya (BRK) study (n = 61; mean age 61 years; 61% female). Underdiagnosis was operationalized as self‐reported absence of hypertension or diabetes despite borderline‐to‐abnormal clinical biomarker status, using systolic blood pressure (SBP) and fasting blood glucose (FBG) levels. Sex‐specific and demographic‐related associations were assessed using logistic regression models. Results Underdiagnosis of key dementia‐related CMRFs (hypertension and diabetes) was widespread across all cohorts, indicating systemic challenges in early detection and management. Hypertension underdiagnosis was more prevalent in urban men from the East African (EA) and African American (AA) cohorts (OR: 2.74 [0.95–7.90] and 1.65 [1.39–1.95], respectively). Conversely, rural women from the Ibadan cohort had a higher likelihood of underdiagnosed hypertension. Diabetes underdiagnosis was more frequent among African American men (OR: 1.28 [0.98–1.69]), with similar trends observed in indigenous African men. Notable demographic and contextual variability were observed, with underdiagnosis patterns differing by sex, marital status, socio‐economic disparities and cognitive diagnosis. Conclusion The systematic underdiagnosis of CMRFs in African populations underscore critical disparities in dementia risk identification. These findings highlight the urgent need for culturally and contextually adapted, gender‐sensitive, and geographically tailored prevention strategies to improve early diagnosis and management of CMRFs. Addressing these gaps is essential for promoting global brain health equity, particularly for individuals of African ancestry. Future research to be presented will explore longitudinal associations between underdiagnosed CMRFs and cognitive decline as well as incident dementia, informing targeted interventions for dementia prevention.

Background Dementia research accounts for only 0.1% of all research in Africa, making it the lowest among all low‐ and middle‐income country (LMIC) regions. The development and adaptation of biological and psychosocial measures in ethnically and culturally diverse populations remain limited but are essential for culturally informed research. This is particularly critical for examining sex‐ and gender‐based vulnerabilities to Alzheimer's disease and related dementias (ADRD), including factors such as reproductive health and fertility. Method We conducted a thorough review of our clinical and health questionnaires for cultural relevance and sensitivity through a series (n = 3) of focus groups discussions. These focus groups included a diverse range of participants, such as expert clinical and academic stakeholders, local community members, health promoters, community leaders, and representatives, ensuring a well‐rounded and inclusive approach. Result Certain questions about sexual behavior, sexually transmitted diseases, biological and adopted children, and fertility were deemed culturally inappropriate and required rephrasing for sensitivity. To build rapport, these questions were strategically placed after less sensitive topics. Additionally, gaps were identified, including missing questions on traditional fertility practices (e.g., herbal remedies), male puberty characteristics, and partner support during and after childbirth. Addressing these gaps by incorporating local beliefs and traditions will enable a more holistic understanding of reproductive health behaviors. Furthermore, translations overlooked subtle linguistic nuances, highlighting the need for more detailed explanations or alternative concepts in Swahili to ensure clarity and accuracy. Conclusion The Fember‐Africa study aims to bridge a critical gap in understanding sex‐ and gender‐specific differences in Africa, shedding light on the disproportionately higher prevalence of dementia among women of African ancestry. Through the culturally sensitive adaptation of reproductive health assessment tool, the study seeks to generate valuable insights that can inform the prevention and management of Alzheimer's disease and related dementias (ADRD) in this underrepresented population.

Dementia rates are rising globally, with the burden increasing most rapidly in low‐ to middle‐income countries. Despite this, research into Alzheimer's disease and related dementias (ADRD) among African populations remains limited, with existing models based on Western cohorts that overlook sex‐, gender‐, and ancestry‐specific factors. The Female Brain Health and Endocrine Research in Africa (FemBER‐Africa) project, hosted at the Brain and Mind Institute, Aga Khan University, Kenya, will establish a deeply phenotyped cohort of 250 African individuals across the ADRD spectrum. It will assess sex‐specific risk factors linked to ethnicity, lifestyle, and endocrinological variables using fluid‐based biomarkers (blood and saliva), neuroimaging (magnetic resonance imaging and positron emission tomography), and culturally adapted cognitive tests. By comparing data with Western and diasporic cohorts, the study aims to identify ancestry‐specific and shared mechanisms driving ADRD risk and progression. The findings will support targeted, culturally relevant prevention and intervention strategies, addressing the underrepresentation of African populations in global dementia research. Highlights By 2030, > 78 million individuals are expected to have dementia, with the highest burden among women in low‐ to middle‐income countries. Despite this, African populations remain underrepresented in Alzheimer's disease and related dementias (ADRD) research. Existing ADRD risk models fail to account for the unique influence of sex, gender, and ancestry on dementia risk. Female‐specific reproductive and hormonal factors, including menopause transition and hormone therapy use, are poorly integrated into current models. The Female Brain Health and Endocrine Research in Africa (FemBER‐Africa) project is the first large‐scale study to examine sex‐ or gender‐specific and endocrine contributors to ADRD in an African population, using advanced diagnostic, biomarker, and culturally adapted cognitive assessments. The study will assess how biological (hormonal, metabolic), lifestyle (physical activity, diet), and socio‐cultural (education, health‐care access) factors interact to influence ADRD risk in African women. Insights from FemBER‐Africa will inform the development of sex‐ and gender‐specific, culturally adapted ADRD prevention strategies, enhancing the precision and equity of dementia mitigation efforts globally.

Cardiometabolic risk factors (CMRFs), such as hypertension and diabetes, are modifiable contributors to dementia risk. However, these conditions are often underdiagnosed or undertreated, particularly in African populations. This study aimed to examine discrepancies between self-reported and objectively measured CMRFs across multiple indigenous African and African diaspora cohorts, investigate sex-specific patterns of underdiagnosis, and explore their implications for dementia risk and brain health equity. Data were analyzed from three cohorts: (1) the African American (AA) and rural Nigerian Indianapolis-Ibadan Dementia Study cohort (n = 4,353; mean age 74 years; 66% female), (2) the East African (EA) AD-Detect Kenya project (n = 51; mean age 55 years; 51% female), and (3) the EA Brain Resilience Kenya (BRK) study (n = 61; mean age 61 years; 61% female). Underdiagnosis was operationalized as self-reported absence of hypertension or diabetes despite borderline-to-abnormal clinical biomarker status, using systolic blood pressure (SBP) and fasting blood glucose (FBG) levels. Sex-specific and demographic-related associations were assessed using logistic regression models. Underdiagnosis of key dementia-related CMRFs (hypertension and diabetes) was widespread across all cohorts, indicating systemic challenges in early detection and management. Hypertension underdiagnosis was more prevalent in urban men from the East African (EA) and African American (AA) cohorts (OR: 2.74 [0.95-7.90] and 1.65 [1.39-1.95], respectively). Conversely, rural women from the Ibadan cohort had a higher likelihood of underdiagnosed hypertension. Diabetes underdiagnosis was more frequent among African American men (OR: 1.28 [0.98-1.69]), with similar trends observed in indigenous African men. Notable demographic and contextual variability were observed, with underdiagnosis patterns differing by sex, marital status, socio-economic disparities and cognitive diagnosis. The systematic underdiagnosis of CMRFs in African populations underscore critical disparities in dementia risk identification. These findings highlight the urgent need for culturally and contextually adapted, gender-sensitive, and geographically tailored prevention strategies to improve early diagnosis and management of CMRFs. Addressing these gaps is essential for promoting global brain health equity, particularly for individuals of African ancestry. Future research to be presented will explore longitudinal associations between underdiagnosed CMRFs and cognitive decline as well as incident dementia, informing targeted interventions for dementia prevention.