Dementia in the Middle East and North Africa: an integrative narrative review of epidemiology, risk structure, and health system implications.

BACKGROUND

Dementia prevalence in the Middle East and North Africa (MENA) is projected to rise exponentially, with estimates suggesting increases of 367% by 2050. This region faces distinctive challenges, including rapid demographic transition, high rates of modifiable risk factors, and fragmented health systems. This paper examines region-specific risk factors and pooled prevalence rates of dementia across the MENA region.

METHODS

We conducted a narrative review of dementia risk factors in the MENA region, including analysis of population-attributable risk (PAR) estimates and pooled estimates of dementia prevalence among adults aged 50 years and older.

RESULTS

Dementia prevalence was estimated at 1.84% among individuals aged 50 years and older, increasing to 3.81% among those aged 60 years and older, with substantial variability across countries. Smoking (>30%), physical inactivity ( ~ 50%), and high burdens of diabetes, hypertension, and obesity were consistently associated with increased dementia risk. Additional region-specific drivers include nutritional transitions, gut dysbiosis, consanguinity, and environmental risk factors such as air pollution and climate-related heat stress. Critical barriers to prevention and care include limited research infrastructure, low health literacy, stigma, and inequitable health care access.

CONCLUSIONS

Dementia prevalence in MENA is rising rapidly, driven by demographic change and high exposure to modifiable risk factors that are relatively region-specific in terms of their contribution. Strengthening prevention, early detection, and equitable access to care should be regional health priorities.