ALZHEIMER’S: BEYOND MEMORY LOSS

MIMI OSAWAYE OSAMWONYI argues for better control of blood pressure, diabetes, cholesterol, in addition to regular exercise

Each year, countless Nigerian families watch loved ones slip into the shadows of their own memories—forgetting grandchildren’s names, getting lost on familiar routes to the local market, or struggling with simple daily routines like taking medication. While long brushed off as a natural, inevitable consequence of aging, this decline is not normal. It is frequently the sign of a neurodegenerative condition, most commonly Alzheimer’s disease.

Dementia is a medical condition in which a person has a major decline in one or more cognitive (thinking abilities) domain such as: memory (remembering information and events), attention (staying focused), executive function (planning, solving problems, and making decisions), language (understanding and using words), perceptual-motor function (understanding what the eyes see and coordinating movement), social cognition (understanding other people and behaving appropriately in social situations).

The decline can be serious enough to affect a person’s independence and everyday activities. It typically occurs in clear consciousness, and is not caused by delirium, which is a sudden state of confusion, or another short-term medical problem.

Alzheimer’s disease is the most common cause of dementia. It is a progressive neurodegenerative condition, meaning that brain cells and their connections gradually become damaged. Over time, it affects the ability to form and remember memories, think and reason, use language, make sound judgments, and eventually carry out even simple daily activities. Other major types of dementia include vascular dementia, caused by problems with blood flow in the brain; Lewy body dementia, linked to abnormal protein deposits in brain cells; and frontotemporal dementia, which mainly affects the brain areas involved in behavior, personality, and language.

Alzheimer’s disease as well as the other forms of dementia are not normal parts of ageing. Older age is the strongest risk factor, but several other factors especially those that can be changed also affect the risk of developing dementia. These include high blood pressure, diabetes, lack of physical activity, smoking, drinking too much alcohol, obesity, untreated hearing loss, depression, social isolation, and limited access to education.

Dementia affects much more than the person who has it. As the condition progresses, it reduces independence and quality of life, creates major physical, emotional, and financial pressures for caregivers and families, and increases demands on communities, healthcare professionals, and the health system.

A 2019 systematic review estimated overall dementia prevalence among older Nigerians at roughly 4.9%, and calculated that the number of Nigerians aged 60 and above living with dementia rose from about 63,500 in 1995 to 318,000 in 2015. Community studies in different parts of the country have found prevalence ranging from about 2.8% to 6.4%, with Alzheimer’s disease consistently emerging as the leading subtype. In one older Ibadan study, it accounted for roughly 64% of all dementia cases. The honest message is that Nigeria carries a real and likely growing dementia burden, one that will only expand as the population ages, and we urgently need better data to understand its true magnitude.

The response so far rests on several pillars. Clinically, neurologists, psychiatrists, geriatricians, physicians, and allied health professionals diagnose and manage patients, with cognitive assessment available in specialist centres and treatments used to manage symptoms and control vascular risk factors. Beyond the clinic, NGOs, professional bodies, and community organisations contribute to awareness, while families remain, as they long have been, the backbone of daily care. Nigerian researchers have added meaningfully to the evidence base, even as it remains thin relative to the need.

On the policy front, there has been meaningful recent progress. In July 2026, Nigeria’s Federal Ministry of Health and Social Welfare announced plans to establish a Brain Health Desk under the National Mental Health Programme and to develop the country’s first National Brain Health Agenda. The Ministry explicitly identified dementia among the neurological conditions requiring stronger national coordination and action.

This policy momentum is also reflected in recent Nigerian scholarship. A 2026 paper in International Psychogeriatrics proposed a modern national framework for dementia care built around integrated care, healthy ageing and prevention, diagnostic innovation and primary-care screening, community awareness, workforce development and sustainable financing, and cross-sectoral partnerships.

The most important shift Nigeria needs is from late diagnosis to early recognition. Families and primary healthcare workers should be equipped to notice persistent memory decline, repeated questions, getting lost in familiar surroundings, difficulty managing money or medication, personality changes, and a decline in previously routine activities — and to recognise that these are different from ordinary ageing.

Alongside earlier recognition, we need a serious commitment to prevention, thinking about brain health across an entire lifetime rather than waiting for dementia to appear. That means better control of blood pressure, diabetes, cholesterol, obesity, smoking, and alcohol use, paired with regular exercise, a healthy diet, cognitive and social engagement, restorative sleep, hearing care, and lifelong learning.

Dementia care must not remain the sole preserve of specialists. Primary healthcare providers need the tools and training to recognise warning signs, screen appropriately, investigate reversible causes, refer patients onward, and follow up over time.

We must remember the caregiver, who is often the invisible second patient in this story. Caregivers need education, psychological support, respite services, peer support groups, financial and social assistance, and clear guidance on managing behavioural changes and safety at home.

Finally, Nigeria needs to invest in its own data — on prevalence, incidence, the balance between Alzheimer’s and other dementias, risk factors, age and sex patterns, economic and caregiver burden, and access to diagnosis and treatment. Without this, planning will always be guesswork.

No single group can solve this alone. Government must provide policy, funding, and integration into health services. Healthcare professionals — neurologists, psychiatrists, geriatricians, nurses, psychologists, therapists, pharmacists, and social workers — must deliver coordinated care. Universities and researchers must build the Nigerian evidence base. Families and caregivers remain central to early recognition and daily support. Traditional and religious leaders and community health workers can help dissolve stigma at the grassroots. NGOs and advocacy groups can extend education and support. The private sector — hospitals, laboratories, pharmaceutical and technology companies, insurers, and employers — can bring resources and innovation. The media has a particular duty to correct the widespread misconception that memory loss is simply an inevitable part of growing old. And emerging technologies, including artificial intelligence, can support cognitive screening, clinical decision-making, caregiver education, and access to specialist expertise through telemedicine — always as a complement to clinical judgment, never a replacement for it.

Alzheimer’s disease is not merely a problem of memory, and it is not merely a problem of old age. It is a brain-health challenge, a public-health challenge, and ultimately a societal one. Nigeria’s task now is to move from reacting to dementia only after significant disability has set in, toward promoting brain health across the whole of life — recognising decline earlier, strengthening diagnosis and care, standing behind families and caregivers, and building the reliable national data this fight demands. Government, healthcare professionals, researchers, families, communities, the private sector, faith-based organisations, and the media all have a part to play. The earlier we know, the more we can do — and that is a message every Nigerian family deserves to hear.

This September, Alzheimer’s Disease International has set the theme for World Alzheimer’s Month and World Alzheimer’s Day as “The Earlier You Know, The More You Can Do: A Dementia Diagnosis Matters.” It is a call to break the stigma that keeps families silent, and to reframe a diagnosis — not as an ending, but as the beginning of action.

Dr Osamwonyi,

MBBS, FWACP (Neurology) is

Head of Department Internal Medicine,

Maitama District Hospital, Abuja