Dementia care gaps in Sub-Saharan Africa: A scoping review of technology, environmental, community perspectives, and financial constraints

Dementia is a growing public health challenge in Sub-Saharan Africa (SSA), where population aging is expected to substantially increase the regional burden of dementia in the coming decades. Rapidly changing demographics, underdeveloped health infrastructure, and limited awareness of dementia symptoms and care pathways contribute to delayed diagnosis, treatment, and care. This scoping review examined literature published from 2021 to 2025 to identify gaps in dementia care across four key domains: environmental and social factors, technological capacity, community-based caregiving, and financial and economic factors. First, social and ecological factors, including low health literacy, rural residence, and weak primary care infrastructure, influence disease diagnosis and access to care. Second, technological capacity remains limited, including scarce access to neuroimaging and diagnostic tools, limited telemedicine coverage, weak electronic health information systems, and insufficient digital health solutions for early detection, management, and monitoring. Third, evidence from community-based care highlights heavy reliance on informal caregivers who often lack training and institutional support, resulting in substantial emotional, physical, and financial burden. Finally, inadequate public financing for dementia care, coupled with limited insurance coverage, further restricts access to dementia care services and support. Overall, this review highlights critical gaps in policy, evidence generation, cost-effective technology investment, caregiver support, and health systems strengthening across all levels of care. Addressing these multidimensional challenges is crucial to improving the quality of life for people living with dementia and their caregivers across SSA.