On World Brain Day, Dr Patty Francis, Neurological Association of South Africa (NASA) president, warns South Africans that dementia can be prevented by tackling 14 changeable risk factors.
Image credit: Emre Keshavarz on Pexels
The World Health Organisation estimates that 57 million people currently live with dementia globally.
Risk factors
This number will almost double every 20 years, reaching 78 million by 2030 and 153 million by 2050. At least 60% of people with dementia live in low- and middle-income countries, but by 2050 this will rise to 71%.
Sub-Saharan Africa is expected to bear a growing share of this burden, with numbers projected to nearly double every 20 years, increasing from 2.13 million people to 3.48 million by 2030 and 7.62 million by 2050.
Overall, around 45% of cases of dementia are potentially preventable by addressing 14 modifiable risk factors at different stages during the life course.
These include things such as not completing secondary education, social isolation, and depression, as well as several medical conditions such as hypertension, obesity and diabetes.
Diet might be an important factor in addition to these 14 factors, and has a key role in reducing the risk of chronic diseases that affect dementia risk, and is an important component of multidomain approaches to dementia risk reduction.
Francis says the brain is highly sensitive to long-term physical, emotional and environmental stressors.
“The rise in dementia in our region is deeply concerning considering that we carry high burdens of HIV, hypertension, diabetes and stroke, all of which are linked to increased dementia risk,” said Francis.
Lifelong brain health
“The most powerful message we can share this World Brain Day is that dementia is not just about ageing, it’s about lifelong brain health. What we do in our 30s, 40s, and 50s has a direct impact on our risk later in life,” said Dr Francis.
Although addressing risk factors at an early stage of life is desirable, there is also benefit from tackling risk throughout life; it is never too early or too late to reduce dementia risk.
“Dementia doesn’t happen overnight. It often starts with decades of unmanaged risk factors such as high blood pressure, physical inactivity, obesity, smoking, poor sleep, alcohol abuse and hearing loss, all of which silently damage brain tissue.
“When addressing these, research shows dementia could be prevented or delayed in up to four in 10 cases.”
“Every stage of life offers an opportunity to protect your brain,” said Francis.
“From maternal nutrition to childhood immunisation, and from midlife stress management to staying socially connected in older age. Preventions start early and are lifelong.”
While dementia presents differently in each person, common warning signs include:
- Memory loss that disrupts daily life.
- Difficulty performing familiar tasks.
- Language problems, such as difficulty in speaking or writing.
- Confusion with time and place.
- Trouble understanding visual images.
- Misplacing things and losing the ability to retrace steps.
- Decreased or poor judgment.
- Personality or mood changes.
- Withdrawal from work or social activities.
- Problems with reasoning or problem-solving.
- Trouble with planning and organising.
- Poor coordination and control of movements.
- Confusion and disorientation.
“It’s important not to dismiss symptoms as ‘just getting older’,” Francis said. “Even in younger adults, persistent cognitive changes should be assessed by a neurologist or specialist physician.”
Some forms of dementia are amenable to therapy, such as HIV-related dementia or deficiency in vitamin B12.
While there is currently no cure for Alzheimer's disease, for example, early diagnosis and treatment can significantly slow progression and improve quality of life.
Phyllis Ndlovu 18 Jul 2025 Options include:
- Medication to manage cognitive symptoms and behaviour.
- Cognitive rehabilitation and occupational therapy.
- Management of underlying conditions like hypertension or diabetes.
Francis says new drug developments, such as anti-amyloid therapies, are promising, but remain costly and limited in availability in most low- and middle-income countries.
“In South Africa, our most urgent need is access to early screening and specialist care, particularly in under-resourced communities,” said Francis. “We also need to destigmatise dementia, so families feel supported rather than isolated.”
“This World Brain Day, we’re calling on all South Africans to prioritise brain health from the earliest stages of life,” said Francis. “
Healthy brains build healthy communities, and the power to prevent dementia starts with awareness, education and action.”
Where to get help
South Africans can seek support and guidance from:
- Your knowledgeable local GP or community clinics for referral to specialists.
- Neurology departments in major hospitals.
- Alzheimer’s South Africa (ADASA) – www.adasa.org.za.
