Dementia Is Quietly Rising in Nigeria — And the Country Isn’t Ready

ABUJA — Nigeria does not have a National Dementia Action Plan. It does not have clinical diagnostic protocols designed for African patients. It does not have a public health campaign that tells ordinary Nigerians the difference between normal aging and cognitive decline. And according to one of the world’s leading brain health researchers, the country may have less time than it thinks before dementia becomes one of its most devastating public health crises.

Dr. Chi Udeh-Momoh, a transnational neuroscientist who holds faculty positions at Wake Forest University and the University of Southern California, appeared on Volume with FemiDlive to deliver a message that is as urgent as it is underreported: dementia is no longer a Western disease, and Africa — including Nigeria — is not prepared for what is coming.

The scale of the problem is staggering. Dementia cases across Africa are projected to increase sharply by 2050. Nigeria, as the continent’s most populous country and fastest-growing elderly population, sits at the epicentre of that trajectory. But there is a countervailing fact that Dr. Udeh-Momoh was emphatic about: up to 65 percent of dementia risk in African settings may be preventable. The condition is not inevitable. The crisis, if it arrives, will be partly a failure of prevention and policy, not just of biology.

Why is Nigeria unprepared? Dr. Udeh-Momoh identified several interlocking failures. First, stigma. Cognitive decline in elderly Nigerians is routinely dismissed — by families, by healthcare workers, by society — as “old age,” “spiritual attack,” or simply an unremarkable diminishment of a person whose productive years are behind them. That dismissal is lethal. The earlier dementia is identified, the greater the window for intervention.

Second, the diagnostic tools used in Nigeria were not designed for Nigerian patients. The cognitive tests that Western clinics use to identify dementia were standardised on Western populations, with Western educational assumptions, Western literacy levels, and Western cultural reference points. When applied to Nigerian patients — many of whom had limited formal schooling, grew up speaking indigenous languages first, and carry different memory architectures — these tools produce systematically biased results. “You cannot measure an Igbo elder’s brain health with a test designed for a retired American schoolteacher,” Dr. Udeh-Momoh said.

Africa FINGERS — the Africa-adapted version of the Finnish FINGERS programme, the world’s first large-scale dementia prevention trial — is her answer. The initiative, which Dr. Udeh-Momoh leads as Chief Investigator, is running in Nigeria and Kenya. It is the continent’s first attempt to demonstrate scientifically that lifestyle interventions — exercise, nutrition, mental stimulation, social connection, vascular risk management — can actually reduce the incidence of dementia in African populations. But crucially, the Africa FINGERS design incorporates elements that the Western version never needed: financial stress support, spirituality, and community-based delivery, because these are the realities that shape brain health in African settings.

The conversation turned uncomfortable when it reached government. Nigeria does not have dementia on its public health agenda in any meaningful way. Dr. Udeh-Momoh described early conversations with policymakers as promising in tone but empty in action. The path forward, she suggested, runs through the insurance sector — if insurers can be shown the long-term financial case for prevention over treatment, they may become more powerful advocates for dementia policy than any health ministry.

Perhaps the most unsettling part of Dr. Udeh-Momoh’s analysis was her answer to the question: can dementia start in your 30s? The answer is yes — not as full dementia, but as a trajectory. The lifestyle choices that young Nigerians are making right now — the energy drinks, the processed food, the sedentary jobs, the unmanaged hypertension, the chronic financial stress — are laying the neurological groundwork for cognitive decline decades later. The brain is a long game, and Nigeria’s young professional class is playing it badly without knowing it.

What Dr. Udeh-Momoh is asking for is not complicated in principle: African-led research, funded by African governments and their partners, producing African diagnostic tools, delivered through African community structures, interpreted through African cultural lenses. The science exists. The will to fund it, at the government level, does not — yet.

The conversation on Volume with FemiDlive ended with a challenge to Nigeria’s policymakers: add dementia to the national health agenda before the crisis arrives. Prevention is infinitely cheaper than care. But prevention requires the political will to take seriously a disease that currently has no powerful constituency, no celebrity advocates, and no dramatic acute presentation that forces its way onto the evening news.

The forgetting is quiet. And Nigeria, right now, is choosing not to remember it is coming.