. 2025 Jun;21(6):e70388.

doi: 10.1002/alz.70388.

Down syndrome in Africa: Challenges, opportunities, and future directions

Eimear McGlinchey^{1

2}, Salina Tewolde³, Amanda He⁴, Juan Fortea^{5

6

7}, Lingani Mbakile-Mahlanza^{1

8}, Ayda Tefera¹, Emmanuel Epenge^{1

9}, Jason Hassenstab¹⁰, Alexander Jäck^{11

12

13}, Kirti Ranchod^{1

14}, Shaimaa El-Jaafary^{1

15}, Johannes Levin^{11

12

16}, Mohamed Salama^{1

17}, Eric Rubenstein³, Rufus Akinyemi^{1

18}, Tolulope Akinyemi¹⁹, Temitope Farombi^{1

18}, Brian Lawlor¹, Jean Ikanga^{20

21}, Nicholas J Ashton^{22

23

24}, Sarah Stout¹⁰, Joyce Balls-Berry^{10

25}, Atholl Valdon Kleinhans^{26

27}, Rachel Maina²⁸, Zul Merali²⁸

Affiliations

¹ Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin 2, Ireland.
² Trinity Centre for Ageing and Intellectual Disability, Trinity College Dublin, Dublin 2, Ireland.
³ Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.
⁴ School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁵ Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau, Carrer de Sant Quintí, Barcelona, Spain.
⁶ Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Carrer de Sant Quintí, Barcelona, Spain.
⁷ Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Gran Via de les Corts Catalanes, Barcelona, Spain.
⁸ Psychology Department, Faculty of Social Sciences, University of Botswana, Gaborone, Botswana.
⁹ Neurology Department, Faculty of Medicine, Protestant University of Congo, Kinshasa, Democratic Republic of the Congo.
¹⁰ Departments of Neurology and of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA.
¹¹ Department of Neurology, LMU University Hospital, Munich, Germany.
¹² Department of Neurology, LMU University Hospital, German Center for Neurodegenerative Diseases, Munich, Germany.
¹³ Together For Ghana e.V., Munich, Germany.
¹⁴ University of the Witwatersrand, Johannesburg, South Africa.
¹⁵ Neurology Department, Cairo University, Cairo, Egypt.
¹⁶ German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
¹⁷ Institute of Global Health and Human Ecology (I-GHHE), The American University in Cairo (AUC), New Cairo, Egypt.
¹⁸ Neuroscience and Ageing Research Unit, College of Medicine, University of Ibadan, Ibadan, Nigeria.
¹⁹ Department of Molecular Biology, Lead City University, Ibadan, Nigeria.
²⁰ Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
²¹ School of Medicine, University of Kinshasa and Catholic University of Congo, Kinshasa, Democratic Republic of the Congo.
²² Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
²³ Banner Alzheimer's Institute and University of Arizona, Phoenix, Arizona, USA.
²⁴ Banner Sun Health Research Institute, Sun City, Arizona, USA.
²⁵ Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA.
²⁶ Department of Public Health, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa.
²⁷ Atlantic Fellowship for Health Equity, Cape Town, South Africa.
²⁸ Brain and Mind Institute, Aga Khan University, Nairobi, Kenya.

PMID: 40538002
PMCID: PMC12179337
DOI: 10.1002/alz.70388

Down syndrome in Africa: Challenges, opportunities, and future directions

Eimear McGlinchey et al. Alzheimers Dement. 2025 Jun.

. 2025 Jun;21(6):e70388.

doi: 10.1002/alz.70388.

Authors

Affiliations

¹ Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin 2, Ireland.
² Trinity Centre for Ageing and Intellectual Disability, Trinity College Dublin, Dublin 2, Ireland.
³ Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.
⁴ School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁵ Sant Pau Memory Unit, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau, Carrer de Sant Quintí, Barcelona, Spain.
⁶ Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Carrer de Sant Quintí, Barcelona, Spain.
⁷ Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Gran Via de les Corts Catalanes, Barcelona, Spain.
⁸ Psychology Department, Faculty of Social Sciences, University of Botswana, Gaborone, Botswana.
⁹ Neurology Department, Faculty of Medicine, Protestant University of Congo, Kinshasa, Democratic Republic of the Congo.
¹⁰ Departments of Neurology and of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA.
¹¹ Department of Neurology, LMU University Hospital, Munich, Germany.
¹² Department of Neurology, LMU University Hospital, German Center for Neurodegenerative Diseases, Munich, Germany.
¹³ Together For Ghana e.V., Munich, Germany.
¹⁴ University of the Witwatersrand, Johannesburg, South Africa.
¹⁵ Neurology Department, Cairo University, Cairo, Egypt.
¹⁶ German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
¹⁷ Institute of Global Health and Human Ecology (I-GHHE), The American University in Cairo (AUC), New Cairo, Egypt.
¹⁸ Neuroscience and Ageing Research Unit, College of Medicine, University of Ibadan, Ibadan, Nigeria.
¹⁹ Department of Molecular Biology, Lead City University, Ibadan, Nigeria.
²⁰ Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
²¹ School of Medicine, University of Kinshasa and Catholic University of Congo, Kinshasa, Democratic Republic of the Congo.
²² Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
²³ Banner Alzheimer's Institute and University of Arizona, Phoenix, Arizona, USA.
²⁴ Banner Sun Health Research Institute, Sun City, Arizona, USA.
²⁵ Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA.
²⁶ Department of Public Health, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa.
²⁷ Atlantic Fellowship for Health Equity, Cape Town, South Africa.
²⁸ Brain and Mind Institute, Aga Khan University, Nairobi, Kenya.

PMID: 40538002
PMCID: PMC12179337
DOI: 10.1002/alz.70388

Abstract

Introduction: As life expectancy improves for people with Down syndrome (DS) in Africa, the risk of developing DS-associated Alzheimer's disease (DSAD) will rise. There is a pressing need to plan for this emerging challenge, particularly in the context of existing health and social disparities.

Methods: This work emerged from a pan-African collaboration, including discussions at the Brain Ageing and Dementia in Low- and Middle-Income Countries conference held in Nairobi in 2024, where stakeholders identified regional priorities for DS and dementia care.

Results: Limited epidemiological, cognitive, biomarker data, delayed diagnoses, and gaps in specialized services may impact access to care. However, innovative solutions, such as mobile biomarker sampling and culturally adapted cognitive assessments, offer promising strategies.

Discussion: Integrating global advances in DSAD research with Africa's strengths in community-based care offers opportunities. By prioritizing research, capacity building, and health system integration, this work advocates for the inclusion of DS in Africa's dementia strategies.

Highlights: Projected increases in life expectancy for individuals with Down syndrome (DS) in Africa will lead to a substantial rise in DS-associated Alzheimer's disease (DSAD), necessitating urgent planning and response. There is a critical lack of epidemiological, cognitive, and biomarker data on adults with DS in Africa, hindering accurate diagnosis, care planning, and inclusion in global research. Innovative, scalable solutions-such as mobile biomarker sampling and culturally adapted cognitive assessments-offer an opportunity to integrate scientific advances with Africa's strengths in community-based care. Investment in research and capacity building is essential to address current gaps, reduce disparities, and ensure equitable access to emerging diagnostics and treatments for DSAD across the continent.

Keywords: Africa; Alzheimer's disease; Down syndrome; Global South; equity.

PubMed Disclaimer

Conflict of interest statement

J. F. reported receiving personal fees for service on the advisory boards, adjudication committees or speaker honoraria from AC Immune, Adamed, Alzheon, Biogen, Eisai, Esteve, Fujirebio, Ionis, Laboratorios Carnot, Lilly, Life Molecular Imaging, Lundbeck, Perha, Roche, and, outside the submitted work. J. F. reports holding a patent for markers of synaptopathy in neurodegenerative disease (licensed to Adx, EPI8382175.0). No other conflicts of interest to report. Author disclosures are available in the Supporting Information.

Figures

**FIGURE 1**
Geographic distribution of identified Down syndrome (DS) studies across Africa. This figure illustrates the geographic distribution of identified published studies on DS across the African continent.

See this image and copyright information in PMC

References

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Down syndrome in Africa: Challenges, opportunities, and future directions

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