Current state of dementia screening, risk reduction strategies, and barriers to the uptake of evidence-based dementia care in primary healthcare in Africa: a scoping review and call for implementation research

Introduction Dementia is a growing public health challenge worldwide, particularly in Africa. Although various screening tools have been used across different settings in the region, evidence on dementia screening practices, risk reduction strategies, and barriers to evidence-based dementia care has not been systematically mapped. This scoping review aimed to map the available evidence on dementia screening practices, risk reduction approaches, and barriers to dementia care across Africa. Methods This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. The review protocol was prospectively registered on the Open Science Framework (OSF). A comprehensive search of major databases (PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, Google Scholar) and grey literature was conducted. Eligible studies focused on dementia screening, risk reduction strategies, and barriers to evidence-based dementia care in primary healthcare settings across Africa. Study selection and data extraction were independently performed by three reviewers, and findings were synthesized using descriptive mapping. Results Of the 3,102 records identified, 16 studies met the inclusion criteria. Nine studies reported dementia screening practices using a range of screening tools, most commonly the Brief Community Screening Instrument for Dementia (CSID) and the Mini-Mental State Examination (MMSE). The available evidence suggests that dementia screening was largely conducted within research settings rather than as part of routine primary healthcare. Six studies identified barriers to evidence-based dementia screening and care, including workforce shortages, limited infrastructure and funding, inadequate training, low policy prioritization, sociocultural stigma, and limited public awareness. Only one study evaluated the implementation of dementia risk reduction strategies in an African context, highlighting an important evidence gap. Conclusions Evidence on dementia screening, risk reduction, and care integration in African primary healthcare remains limited. Key barriers include health system constraints, workforce shortages, inadequate infrastructure and funding, and sociocultural challenges. Future implementation research should evaluate culturally appropriate strategies to strengthen dementia detection, prevention, and integration of dementia services into primary healthcare across Africa.