Management of Dementia in a Resource-Constrained Sub-Saharan African Setting: Outcome of a Retrospective Survey of Clinical Practice in the Only Neuropsychiatric Facility in Northeastern Nigeria.

Abstract

Introduction: Dementia prevalence is rising in sub-Saharan Africa due to a combination of factors, including population growth and aging. In resource-constrained settings, such as Northeastern Nigeria, dementia management is challenged by delayed diagnosis and limited specialist care. This study evaluates the burden of dementia and its management at the Federal Neuropsychiatric Hospital Maiduguri (FNHM), the only neuropsychiatric facility in Northeastern Nigeria. The study aims to provide insights into current dementia trends and practices and identify key areas for improvement. Methods: A retrospective analysis of patient records at FNPH Maiduguri was conducted, including patients aged 60 and above diagnosed with dementia between 1999 and 2023. Data on patient demographics, dementia subtypes, comorbidities, symptoms, diagnostic investigations, and treatment modalities were analysed. Results: The Available record from the hospital health records register showed that the total number of diagnosed cases of dementia in the FNHM is 1,216 cases with a male predominance (56%). Alzheimers disease was the most common subtype (60.5%), followed by vascular dementia (24.5%). Hypertension was the most frequently reported comorbidity (41.6%). Cognitive symptoms, particularly memory loss, were reported in all cases, while behavioural symptoms, such as agitation and hallucinations, were reported in some cases. The most commonly administered treatments included cognitive enhancers (donepezil), supplements (gingko biloba), and non-drug therapies (psychoeducation). However, 70.9% of patients were lost to follow-up, highlighting a critical gap in long-term care. Conclusion: The increasing burden of dementia at the only neuropsychiatric facility in Northeastern Nigeria highlights the urgent need for investments and targeted interventions. Enhancing patient engagement, strengthening follow-up systems, and expanding diagnostic and treatment capacities will improve care outcomes and address the growing demands for dementia management in this underserved region.