Trends and projections for Alzheimer's disease and other dementias in Kenya: Analysis of the global burden of disease data 1990–2021 in relation to Africa and the world

Background: Dementia, predominantly Alzheimer's disease, poses a growing public health challenge in low- and middle-income countries like Kenya. This is driven by rapid population aging and rising prevalence of non-communicable diseases. Understanding trends in dementia burden is essential for informing healthcare planning and preventive strategies. Objective: This study aimed to analyze trends in dementia burden in Kenya from 1990 to 2021 using the Global Burden of Disease (GBD) data, comparing estimates with sub-Saharan Africa, Africa, and global benchmarks, while assessing modifiable risk factors and projecting to 2050. Methods: Secondary analysis of GBD 2021 data examined age-standardized incidence, prevalence, mortality, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs) for Alzheimer's disease and other dementias in Kenya, disaggregated by age and sex. Joinpoint regression calculated average annual percent changes (AAPC); autoregressive integrated moving average (ARIMA) models forecasted prevalence, mortality, and DALYs to 2050. Results: In 2021, Kenya's age-standardized prevalence rate (ASPR) was 605.1 per 100,000 (95% UI: 525.2–689.5), exceeding SSA (529.5) and Africa (590.0) but below global (694.0); incidence was 105.1 (95% UI: 91.6–119.6). Females bore higher burdens across metrics (e.g., ASPR: 697.1 vs. 459.4 in males). From 1990–2021, ASPR and incidence declined (AAPC: −0.14% to −0.21%, p < 0.001), while DALYs (AAPC: 0.19%–0.23%, p < 0.001) and mortality (AAPC: 0.29%–0.36%, p < 0.001) rose, driven by YLLs. Conclusions: Despite declining age-standardized incidence and prevalence, rising mortality and DALYs signal escalating dementia burden in Kenya, amplified by metabolic risks and aging. Females face disproportionate impacts. Urgent integration of risk reduction into primary care, enhanced surveillance, and culturally tailored strategies per the Nairobi Declaration are needed to mitigate future challenges in low- and middle-income countries.