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

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.