{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:14:07Z","timestamp":1792818847760,"version":"4.5.0"},"reference-count":41,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,3,2]],"date-time":"2025-03-02T00:00:00Z","timestamp":1740873600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Davos alzheimer's Collaborative"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The rising number of older people, including those living with Alzheimer's disease and related dementias (AD\/ADRD) in sub-Saharan Africa (SSA) highlights the need for an improved clinical diagnosis and management of the diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To understand and describe healthcare providers\u2019 perceptions and practices regarding AD\/ADRD diagnosis and care in Kenya, not previously reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an ethnographic study involving observations and semi-structured interviews with healthcare providers working at the Aga Khan University Hospital, Nairobi (AKUHN) Kenya. Twenty-one healthcare providers were purposively recruited and interviewed in English, with the data transcribed verbatim and thematically analysed using Nvivo version 14.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our findings reveal that AKUHN's dementia diagnostic pathway aligns with universal best practice models and involves multidisciplinary care. Yet, healthcare providers noted that this level of care is not representative of most public hospitals in Kenya, where a lack of diagnostic equipment and trained staff severely limits patient access to timely dementia care. In addition, new medications that can slow AD\/ADRD progression, are not readily available in Africa, including Kenya. We also identified barriers to timely diagnosis and care such as: lack of dementia policy and guidelines, limited expertise of healthcare providers, high cost of care, and sociocultural factors, including stigma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We emphasize the need for the Kenyan government and relevant stakeholders to develop social and healthcare policies and allocate resources to raise awareness about dementia and combat stigma; train healthcare providers; improve early detection and service delivery through access to diagnostic tools, and establish clear guidelines\/protocols for AD\/ADRD care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877251320411","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T13:34:10Z","timestamp":1741095250000},"page":"862-874","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Healthcare providers perspectives and perceptions of dementia diagnosis and management at the Aga Khan University Hospital, Nairobi, Kenya"],"prefix":"10.1177","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4781-7101","authenticated-orcid":false,"given":"Edna N","family":"Bosire","sequence":"first","affiliation":[{"name":"Brain &amp; Mind Institute, Aga Khan University, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2665-7807","authenticated-orcid":false,"given":"Karen","family":"Blackmon","sequence":"additional","affiliation":[{"name":"Brain &amp; Mind Institute, Aga Khan University, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8599-0174","authenticated-orcid":false,"given":"Lucy W","family":"Kamau","sequence":"additional","affiliation":[{"name":"Brain &amp; Mind Institute, Aga Khan University, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7357-4692","authenticated-orcid":false,"given":"Chinedu","family":"Udeh-Momoh","sequence":"additional","affiliation":[{"name":"Brain &amp; Mind Institute, Aga Khan University, Nairobi, Kenya"},{"name":"School of Medicine, Wake Forest University, Winston-Salem, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8819-0851","authenticated-orcid":false,"given":"Dilraj","family":"Sokhi","sequence":"additional","affiliation":[{"name":"Neurology Department, Aga Khan University Hospital, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7957-5426","authenticated-orcid":false,"given":"Jasmit","family":"Shah","sequence":"additional","affiliation":[{"name":"Brain &amp; Mind Institute, Aga Khan University, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1191-2165","authenticated-orcid":false,"given":"Sylvia","family":"Mbugua","sequence":"additional","affiliation":[{"name":"Neurology Department, Aga Khan University Hospital, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0109-8308","authenticated-orcid":false,"given":"Kendi","family":"Muchungi","sequence":"additional","affiliation":[{"name":"Brain &amp; Mind Institute, Aga Khan University, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0942-9797","authenticated-orcid":false,"given":"Irene","family":"Meier","sequence":"additional","affiliation":[{"name":"Davos Alzheimer's Collaborative, Wayne, USA &amp; Gen\u00e8ve, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaibhav","family":"Narayan","sequence":"additional","affiliation":[{"name":"Davos Alzheimer's Collaborative, Wayne, USA &amp; Gen\u00e8ve, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3162-3115","authenticated-orcid":false,"given":"Olivera","family":"Nesic","sequence":"additional","affiliation":[{"name":"Brain &amp; Mind Institute, Aga Khan University, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6360-7913","authenticated-orcid":false,"given":"Zul","family":"Merali","sequence":"additional","affiliation":[{"name":"Brain &amp; Mind Institute, Aga Khan University, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,2]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awac217"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.4782"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30499-X"},{"key":"e_1_3_4_5_2","volume-title":"Global action plan on the public health response to dementia 2017\u20132025","author":"World Health Organization","year":"2017","unstructured":"World Health Organization. Global action plan on the public health response to dementia 2017\u20132025. Geneva: World Health Organization, 2017, Available from: http:\/\/www.who.int\/mental_health\/neurology\/dementia\/action_plan_2017_2025\/en\/."},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.02.020401"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01296-0"},{"key":"e_1_3_4_8_2","article-title":"Prevalence of dementia in Nigeria: a systematic review of the evidence","volume":"3","author":"Adeloye D","year":"2019","unstructured":"Adeloye D, Auta A, Ezejimofor M, et al. Prevalence of dementia in Nigeria: a systematic review of the evidence. J Glob Health Rep 2019; 3: e2019014.","journal-title":"J Glob Health Rep"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/00469580211011933"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/s21030778"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.2023.2217025"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psc.2022.07.010"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12432"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/opn.12427"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-072432"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13748"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.803475"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00274-0"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0144686X21000660"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182360"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.4102\/phcfm.v6i1.682"},{"key":"e_1_3_4_22_2","unstructured":"Meyer AC Ndetei D. Providing sustainable mental health care in Kenya: a demonstration project. In: Forum on Neuroscience and Nervous System Disorders; Board on Health Sciences Policy; Board on Global Health; Institute of Medicine; National Academies of Sciences Engineering. 2016. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK350312."},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1080\/17439760.2016.1262614"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/arclin\/acz086"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-019-1283-9"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10433-021-00652-4"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12264-018-0249-z"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-023-02215-8"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1017\/S135561771700100X"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610217002344"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/0891988720901785"},{"key":"e_1_3_4_32_2","first-page":"1","article-title":"Environmental and lifestyle risk factors for early-onset dementia: a systematic review","volume":"93","author":"Bosi M","year":"2022","unstructured":"Bosi M, Malavolti M, Garuti C, et al. Environmental and lifestyle risk factors for early-onset dementia: a systematic review. Acta Biomed 2022; 93: 1\u201316.","journal-title":"Acta Biomed"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.2217\/nmt.14.47"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.3233\/ADR-180070"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.3389\/fragi.2023.1143408"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/geroni\/igz043"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/2307443"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.1561"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13195-022-00984-y"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-023-05129-5"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-14-84"},{"key":"e_1_3_4_42_2","first-page":"195750","article-title":"Epidemiology of dementia among the elderly in Sub-Saharan Africa","volume":"2014","author":"Olayinka OO","year":"2014","unstructured":"Olayinka OO, Mbuyi NN. Epidemiology of dementia among the elderly in Sub-Saharan Africa. Int J Alzheimers Dis 2014; 2014: 195750.","journal-title":"Int J Alzheimers Dis"}],"container-title":["Journal of Alzheimer\u2019s Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877251320411","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13872877251320411","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877251320411","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T10:10:00Z","timestamp":1777371000000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13872877251320411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,2]]},"references-count":41,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1177\/13872877251320411"],"URL":"https:\/\/doi.org\/10.1177\/13872877251320411","relation":{},"ISSN":["1387-2877","1875-8908"],"issn-type":[{"value":"1387-2877","type":"print"},{"value":"1875-8908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,2]]}}}