Abstract
BACKGROUND: Dementia is a major global health challenge with rising burden in LMICs, particularly in sub-Saharan Africa. While biological and genetic factors contribute to dementia risk, social determinants such as gender, education, and nutrition, play critical roles. Women are disproportionately affected, not only because of longer life expectancy but also due to lifelong disparities in educational attainment, nutrition status, and healthcare access. Evidence from Nigeria suggests that short stature; a biomarker of early-life under-nutrition, and poor education, are associated with increased dementia risk in diabetic women. METHODS: This narrative systematic review with policy modelling focused on Nigeria and sub-Saharan Africa survey data and peer-reviewed research on gender differences in dementia prevalence and mediating socioeconomic variables such as education level and early-life nutrition status. PROSPERO; Registration ID: CRD420251252745. RESULTS: Women with lower education and poor childhood growth are more prone to dementia in later life. Evaluation of national and regional policies that address impact of education and nutrition disparity on dementia show singular implementation of the policy on poor education of the girl child compared to nutrition policy impact. Dual implementation of both policies; nutrition and education, may significantly reduce dementia burden among women. This work proposes a framework that targets critical life-course junctions via simultaneous application of policies on education and nutrition, to enable reduction of dementia prevalence in Nigerian women. Such approach is reinforced by the WHO report on life course interventions at critical life points, for sustained impact on disease reduction. CONCLUSION: The authors recommend synergistic application of existing or newly designed education and early-life nutrition strategies, to curtail dementia incidence in Nigerian and sub-Saharan women. Evidence from policy-modeling shows that multi-component interventions across the lifespan are superior to single-factor approaches. Such a policy framework that target girls’ nutrition and universal access to education, should be integrated into multi-sectoral public efforts to curb dementia rise in the society.