Public Health

Social engagement (SE) is increasingly recognized as key modifiable risk factor for Alzheimer's Disease (AD), yet its role among indigenous African populations is less explored. Understanding how SE influences AD risks, progression and treatment is crucial for developing effective population-specific interventions. We investigated the association between SE, and AD among indigenous Africans from nine countries.

Data were collected by the African Dementia Consortium as part of the ongoing READD-ADSP study. We analysed a sample of 1,018 participants (509 case-control pairs matched by age, sex and ethnicity). Cases had AD while controls were cognitively unimpaired. SE was assessed through self-reported frequency of interactions with close individuals, categorized as low (<2 times/week) and high (≥5 times/week). Additionally, radio and television listening habits were recorded. Conditional logistic regression was used to assess associations, adjusting for education, living arrangement, urban/rural residence, religion and socioeconomic status.

Mean age was comparable between cases (75.6 ± 9.5 years) and controls (75.3 ± 9.5 years, p = 0.613). Childhood SE did not differ significantly (p = 0.445) but in adulthood, SE was lower among cases (27.0%) than controls (20.5%). Low SE in adulthood was significantly associated with higher odds of AD (AOR=1.89, 95% CI: 1.33-2.70). More controls (57.7%) than cases (31.8%) listened to radio almost daily, which was linked to reduced odds of AD (AOR=0.29, 95% CI: 0.21-0.43). Watching TV daily was associated with slightly reduced odds (OR=0.69, 95% CI: 0.49-0.99).

Findings suggest that low SE is associated with AD risk in African populations, highlighting the need for socially inclusive interventions to promote social participation and reduce isolation. Future longitudinal research should explore protective factors and underlying mechanisms in diverse African contexts.