Many people dismiss certain changes in memory and thinking as simply "old age”, when they may actually be signs of disease. Dementia is not ordinary forgetfulness, nor is it an inevitable part of ageing. It progressively affects memory, thinking, language and the ability to manage everyday activities. Alzheimer’s disease is its most common cause. Recognising the difference matters because delayed diagnosis can mean delayed care and support.
The issue is becoming increasingly important as Rwanda’s population ages. Life expectancy rose from 46.4 years in 1978 to 69.6 years in 2022. The 2022 Population and Housing Census counted 862,929 people aged 60 and above, representing 6.5% of the population. Of these, 58.7% were women. Meanwhile, fertility has declined to 3.7 children per woman. These demographic changes mean that more people will live into older age, while changing family sizes may affect how households organise and provide care.
The health needs of this ageing population are already visible. A 2025 study by the University of Global Health Equity, involving 4,369 adults in Kigali and Burera, found that 55.2% had multimorbidity, meaning two or more chronic health conditions. It identified signs of probable dementia in 3% of participants and possible dementia in another 8.6%. These were screening findings, not confirmed diagnoses or national prevalence estimates.
Similarly, a University of Rwanda study involving 200 patients aged 60 and above at CHUB and CHUK found cognitive impairment in 61.5% of participants. The researchers suggested that existing medical conditions and low levels of formal education might partly explain the findings. However, because the participants were hospital patients, this figure should not be interpreted as the prevalence of cognitive impairment among Rwanda’s general older population.
Rwanda still lacks a reliable national estimate of dementia prevalence. A 2024 review of population-based studies in East Africa found estimates ranging from 6.1% to 23%. Differences in study methods and diagnostic approaches make direct comparisons difficult. The wide range underscores how much remains unknown about the condition in our region (Yenesew M. A. et al., 2024).
Beyond diagnosis, ageing raises questions about who provides care and how it is financed. Many older people depend on family members for daily support, often without formal training or financial assistance. As families become smaller and more people work outside the home, relying almost entirely on relatives may become increasingly difficult. Women frequently carry a disproportionate share of caregiving responsibilities.
Other countries offer useful lessons. Japan promotes dementia-friendly communities that support people living with the condition, while Australia’s national action plan focuses on prevention, early diagnosis, coordinated care and family support. WHO also emphasises reducing dementia risk through healthier lifestyles and better management of conditions such as hypertension and diabetes.
What could Rwanda prioritise?
Count it: Conduct a nationally representative study to establish how common dementia is, identify risk factors and understand the needs of affected households. Reliable local evidence would guide planning and resource allocation.
Check it: Equip primary healthcare workers to recognise early signs of cognitive decline, identify possible causes and refer patients for appropriate assessment. Training should also cover mobility, nutrition, daily functioning and family caregiving.
Support it: Strengthen continuity of healthcare for older people, provide practical guidance to families and improve coordination between health and social protection services. Caregiver support is essential to helping families manage long-term care.
Rwanda has demonstrated the value of investing in preventive and community-based healthcare. Preparing for an ageing population calls for the same forward-looking approach. Living longer should also mean living with dignity, independence and quality of life. The first step is to raise awareness and stop dismissing dementia as simply "old age”.
The writer is a global health specialist.