Ethiopia

The Mini-Mental State Examination test (MMSE) is the most commonly used cognitive test in Ethiopia, but scores are rarely adjusted for age, education, gender, or language proficiency, so it is suggested that these factors be considered when interpreting results to improve accuracy for Alzheimer’s disease screening. Two other screening tools that have been validated for use in Ethiopia are the Montreal Cognitive Assessment (MoCA) and the Rowland Universal Dementia Assessment Scale (RUDAS). These tests are relatively accessible in clinical and research settings in Ethiopia because they are brief, inexpensive, and easy to administer, but their effectiveness can be limited in populations with very low literacy, requiring careful interpretation or adjusted cutoffs. There is also an ongoing pilot project aiming to translate, culturally adapt, and validate the Brain Health Assessment (BHA) battery in Amharic for Ethiopia.

Advanced neuroimaging is not widely available within Ethiopia’s public health system. A study from 2011 assessing radiological services in Addis Ababa’s public hospitals revealed a critical deficit: while all facilities provided basic X-ray and ultrasound, only 18% had a functional computed tomography (CT) scanner, and none had a magnetic resonance imaging (MRI) machine. Compounding the problem of scarcity was an issue of maintenance, with the study finding that a quarter of all existing radiological equipment was non-functional. Although the situation has improved incrementally, access remains a profound challenge for the vast majority of the population.

In contrast to the deficits in the public sector, numerous private hospitals and standalone diagnostic centres advertise state-of-the-art CT and MRI services, catering to people who can afford to pay out-of-pocket. This has created a two-tiered system where access to a comprehensive diagnostic workup is largely dependent on a person’s socioeconomic status and geographic location.

Genetic testing for Alzheimer’s disease is currently limited and primarily conducted through the MRC-ET Advanced Laboratory in Addis Ababa. However, there is a lack of publicly available details regarding the specific Alzheimer’s disease test offered by MRC-ET. It is not specified which genes are analysed.

Fluid biomarker tests, using either cerebrospinal fluid (CSF) or blood samples to measure amyloid-beta and tau proteins, are not part of the routine clinical use for diagnosing Alzheimer’s disease in Ethiopia, due in large part to significant infrastructure barriers. For example, standard protocols often require samples to be stored in specialized, ultra-cold -80°C freezers, which are impractical in many settings. However, this may change, as recent research (including work from Ethiopia) suggests that key biomarkers are stable at a standard -20°C, potentially removing this major barrier in the future.

In Ethiopia, there are no dedicated memory clinics for Alzheimer’s disease diagnosis. In the public system, there are only three general institutional care centres for older people in the entire country, none of which are specified as being Alzheimer’s disease or dementia-focused. Most residential facilities are located in Addis Ababa, making them geographically and financially inaccessible to the majority of the population.

There is also a complete absence of formal day centres that would provide structured activities for people living with dementia and respite for care partners. While non-governmental organisations (NGOs) like Mekedonia Home for the Elderly and Mentally Disabled provide essential shelter and food for the destitute elderly in several cities, limitations around specialized training or resources required for dementia care persists. However, a private home-care sector is developing in Addis Ababa, with agencies like Lifeline Addis explicitly listing dementia among the chronic illnesses they serve through in-home nursing and support.

Palliative care is critically underdeveloped, donor-dependent, and almost entirely unavailable outside the capital. The main providers are NGOs (Hospice Ethiopia, Mary Joy Development Association, and Beza for Generation) in Addis Ababa that offer free, community-based care, including home visits. However, its services are not specialized for Alzheimer’s disease, as its primary mandate is to serve people living with cancer and HIV/AIDS. With its operations confined to Addis Ababa, over 78% of the population living in rural areas has virtually no access to formal end-of-life care or essential pain management medications.

The government provides no direct financial aid, stipends, or specific schemes for carers of people living with Alzheimer’s disease. Local NGOs and charities occasionally provide assistance to older people, but they do not offer consistent caregiver salaries, universal respite care, or ongoing caregiver allowances.

With no public or subsidized nursing homes, families must choose between expensive private home-care services or providing care themselves. However, one qualitative study in Addis Ababa found that caregivers often lack a medical understanding of dementia.

Researchers at the University of Gondar have developed an innovative ensemble deep learning model combined with quantum machine learning classifiers to enhance the accuracy and efficiency of Alzheimer’s disease classification. This hybrid approach leverages the strengths of both classical deep learning architectures and quantum computing to process and analyse brain imaging data.

Research from the Africa-FINGERS consortium — involving institutions across Africa and global partners — is working on adapting multimodal lifestyle interventions such as diet, exercise, cognitive training, and vascular risk management to prevent dementia in African populations, including Ethiopia. The study focuses on culturally tailoring these strategies to local socioeconomic conditions, healthcare systems, and cultural practices, proposing a precision-brain-health framework to make dementia prevention effective and equitable across the continent.