Bridging Research Infrastructure for Dementia Gaps in East Africa (BRIDGE-AFRICA)
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Project Summary The proposed work will build research infrastructure for Alzheimer’s disease and related dementias (ADRD) in East Africa. We build on MPI Valcour’s, 10-year history of cognitive research in East Africa and activities of the Atlantic Fellows for Equity in Brain Health (AFEBH) program at UCSF, led by Valcour and Miller (see LOS), which has an 8-year history of investment in training ADRD researchers in the region. To date, AFEBH has trained 34 Atlantic Fellows in Africa, including three working in Kenya and nine working in Ethiopia. These include MPI Zewde working at the University of Addis Ababa and MPI Udeh-Momoh leading research at Aga Khan University in Nairobi. The proposal leads with a harmonized cognitive and clinical assessment protocol across two countries in a manner that can become scalable across Africa within the unique Atlantic Fellow network. During the UG3 phase, we will create the tools and demonstrate feasibility for a harmonized two-country intervention-ready cohort of representative community dwelling individuals at risk for ADRD. This work will include finalizing the creation of a harmonized multidomain cognitive assessment battery underway and supported by UCSF’s AFEBH program and the fortification of collaborative community outreach teams to inform culturally appropriate research enrollment and procedure practices. We will continue to train new African AFEBH at UCSF at no cost to this proposal. In the UH3 phase, we will build out cohorts of 200 controls, 50 patients with dementia, and 200 individuals at risk for ADRD in each country, resulting in 900 total enrollees for future intervention trials. During this phase, we will optimize ADRD diagnostics through examination of culturally adapted cognitive and functional assessment tools in our harmonized battery and plasma biomarkers. Through community engagement, we will determine optimal approaches for dementia prevention leveraging targets highlighted in published modifiable risk factors (e.g., hypertension, physical activity, cognitive stimulation) and determine feasibility in preparation for independent research grant applications (e.g., R01s) focused on multidomain prevention strategies. The application draws further support from the Alzheimer’s Association in the U.S., who has partnered with the AFEBH program at UCSF for 8 years to provide competitively reviewed pilot funds allowing fellows to work in their region ($3.4 M to date). They will also continue to co- deliver with the AFEBH program an international conference to be held in Cape Town, South Africa in 2024 with two additional conferences in Africa in support of this proposal (see LOS, no cost to this proposal). Together, this intensive effort will create the tools and cohorts needed to for substantial neuroscience development for ADRD in Africa.
