Building Unique Infrastructure for Large-scale Dementia research in French-Speaking Africa (BUILD-FSA) Project - ABSTRACT There are currently approximately 55 million individuals worldwide living with Alzheimer's Disease (AD) and AD- related dementias (AD/ADRD) and estimated to reach 78 million by 2030. AD/ADRD affect both patients and family members, resulting in high personal and societal costs in lost opportunities. As the population ages, AD/ADRD are becoming even more prevalent in Low and Middle-income Countries, including in Sub-Saharan Africa (SSA). SSA will experience some of the highest burdens of AD/ADRD by 2050. Africans are the most genetically diverse people on Earth, living in various environments that confer regional or population-specific genetic variants associated with diseases. The multifaceted diversities of SSA have impacted AD/ADRD perception, access to care, and research. Hence, data on its biology is very limited, and information on risk factors to inform intervention and prevention strategies is sparse and inconsistent across the continent. Besides the lack of resources and funding, linguistic and cultural barriers constitute significant obstacles to AD/ADRD research in SSA. Thus, it is imperative to build research capacities involving cultural and linguistic specificities in SSA, especially in the underserved and least studied French-speaking SSA (FS-SSA), with ~ 370 million inhabitants across 21 countries, representing > 25% of the African population. Our current proposal (BUILD- FSA) leverages several prior partnerships (AI-BOND project, 3T MRI transfer project) between the South Texas Alzheimer’s Disease Research Center (STAC) and the Brain Research Africa Initiative (BRAIN) in Cameroon (CMR), both founded to improve brain health in least-served communities. The long-term goal of the STAC- BRAIN platform is to build sustainable research and care infrastructure to provide deep phenotyping and propose strategies to curb the growing incidence of AD/ADRD in FS-SSA. Specifically, we will in UG3 phase: (a) build collaborative leadership and administrative infrastructure for AD/ADRD research in CMR (Aim 1); (b) build computational capacity and strengthen research, public health, and community training in AD/ADRD for FS-SSA (Aim 2); (c) Develop neuropsychological assessment tools and protocols, screen and collect pilot data to create a prospective AD/ADRD-focused cohort in CMR (Aim 3); and in UH3 phase: (d) establish pilot longitudinal cohort in Cameroon and extend to Chad and Central African Republic (Aim 1); and (e) Explore the impact of C/NCD, sociodemographic factors, lifestyle and sleep chronobiology on AD/ADRD in FS-SSA (Aim 2); and (f) Explore associations between gut dysbiosis and AD/ADRD (Aim 3). These proposed studies will begin to fill the data gap on dementia in Africa and complement similar initiatives. Our infrastructure-built resources and innovative studies align with NIA Strategic Goal-D: “Improve our understanding of the aging brain, AD, related dementias, and other neurodegenerative diseases...”, and RFA-AG-24-027 Specific Area of Interest: “studies that advance the understanding of AD/ADRD in Africa…”; “Genetic, omics… blood-based biomarkers.”; “methods for recruitment, retention, and data collection…”.
