Prevalence of dementia and mild cognitive impairment in Morocco: A population-based study
This nationwide telephone survey of 1,662 Moroccan adults aged 60 and older reveals a weighted prevalence of 11.6% for dementia and 23.6% for mild cognitive impairment, highlighting a substantial cognitive health burden across the country's 12 administrative regions.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
The human mind is a vast landscape that changes as we grow older. For most, these changes are subtle, like the gradual softening of focus or the occasional need to pause and recall a name. But for some, the decline is steeper and more permanent, eroding the ability to manage daily life, recognize loved ones, or navigate familiar streets. This condition, known as dementia, is not a single disease but a collection of symptoms caused by various brain disorders, with Alzheimer's disease being the most common. Before a person reaches the point of full dementia, many experience a middle ground called mild cognitive impairment. In this state, memory and thinking skills are noticeably worse than expected for one's age, yet the person can still care for themselves and function independently. Understanding how common these conditions are, and who they affect most, is crucial for planning healthcare and support systems, especially in countries where data has been scarce.
In Morocco, a team of researchers set out to map the landscape of cognitive health among older adults. They focused on the population aged sixty and above, a group where the risk of memory loss begins to rise significantly. The team, led by Abdelilah Benouajjit and Zouhayr Souirti from Sidi Mohamed Ben Abdellah University, conducted a massive nationwide survey to find out exactly how many people were living with dementia or mild cognitive impairment. Because visiting every household in the country would be logistically impossible, they used a different approach: they called people on their mobile phones. This method allowed them to reach across all twelve administrative regions of Morocco, from the bustling economic hubs to remote rural areas, gathering a representative picture of the nation's cognitive health.
The study involved 1,662 adults aged sixty or older. The process began with a two-step screening designed to be quick and effective over the phone. First, participants took a shortened version of a standard memory test called the Montreal Cognitive Assessment, adapted for telephone use and spoken in the local Moroccan dialect. They also answered a brief questionnaire about their memory and daily habits. If a participant scored low on the memory test or reported significant changes in their thinking, they were flagged as "screen-positive." These individuals then underwent a second, more detailed interview conducted by neurologists. These specialists asked deeper questions about how the memory issues affected the person's ability to live independently, manage finances, or maintain social relationships. Based on these conversations, the doctors made a final diagnosis, distinguishing between those who had lost their independence (dementia) and those who were struggling but still independent (mild cognitive impairment).
The results revealed a significant burden of cognitive impairment in the country. In the raw group of people they spoke to, 5.1% were diagnosed with dementia and 18.2% with mild cognitive impairment. However, the researchers knew that their group of callers did not perfectly match the entire population of Morocco; for instance, there were fewer very old people in their sample than in the real world. When they adjusted their numbers to reflect the actual age, gender, and regional makeup of the country, the picture changed. The estimated prevalence of dementia rose to 11.6%, and mild cognitive impairment rose to 23.6%. This jump highlights a critical reality: because the risk of these conditions increases sharply with age, and because the oldest people are often the hardest to reach in phone surveys, the true number of affected individuals is likely higher than a simple count suggests.
The study also peeled back the layers to see who was most at risk. Age was the strongest factor; the likelihood of having dementia or mild cognitive impairment grew steadily as people got older. Among those aged sixty to sixty-four, the rates were relatively low, but for those over seventy, the numbers climbed dramatically. Gender played a role as well, with women showing higher rates of both conditions than men. Education was another key piece of the puzzle; people with less formal schooling were more likely to have cognitive issues than those with university degrees. The researchers also found that living in rural areas was associated with higher rates of impairment compared to city living. Furthermore, certain health conditions, such as diabetes, high blood pressure, and problems with vision or hearing, were linked to a greater likelihood of cognitive decline. Interestingly, while factors like smoking and alcohol use were examined, they did not show a strong statistical link to the conditions in this specific study.
This nationwide effort provides the first detailed look at the scale of cognitive impairment in Morocco. By using telephone interviews, the team managed to gather data from a wide cross-section of society, offering a baseline for future research and healthcare planning. The findings suggest that as the population ages, the number of people needing support for memory and thinking problems will grow substantially. The researchers noted that their method had limitations, such as the difficulty of assessing hearing or vision over the phone and the fact that they could not visit people in person to observe them directly. Despite these constraints, the study offers a clear and urgent signal: cognitive impairment is a major public health challenge in Morocco, affecting a significant portion of the older adult population, and it requires attention and resources to manage effectively.
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