Background:

Dementia is a growing public health priority in sub-Saharan Africa (SSA), where health systems face limited resources and a shortage of trained professionals. Physical activity-based interventions are increasingly recognized as a promising approach in managing dementia, yet evidence from SSA remains limited. This scoping review aimed to map and synthesize existing studies on physical activity-based interventions for dementia and cognitive impairment in SSA.

Methods:

The review addressed three key questions: (1) What types of physical activity interventions have been implemented in SSA? (2) What clinical outcomes have been measured? (3) What socioeconomic and cultural considerations were reported in intervention design and implementation? Studies were eligible if they assessed or implemented physical activity interventions among older adults living with dementia or included people aged 65 years and above with cognitive impairment from any SSA country. No limits were placed on year or language of publication.

Following the JBI methodology for scoping reviews and the PRISMA-ScR guidelines, we conducted a comprehensive search in PubMed, CINAHL, PsycINFO, SPORTDiscus, Scopus, Embase, and African Journals Online. Grey literature sources, including Google Scholar and the Database of African Theses and Dissertations—Research, were also searched. A hand search of reference lists of all articles included at full-text screening was also completed. Data were charted and summarized descriptively, with results presented in narrative and visual forms.

Results:

After removal of duplicates, 4,471 records were screened, with only four studies meeting the inclusion criteria. Three were intervention studies (two in Nigeria and one in South Africa), and one was an observational study conducted across multiple low- and middle-income countries (including Ghana and South Africa). Study settings included residential care homes, community facilities, and population-based surveys. Interventions ranged from group-based aerobic, resistance, and balance exercises to structured, progressive task-oriented circuit training and multi-modal programs combining physical activity with brain-stimulating games. These interventions were delivered over 8–12 weeks, typically in supervised group formats.

Common clinical outcomes measured included cognitive function, activities of daily living, physical endurance, and quality of life. All intervention studies reported improvements in cognitive function, with some noting maintenance of daily functioning or delayed decline. The observational study found that older adults (≥65 years) with mild cognitive impairment in Ghana were significantly more likely to report insufficient physical activity compared to other older adults of similar age.

Socioeconomic and cultural considerations were addressed to varying degrees. Studies adapted interventions for low-resource environments by using minimal equipment and leveraging caregiver support. Cultural relevance was reflected in the inclusion of familiar games, gender-sensitive activities, and efforts to address stigma. However, few studies reported participatory design processes or detailed engagement with local communities in shaping interventions.

Conclusion:

Physical activity-based interventions implemented in SSA show promise in improving cognitive and functional outcomes for people with dementia or cognitive impairment. While limited, the evidence highlights potential benefits of low-cost, contextually appropriate physical activity programs in SSA. Future research should prioritize participatory approaches and long-term evaluations to inform scalable, culturally appropriate interventions for dementia care in SSA.

Michael Ibekaku is a third-year PhD candidate at Dalhousie University’s School of Physiotherapy in Canada. His doctoral research focuses on co-creating physical activity interventions to support people living with dementia in long-term care settings, with a specific emphasis on contextually relevant approaches for low- and middle-income countries. Michael holds a background in physiotherapy and has clinical and academic experience in both Nigeria and Canada.

His current work draws on participatory and appreciative action and reflection methodology to engage diverse stakeholders in designing sustainable, person-centred care practices for older adults with cognitive impairment. He has contributed to national and international research projects on dementia care, rehabilitation, and healthy ageing, and currently serves as the Publicity Secretary of Emerging Researchers and Professionals in Ageing-African Network (ERPAAN)- a multidisciplinary research network aimed at strengthening ageing research capacity in sub-Saharan Africa.

Michael is passionate about health equity, knowledge translation, and building capacity for dementia care in under-resourced settings in sub-Saharan Africa. His long-term goal is to influence policy and practice through community-driven, evidence-informed solutions that enhance the quality of life for older adults globally.