Afm Saiful Islam, Raoha Saif, Baraa Alghalyini, Abdul Rehman Zia Zaidi
BackgroundDementia is an emerging public health priority in Saudi Arabia, driven by population aging and a high prevalence of vascular and metabolic disease. Despite increasing research activity, evidence remains fragmented, limiting understanding of the national burden and determinants of dementia.ObjectiveTo synthesize evidence on dementia epidemiology, risk factors, awareness, comorbidities, caregiving challenges, and research trends in Saudi Arabia.MethodsA systematic review was conducted following PRISMA 2020 guidelines. PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar were searched for studies reporting dementia-related outcomes in Saudi populations. Given heterogeneity in study designs, sampling methods, and diagnostic criteria, findings were narratively synthesized.ResultsFifty-five studies met the inclusion criteria. Alzheimer's disease was the most common dementia subtype. Prevalence estimates among adults aged 60 years and older ranged from 3.8% to 6.3%, reflecting differences in diagnostic approaches and sampling methods. Diabetes and hypertension were the most consistently identified risk factors, while depression and anxiety were also associated with dementia. Public awareness was low, with stigma contributing to delayed recognition and underdiagnosis. Caregiving was family-based and associated with significant burden. Dementia commonly co-occurs with cardiometabolic, neuropsychiatric, and other chronic conditions. Research activity increased after 2020, with over half of the included studies published between 2020 and 2024; however, methodological inconsistencies and limited rural representation remain.ConclusionsDementia research in Saudi Arabia has expanded, yet epidemiological estimates remain inconsistent. Standardized diagnostic practices, enhanced surveillance, and public health strategies addressing risk reduction, awareness, and caregiver support are needed to address the dementia burden.