Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019

Emma Nichols(University of Washington), Jaimie D Steinmetz(University of Washington), Stein Emil Vollset(University of Washington), Kai Fukutaki(University of Washington), Julian Chalek(University of Washington), Foad Abd-Allah(University of Washington), Amir Abdoli(University of Washington), Ahmed Abualhasan(University of Washington), Eman Abu‐Gharbieh(University of Washington), Tayyaba Akram(University of Washington), Hanadi Al Hamad(University of Washington), Fares Alahdab(University of Washington), Fahad Alanezi(University of Washington), Vahid Alipour(University of Washington), Sami Almustanyir(University of Washington), Hubert Amu(University of Washington), Iman Ansari(University of Washington), Jalal Arabloo(University of Washington), Tahira Ashraf(University of Washington), Thomas Astell‐Burt(University of Washington), Getinet Ayano(University of Washington), José Luís Ayuso‐Mateos(University of Washington), Atif Amin Baig(University of Washington), Anthony Barnett(University of Washington), Amadou Barrow(University of Washington), Bernhard T. Baune(University of Washington), Yannick Béjot(University of Washington), Woldesellassie Bezabhe(University of Washington), Yihienew Mequanint Bezabih(University of Washington), Akshaya Srikanth Bhagavathula(University of Washington), Sonu Bhaskar(University of Washington), Krittika Bhattacharyya(University of Washington), Ali Bijani(University of Washington), Atanu Biswas(University of Washington), Srinivasa Rao Bolla(University of Washington), Archith Boloor(University of Washington), Carol Brayne(University of Washington), Hermann Brenner(University of Washington), Katrin Burkart(University of Washington), Richard A. Burns(University of Washington), Luis Alberto Cámera(University of Washington), Chao Cao(University of Washington), Félix Carvalho(University of Washington), Luís Fernando Silva Castro-de-Araujo(University of Washington), Ferrán Catalá-López(University of Washington), Ester Cerin(University of Washington), Prachi P. Chavan(University of Washington), Nicolas Cherbuin(University of Washington), Dinh‐Toi Chu(University of Washington), Vera Marisa Costa(University of Washington), Rosa A S Couto(University of Washington), Omid Dadras(University of Washington), Xiaochen Dai(University of Washington), Lalit Dandona(University of Washington), Rakhi Dandona(University of Washington), Vanessa De la Cruz‐Góngora(University of Washington), Deepak Dhamnetiya(University of Washington), Diana Dias da Silva(University of Washington), Daniel Díaz(University of Washington), Abdel Douiri(University of Washington), David Edvardsson(University of Washington), Michael Ekholuenetale(University of Washington), Iman El Sayed(University of Washington), Shaimaa I El-Jaafary(University of Washington), Khalil Eskandari(University of Washington), Sharareh Eskandarieh(University of Washington), Saman Esmaeilnejad(University of Washington), Jawad Fares(University of Washington), André Faro(University of Washington), Umar Farooque(University of Washington), Valery L. Feigin(University of Washington), Xiaoqi Feng(University of Washington), Seyed‐Mohammad Fereshtehnejad(University of Washington), Eduarda Fernandes(University of Washington), Pietro Ferrara(University of Washington), Irina Filip(University of Washington), Howard Fillit(University of Washington), Florian Fischer(University of Washington), Shilpa Gaidhane(University of Washington), Lucia Galluzzo(University of Washington), Ahmad Ghashghaee(University of Washington), Nermin Ghith(University of Washington), Alessandro Gialluisi(University of Washington), Syed Amir Gilani(University of Washington), Ionela-Roxana Glăvan(University of Washington), E. V. Gnedovskaya(University of Washington), Mahaveer Golechha(University of Washington), Rajeev Gupta(University of Washington), Veer Bala Gupta(University of Washington), Vivek Gupta(University of Washington), Mohammad Rifat Haider(University of Washington), Brian J. Hall(University of Washington), Samer Hamidi(University of Washington), Asif Hanif(University of Washington), Graeme J. Hankey(University of Washington), Shafiul Haque(University of Washington), Risky Kusuma Hartono(University of Washington), Ahmed I Hasaballah, M. Tasdik Hasan(University of Washington), Amr Hassan(University of Washington), Simon I Hay(University of Washington), Khezar Hayat(University of Washington), Mohamed Hegazy(University of Washington), Golnaz Heidari(University of Washington), Reza Heidari‐Soureshjani(University of Washington), Claudiu Herţeliu(University of Washington), Mowafa Househ(University of Washington), Rabia Hussain(University of Washington), Bing‐Fang Hwang(University of Washington), Licia Iacoviello(University of Washington), Ivo Iavicoli(University of Washington), Olayinka Stephen Ilesanmi(University of Washington), Irena Ilić(University of Washington), Milena Ilić(University of Washington), Seyed Sina Naghibi Irvani(University of Washington), Hiroyasu Iso(University of Washington), Masao Iwagami(University of Washington), Roxana Jabbarinejad(University of Washington), Louis Jacob(University of Washington), Vardhmaan Jain(University of Washington), Sathish Kumar Jayapal(University of Washington), Ranil Jayawardena(University of Washington), Ravi Prakash Jha(University of Washington), Jost B. Jonas(University of Washington), Nitin Joseph(University of Washington), Rizwan Kalani(University of Washington), Amit Kandel(University of Washington), Himal Kandel(University of Washington), André Karch(University of Washington), Ayele Semachew Kasa(University of Washington), Gizat M. Kassie(University of Washington), Pedram Keshavarz(University of Washington), Moien AB Khan(University of Washington), Mahalaqua Nazli Khatib(University of Washington), Tawfik Khoja(University of Washington), Jagdish Khubchandani(University of Washington), Min Seo Kim(University of Washington), Yun Jin Kim(University of Washington), Adnan Kısa(University of Washington), Sezer Kısa(University of Washington), Mika Kivimäki(University of Washington), Walter J. Koroshetz(University of Washington), Ai Koyanagi(University of Washington), G Anil Kumar(University of Washington), Manasi Kumar(University of Washington), Hassan Mehmood Lak(University of Washington), Matilde Leonardi(University of Washington), Bingyu Li(University of Washington), Stephen S Lim(University of Washington), Xuefeng Liu(University of Washington), Yuewei Liu(University of Washington), Giancarlo Logroscino(University of Washington), Stefan Lorkowski(University of Washington), Giancarlo Lucchetti(University of Washington), Ricardo Lutzky Saute(University of Washington), Francesca Giulia Magnani(University of Washington), Ahmad Azam Malik(University of Washington), João Massano(University of Washington), Man Mohan Mehndiratta(University of Washington), Ritesh G. Menezes(University of Washington), Atte Meretoja(University of Washington), Bahram Mohajer(University of Washington), Norlinah Mohamed Ibrahim(University of Washington), Yousef Mohammad(University of Washington), Arif Ahmed Mohammed(University of Washington), Ali H. Mokdad(University of Washington), Stefania Mondello(University of Washington), Mohammad Ali Moni(University of Washington), Md. Moniruzzaman, Tilahun Belete Mossie(University of Washington), Gabriele Nagel(University of Washington), Muhammad Naveed(University of Washington), Vinod C Nayak, Sandhya Neupane Kandel(University of Washington), Trang Huyen Nguyen(University of Washington), Bogdan Oancea(University of Washington), Nikita Otstavnov(University of Washington), Stanislav S Otstavnov(University of Washington), Mayowa Owolabi(University of Washington), Songhomitra Panda‐Jonas(University of Washington), Fatemeh Pashazadeh Kan, Maja Pasovic(University of Washington), Urvish Patel(University of Washington), Mona Pathak(University of Washington), Mário Fernando Prieto Peres(University of Washington), Arokiasamy Perianayagam(University of Washington), Carrie B Peterson(University of Washington), Michael Phillips(University of Washington), Marina Pinheiro(University of Washington), М. А. Пирадов(University of Washington), Constance Dimity Pond(University of Washington), Michele Potashman(University of Washington), Faheem Hyder Pottoo(University of Washington), Sergio I. Prada(University of Washington), Amir Radfar(University of Washington), Alberto Raggi(University of Washington), Fakher Rahim(University of Washington), Mosiur Rahman(University of Washington), Pradhum Ram(University of Washington), Priyanga Ranasinghe(University of Washington), David Laith Rawaf(University of Washington), Salman Rawaf(University of Washington), Nima Rezaei(University of Washington), Aziz Rezapour(University of Washington), Stephen R. Robinson(University of Washington), Michele Romoli(University of Washington), Gholamreza Roshandel(University of Washington), Ramesh Sahathevan(University of Washington), Amirhossein Sahebkar(University of Washington), Mohammad Ali Sahraian(University of Washington), Brijesh Sathian(University of Washington), Davide Sattin(University of Washington), Monika Sawhney(University of Washington), Mete Şaylan(University of Washington), Silvia Schiavolin(University of Washington), Allen Seylani(University of Washington), Feng Sha(University of Washington), Masood Ali Shaikh(University of Washington), KS Shaji(University of Washington), Mohammed Shannawaz(University of Washington), Jeevan K. Shetty(University of Washington), Mika Shigematsu(University of Washington), Jae Il Shin(University of Washington), Rahman Shiri(University of Washington), Diego Augusto Santos Silva(University of Washington), João Pedro Silva(University of Washington), Renata Silva(University of Washington), Jasvinder A. Singh(University of Washington), Valentin Yurievich Skryabin(University of Washington), Anna Aleksandrovna Skryabina(University of Washington), Amanda Smith(University of Washington), Sergey Soshnikov(University of Washington), Emma Elizabeth Spurlock(University of Washington), Dan J. Stein(University of Washington), Jing Sun(University of Washington), Rafael Tabarés‐Seisdedos(University of Washington), Bhaskar Thakur(University of Washington), Binod Timalsina(University of Washington), Marcos Roberto Tovani‐Palone, Bach Xuan Tran(University of Washington), Gebiyaw Wudie Tsegaye(University of Washington), Sahel Valadan Tahbaz(University of Washington), Pascual Valdéz(University of Washington), Narayanaswamy Venketasubramanian(University of Washington), Vasily Vlassov(University of Washington), Giang Thu Vu(University of Washington), Linh Gia Vu(University of Washington), Yuan‐Pang Wang(University of Washington), Anders Wimo(University of Washington), Andrea Sylvia Winkler(University of Washington), Lalit Yadav(University of Washington), Seyed Hossein Yahyazadeh Jabbari, Kazumasa Yamagishi(University of Washington), Lin Yang(University of Washington), Yuichiro Yano(University of Washington), Naohiro Yonemoto(University of Washington), Chuanhua Yu(University of Washington), Ismaeel Yunusa(University of Washington), Siddhesh Zadey(University of Washington), Михаил Сергеевич Застрожин(University of Washington), Anasthasia Zastrozhina(University of Washington), Zhi-Jiang Zhang(University of Washington), Christopher J L Murray(University of Washington), Theo Vos(University of Washington)
The Lancet Public Health
January 6, 2022
10.1016/s2468-2667(21)00249-8
Cited by 5,026Open Access
Full Text

Abstract

BACKGROUND: Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. METHODS: We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. FINDINGS: We estimated that the number of people with dementia would increase from 57·4 (95% uncertainty interval 50·4-65·1) million cases globally in 2019 to 152·8 (130·8-175·9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0·1% [-7·5 to 10·8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1·69 [1·64-1·73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1·67 [1·52-1·85]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41-67]) and western Europe (74% [58-90]), and the largest in north Africa and the Middle East (367% [329-403]) and eastern sub-Saharan Africa (357% [323-395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. INTERPRETATION: Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. FUNDING: Bill & Melinda Gates Foundation and Gates Ventures.

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