Global, regional, and national burden of Alzheimer's disease and other dementias, 1990–2019

Abstract

BackgroundWith the increase in the aging population worldwide, Alzheimer's disease has become a rapidly increasing public health concern. Monitoring the dementia disease burden will support health development strategies by providing scientific data.MethodsBased on the data obtained from the 2019 Global Burden of Disease (GBD) database, the numbers and age-standardized rates (ASRs) of incidence, prevalence, death, and disability-adjusted life-years (DALYs) of Alzheimer's disease and other dementias from 1990 to 2019 were analyzed. Calculated estimated annual percentage changes (EAPCs) and Joinpoint regression analyses were performed to evaluate the trends during this period. We also evaluated the correlations between the epidemiology and the sociodemographic index (SDI), an indicator to evaluate the level of social development in a country or region considering the education rate, economic situation, and total fertility rate.ResultsFrom 1990 to 2019, the incidence and prevalence of Alzheimer's disease and other dementias increased by 147.95 and 160.84%, respectively. The ASR of incidence, prevalence, death, and DALYs in both men and women consistently increased over the study period. All the ASRs in women were consistently higher than those in men, but the increases were more pronounced in men. In addition, the ASRs of incidence, prevalence, and DALYs were positively correlated with the SDI. Moreover, the proportion of patients over 70 years old with dementia was also positively correlated with the SDI level. Smoking was a major risk factor for the disease burden of dementia in men, while obesity was the major risk factor for women.ConclusionFrom 1990 to 2019, the Alzheimer's disease burden increased worldwide. This trend was more serious in high-SDI areas, especially among elderly populations in high-SDI areas, who should receive additional attention. Policy-makers should take steps to reverse this situation. Notably, women were at a higher risk for the disease, but the risk in men showed a faster increase. We should give attention to the aging population, attach importance to interventions targeting dementia risk factors, and formulate action plans to address the increasing incidence of dementia.

Can chronic therapeutic drug use by the elderly affect Alzheimer’s disease risk and rate of progression?

“…Although the main risk factor for AD is age, all robust epidemiological studies agree that other relevant risk factors are diabetes, hypertension, and/or hypercholesterolemia, that is, people who have one or more of these conditions are more likely to develop AD-type dementia [1,2,25]. The hypothesis put forward in this article is that it is not the disease, but the chronic medication against diabetes, hypertension, and/or hypercholesterolemia that is the cause of the increased risk of AD.…”

“…However, humans have managed to extend life in the most technically and scientifically developed countries, but with the risk of suffering serious age-related diseases. One of them, Alzheimer's disease (AD), whose global burden on Earth is extreme, is among the most serious diseases of the elderly and scientists have found no cures or effective treatments [1,2].…”

“…The Alzheimer's Association claims: "Dementia is an overall term for diseases and conditions characterized by a decline in memory, language, problem-solving, and other thinking skills." [2][3][4].…”

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“…The important rise in life expectancy strongly increased the impact of neurodegenerative diseases related to aging. It is estimated that there are more than 55 million people affected by dementia [ 1 ], with 150 million cases predicted by 2050 worldwide [ 2 ]. These are alarming figures considering that a non-specifical global decline in cognition was found in approximately 25–50% of the community-dwelling older adults [ 3 ].…”

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“…The burden of dementia has substantially increased over the recent decades [previously estimated as a 117% increase from 1990 to 2016 (1)], exerting public health and financial burden. Recent epidemiological figures demonstrated that nearly 57 million people were living with dementia in 2019, which is projected to increase to 153 million by 2050 (2).…”