Global dementia cases forecasted to triple by 2050
New analysis shows a decrease in prevalence due to education countered by increase due to heart health risk factors

Date:
July 27, 2021
Source:
Alzheimer's Association
Summary:
Positive trends in global education access are expected to decrease
dementia prevalence worldwide by 6.2 million cases by the year 2050.

Meanwhile, anticipated trends in smoking, high body mass index and
high blood sugar are predicted to increase prevalence by nearly
the same number: 6.8 million cases.



FULL STORY ========================================================================== Positive trends in global education access are expected to decrease
dementia prevalence worldwide by 6.2 million cases by the year
2050. Meanwhile, anticipated trends in smoking, high body mass index and
high blood sugar are predicted to increase prevalence by nearly the same number: 6.8 million cases.

Both according to new global prevalence data reported at the Alzheimer's Association International Conference(R) (AAIC(R)) 2021 in Denver and
virtually.


==========================================================================
With these forecasts incorporated, researchers with the Institute for
Health Metrics and Evaluation at the University of Washington School of Medicine reported at AAIC 2021 that they estimate the number of people
with dementia will nearly triple to more than 152 million by 2050. The
highest increase in prevalence is projected to be in eastern sub-Saharan Africa, North Africa and the Middle East.

"Improvements in lifestyle in adults in developed countries and other
places - - including increasing access to education and greater attention
to heart health issues -- have reduced incidence in recent years, but
total numbers with dementia are still going up because of the aging of
the population," said Maria C. Carrillo, Ph.D., Alzheimer's Association
chief science officer. "In addition, obesity, diabetes and sedentary
lifestyles in younger people are rising quickly, and these are risk
factors for dementia." The U.S. National Institute on Aging estimates
people over the age of 65 will make up 16% of the world's population by
2050 -- up from 8% in 2010.

Also reported at AAIC 2021 were two other prevalence/incidence
studies. Key findings include:
* Each year, an estimated 10 in every 100,000 individuals develop
dementia
with early onset (prior to age 65). This corresponds to 350,000
new cases of early onset dementia per year, globally.

* From 1999 to 2019, the U.S. mortality rate from Alzheimer's in the
overall population significantly increased from 16 to 30 deaths
per 100,000, an 88% increase.

* Among all areas of the U.S., mortality rates for Alzheimer's
were highest
in rural areas in the East South Central region of the U.S., where
the death rate from Alzheimer's is 274 per 100,000 in those over 65.

Global Prevalence of Dementia Expected to Grow Rapidly through 2050 To
more accurately forecast global dementia prevalence and produce country-
level estimates, Emma Nichols, MPH, a researcher with the Institute for
Health Metrics and Evaluation at the University of Washington School
of Medicine, and colleagues leveraged data from 1999 to 2019 from the
Global Burden of Disease (GBD) study, a comprehensive set of estimates
of health trends worldwide. This study also aimed to improve on prior
forecasts by incorporating information on trends in dementia risk factors.



========================================================================== Nichols and team found dementia would increase from an estimated 57.4
(50.4 to 65.1) million cases globally in 2019 to an estimated 152.8
(130.8 to 175.6) million cases in 2050. The highest increases were
observed in eastern sub- Saharan Africa, North Africa and the Middle
East. Their analysis suggested that projected increases in cases could
largely be attributed to population growth and aging, although the
relative importance of these two factors varied by world region.

What's more, Nichols and team forecasted dementia prevalence attributable
to smoking, high body mass index (BMI) and high fasting plasma glucose
using the expected relationship between these risk factors and dementia prevalence. They found an increase of 6.8 million dementia cases globally between 2019 and 2050 due specifically to expected changes in these risk factors. Separately and conversely, the researchers found that expected
changes in education levels will lead to a decline in dementia prevalence
of 6.2 million individuals globally between 2019 and 2050. Taken together, these opposing trends come close to balancing each other out.

"These estimates will allow policymakers and decision makers to better understand the expected increases in the number of individuals with
dementia as well as the drivers of these increases in a given geographical setting," Nichols said. "The large anticipated increase in the number of individuals with dementia emphasizes the vital need for research focused
on the discovery of disease-modifying treatments and effective low-cost interventions for the prevention or delay of dementia onset." Recently published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association, Nichols and team used the same data set to estimate that Alzheimer's mortality rates increased by 38.0% between 1990 and 2019.

"Without effective treatments to stop, slow or prevent Alzheimer's and
all dementia, this number will grow beyond 2050 and continue to impact individuals, caregivers, health systems and governments globally,"
Carrillo said. "In addition to therapeutics, it's critical to uncover culturally-tailored interventions that reduce dementia risk through
lifestyle factors like education, diet and exercise." The Alzheimer's Association U.S. Study to Protect Brain Health Through Lifestyle
Intervention to Reduce Risk (U.S. POINTER) is a two-year clinical trial
to evaluate whether lifestyle interventions that simultaneously target
many risk factors protect cognitive function in older adults who are at increased risk for cognitive decline.



========================================================================== Incidence Estimates for Younger Onset Dementia Suggest 350,000 New Cases
per Year Data on younger-onset dementia (YOD), a form of dementia where
the onset of symptoms happens before age 65, is extremely limited. To
better understand the incidence of YOD, Stevie Hendriks, M.Sc., student
at Maastricht University in the Netherlands, and colleagues conducted a systematic literature review of all studies published during the past
30 years that reported figures on how many people developed dementia
before the age of 65.

Hendriks and team found that, overall, the global incidence rate was
10 new cases each year per 100,000 persons. They also found incidence
increases with age. This suggests that around 350,000 people worldwide
develop younger-onset dementia every year. Incidence rates for men and
women were similar, and were highest for Alzheimer's disease, followed
by vascular dementia and frontotemporal dementia.

"Our findings should raise awareness in healthcare professionals,
researchers and policy makers because they show that a significant
number of people are newly affected by young-onset dementia every year," Hendriks said. "This shows the need for investment in tailored healthcare
for this special patient group and more research into how we can best
support but also prevent and treat young-onset dementia." "People living
with younger-onset Alzheimer's face unique challenges when it comes to diagnosis, family, work, finances, future care and -- with the recent
FDA action -- possible treatment options. But support and information is available," said Kristen Clifford, Alzheimer's Association chief program officer. "And you have the power to make a new plan and determine how you choose to live your best life with the disease." Rural Areas of American
South Experience Disproportionate Burden of Alzheimer's Mortality Even
though average lifespan has been steadily increasing over the past several decades in the U.S., there is an increasing divergence in mortality rates
among urban and rural populations. This discrepancy is likely the result
of many health disparities experienced by rural residents compared to
their urban counterparts, including lower socio-economic status, higher
levels of chronic disease, limited availability of internet services,
and less access to health services including primary care.

To specifically understand geographic variations in Alzheimer's disease mortality, Ambar Kulshreshtha, M.D., Ph.D., from Emory University,
and colleagues used data from the National Center for Health Statistics
to examine trends in Alzheimer's death rates between 1999 and 2019 by urbanization levels.

Kulshreshtha and team found that, from 1999 to 2019, the mortality rate
from Alzheimer's in the overall population significantly increased from
16 to 30 deaths per 100,000, an 88% increase. Rural areas across the
United States were shown to have higher mortality rates from Alzheimer's compared to urban areas.

Those rates were highest in rural areas in the East South Central region
at 274 per 100,000 in those 65 years and older, more than three times
that of urban areas in the mid-Atlantic region in which mortality rates
were the lowest.

"Our work shows that there is an increasing discrepancy in Alzheimer's mortality between urban and rural areas. This discrepancy could
be related to, or might be the result of, other urban-rural health
disparities, including access to primary care and other health services, socio-economic level, time to diagnosis, and the rising proportion of
older Americans living in these areas," Kulshreshtha said. "Identifying
and understanding the reasons for these health disparities is critical
for allocating key social and public health resources appropriately."
This study was partially funded by the Alzheimer's Association.

========================================================================== Story Source: Materials provided by Alzheimer's_Association. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Emma Nichols, Theo Vos. Estimating the global mortality from
Alzheimer's
disease and other dementias: A new method and results from the
Global Burden of Disease study 2019. Alzheimer's & Dementia, 2020;
16 (S10) DOI: 10.1002/alz.042236 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/07/210727171713.htm

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