Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016

GBD 2016 Dementia Collaborators, Emma Nichols, Cassandra E I Szoeke, Stein Emil Vollset, Nooshin Abbasi, Foad Abd-Allah, Jemal Abdela, Miloud Taki Eddine Aichour, Rufus O Akinyemi, Fares Alahdab, Solomon W Asgedom, Ashish Awasthi, Suzanne L Barker-Collo, Bernhard T Baune, Yannick Béjot, Abate B Belachew, Derrick A Bennett, Belete Biadgo, Ali Bijani, Muhammad Shahdaat Bin Sayeed, Carol Brayne, David O Carpenter, Félix Carvalho, Ferrán Catalá-López, Ester Cerin, Jee-Young J Choi, Anh Kim Dang, Meaza G Degefa, Shirin Djalalinia, Manisha Dubey, Eyasu Ejeta Duken, David Edvardsson, Matthias Endres, Sharareh Eskandarieh, Andre Faro, Farshad Farzadfar, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Abadi K Gebre, Demeke Geremew, Maryam Ghasemi-Kasman, Elena V Gnedovskaya, Rajeev Gupta, Vladimir Hachinski, Tekleberhan B Hagos, Samer Hamidi, Graeme J Hankey, Josep M Haro, Simon I Hay, Seyed Sina N Irvani, Ravi P Jha, Jost B Jonas, Rizwan Kalani, André Karch, Amir Kasaeian, Yousef Saleh Khader, Ibrahim A Khalil, Ejaz Ahmad Khan, Tripti Khanna, Tawfik A M Khoja, Jagdish Khubchandani, Adnan Kisa, Katarzyna Kissimova-Skarbek, Mika Kivimäki, Ai Koyanagi, Kristopher J Krohn, Giancarlo Logroscino, Stefan Lorkowski, Marek Majdan, Reza Malekzadeh, Winfried März, João Massano, Getnet Mengistu, Atte Meretoja, Moslem Mohammadi, Maryam Mohammadi-Khanaposhtani, Ali H Mokdad, Stefania Mondello, Ghobad Moradi, Gabriele Nagel, Mohsen Naghavi, Gurudatta Naik, Long H Nguyen, Trang H Nguyen, Yirga L Nirayo, Molly R Nixon, Richard Ofori-Asenso, Felix A Ogbo, Andrew T Olagunju, Mayowa O Owolabi, Songhomitra Panda-Jonas, Valéria M de Azeredo Passos, David M Pereira, Gabriel D Pinilla-Monsalve, Michael A Piradov, Constance D Pond, Hossein Poustchi, Mostafa Qorbani, Amir Radfar, Robert C Reiner Jr, Stephen R Robinson, Gholamreza Roshandel, Ali Rostami, Tom C Russ, Perminder S Sachdev, Hosein Safari, Saeid Safiri, Ramesh Sahathevan, Yahya Salimi, Maheswar Satpathy, Monika Sawhney, Mete Saylan, Sadaf G Sepanlou, Azadeh Shafieesabet, Masood A Shaikh, Mohammad Ali Sahraian, Mika Shigematsu, Rahman Shiri, Ivy Shiue, João P Silva, Mari Smith, Soheila Sobhani, Dan J Stein, Rafael Tabarés-Seisdedos, Marcos R Tovani-Palone, Bach X Tran, Tung Thanh Tran, Amanuel T Tsegay, Irfan Ullah, Narayanaswamy Venketasubramanian, Vasily Vlassov, Yuan-Pang Wang, Jordan Weiss, Ronny Westerman, Tissa Wijeratne, Grant M A Wyper, Yuichiro Yano, Ebrahim M Yimer, Naohiro Yonemoto, Mahmoud Yousefifard, Zoubida Zaidi, Zohreh Zare, Theo Vos, Valery L Feigin, Christopher J L Murray, GBD 2016 Dementia Collaborators, Emma Nichols, Cassandra E I Szoeke, Stein Emil Vollset, Nooshin Abbasi, Foad Abd-Allah, Jemal Abdela, Miloud Taki Eddine Aichour, Rufus O Akinyemi, Fares Alahdab, Solomon W Asgedom, Ashish Awasthi, Suzanne L Barker-Collo, Bernhard T Baune, Yannick Béjot, Abate B Belachew, Derrick A Bennett, Belete Biadgo, Ali Bijani, Muhammad Shahdaat Bin Sayeed, Carol Brayne, David O Carpenter, Félix Carvalho, Ferrán Catalá-López, Ester Cerin, Jee-Young J Choi, Anh Kim Dang, Meaza G Degefa, Shirin Djalalinia, Manisha Dubey, Eyasu Ejeta Duken, David Edvardsson, Matthias Endres, Sharareh Eskandarieh, Andre Faro, Farshad Farzadfar, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Abadi K Gebre, Demeke Geremew, Maryam Ghasemi-Kasman, Elena V Gnedovskaya, Rajeev Gupta, Vladimir Hachinski, Tekleberhan B Hagos, Samer Hamidi, Graeme J Hankey, Josep M Haro, Simon I Hay, Seyed Sina N Irvani, Ravi P Jha, Jost B Jonas, Rizwan Kalani, André Karch, Amir Kasaeian, Yousef Saleh Khader, Ibrahim A Khalil, Ejaz Ahmad Khan, Tripti Khanna, Tawfik A M Khoja, Jagdish Khubchandani, Adnan Kisa, Katarzyna Kissimova-Skarbek, Mika Kivimäki, Ai Koyanagi, Kristopher J Krohn, Giancarlo Logroscino, Stefan Lorkowski, Marek Majdan, Reza Malekzadeh, Winfried März, João Massano, Getnet Mengistu, Atte Meretoja, Moslem Mohammadi, Maryam Mohammadi-Khanaposhtani, Ali H Mokdad, Stefania Mondello, Ghobad Moradi, Gabriele Nagel, Mohsen Naghavi, Gurudatta Naik, Long H Nguyen, Trang H Nguyen, Yirga L Nirayo, Molly R Nixon, Richard Ofori-Asenso, Felix A Ogbo, Andrew T Olagunju, Mayowa O Owolabi, Songhomitra Panda-Jonas, Valéria M de Azeredo Passos, David M Pereira, Gabriel D Pinilla-Monsalve, Michael A Piradov, Constance D Pond, Hossein Poustchi, Mostafa Qorbani, Amir Radfar, Robert C Reiner Jr, Stephen R Robinson, Gholamreza Roshandel, Ali Rostami, Tom C Russ, Perminder S Sachdev, Hosein Safari, Saeid Safiri, Ramesh Sahathevan, Yahya Salimi, Maheswar Satpathy, Monika Sawhney, Mete Saylan, Sadaf G Sepanlou, Azadeh Shafieesabet, Masood A Shaikh, Mohammad Ali Sahraian, Mika Shigematsu, Rahman Shiri, Ivy Shiue, João P Silva, Mari Smith, Soheila Sobhani, Dan J Stein, Rafael Tabarés-Seisdedos, Marcos R Tovani-Palone, Bach X Tran, Tung Thanh Tran, Amanuel T Tsegay, Irfan Ullah, Narayanaswamy Venketasubramanian, Vasily Vlassov, Yuan-Pang Wang, Jordan Weiss, Ronny Westerman, Tissa Wijeratne, Grant M A Wyper, Yuichiro Yano, Ebrahim M Yimer, Naohiro Yonemoto, Mahmoud Yousefifard, Zoubida Zaidi, Zohreh Zare, Theo Vos, Valery L Feigin, Christopher J L Murray

Abstract

Background: The number of individuals living with dementia is increasing, negatively affecting families, communities, and health-care systems around the world. A successful response to these challenges requires an accurate understanding of the dementia disease burden. We aimed to present the first detailed analysis of the global prevalence, mortality, and overall burden of dementia as captured by the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016, and highlight the most important messages for clinicians and neurologists.

Methods: GBD 2016 obtained data on dementia from vital registration systems, published scientific literature and surveys, and data from health-service encounters on deaths, excess mortality, prevalence, and incidence from 195 countries and territories from 1990 to 2016, through systematic review and additional data-seeking efforts. To correct for differences in cause of death coding across time and locations, we modelled mortality due to dementia using prevalence data and estimates of excess mortality derived from countries that were most likely to code deaths to dementia relative to prevalence. Data were analysed by standardised methods to estimate deaths, prevalence, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs; computed as the sum of YLLs and YLDs), and the fractions of these metrics that were attributable to four risk factors that met GBD criteria for assessment (high body-mass index [BMI], high fasting plasma glucose, smoking, and a diet high in sugar-sweetened beverages).

Findings: In 2016, the global number of individuals who lived with dementia was 43·8 million (95% uncertainty interval [UI] 37·8-51·0), increased from 20.2 million (17·4-23·5) in 1990. This increase of 117% (95% UI 114-121) contrasted with a minor increase in age-standardised prevalence of 1·7% (1·0-2·4), from 701 cases (95% UI 602-815) per 100 000 population in 1990 to 712 cases (614-828) per 100 000 population in 2016. More women than men had dementia in 2016 (27·0 million, 95% UI 23·3-31·4, vs 16.8 million, 14.4-19.6), and dementia was the fifth leading cause of death globally, accounting for 2·4 million (95% UI 2·1-2·8) deaths. Overall, 28·8 million (95% UI 24·5-34·0) DALYs were attributed to dementia; 6·4 million (95% UI 3·4-10·5) of these could be attributed to the modifiable GBD risk factors of high BMI, high fasting plasma glucose, smoking, and a high intake of sugar-sweetened beverages.

Interpretation: The global number of people living with dementia more than doubled from 1990 to 2016, mainly due to increases in population ageing and growth. Although differences in coding for causes of death and the heterogeneity in case-ascertainment methods constitute major challenges to the estimation of the burden of dementia, future analyses should improve on the methods for the correction of these biases. Until breakthroughs are made in prevention or curative treatment, dementia will constitute an increasing challenge to health-care systems worldwide.

Funding: Bill & Melinda Gates Foundation.

Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Figures

Figure 1
Figure 1
Age-standardised prevalence for Alzheimer's disease and other dementias per 100 000 population by location for both sexes, 2016 ATG=Antigua and Barbuda. FSM=Federated States of Micronesia. Isl=Islands. LCA=Saint Lucia. TLS=Timor-Leste. TTO=Trinidad and Tobago. VCT=Saint Vincent and the Grenadines.
Figure 2
Figure 2
Global years lived with disability (YLDs) and years of life lost (YLLs) rates per 100 000 population due to Alzheimer's disease and other dementias by age, 2016 Values are plotted at the midpoint of 5-year age categories. Shaded areas show 95% uncertainty intervals.
Figure 3
Figure 3
Global age-standardised prevalence of Alzheimer's disease and other dementias by sex, 2016 Prevalence expressed as the percentage of the population that was affected by the disease. Values are plotted at the midpoint of 5-year age categories. Shading indicates 95% uncertainty intervals.
Figure 4
Figure 4
Age-standardised disability-adjusted-life-year (DALY)rates for Alzheimer's disease and other dementias by Socio-demographic Index (SDI), 1990–2016 The black line represents expected values of age-standardised DALY rates for each value of SDI.

References

    1. Prince MJ. World Alzheimer report 2015: the global impact of dementia. 2015. published online Aug 25.
    1. Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement. 2013;9:63–75.
    1. Wu Y-T, Beiser AS, Breteler MMB. The changing prevalence and incidence of dementia over time—current evidence. Nat Rev Neurol. 2017;13:327.
    1. Etters L, Goodall D, Harrison BE. Caregiver burden among dementia patient caregivers: A review of the literature. J Am Acad Nurse Pract. 2008;20:423–428.
    1. Livingston G, Sommerlad A, Orgeta V. Dementia prevention, intervention, and care. Lancet. 2017;390:2673–2734.
    1. Elwood P, Galante J, Pickering J. Healthy lifestyles reduce the incidence of chronic diseases and dementia: evidence from the Caerphilly Cohort Study. PLoS One. 2013;8:e81877.
    1. Chen H, Kwong JC, Copes R. Living near major roads and the incidence of dementia, Parkinson's disease, and multiple sclerosis: a population-based cohort study. Lancet. 2017;389:718–726.
    1. Anstey KJ, Cherbuin N, Budge M, Young J. Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obes Rev. 2011;12:e426–e437.
    1. Anstey KJ, Lipnicki DM, Low L-F. Cholesterol as a risk factor for dementia and cognitive decline: a systematic review of prospective studies with meta-analysis. Am J Geriatr Psychiatry. 2008;16:343–354.
    1. Satizabal CL, Beiser AS, Chouraki V, Chêne G, Dufouil C, Seshadri S. Incidence of dementia over three decades in the Framingham Heart Study. N Engl J Med. 2016;374:523–532.
    1. Schrijvers EMC, Verhaaren BFJ, Koudstaal PJ, Hofman A, Ikram MA, Breteler MMB. Is dementia incidence declining?: trends in dementia incidence since 1990 in the Rotterdam Study. Neurology. 2012;78:1456–1463.
    1. Ferri CP, Prince M, Brayne C. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005;366:2112–2117.
    1. Naghavi M, Abajobir AA, Abbafati C. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1151–1210.
    1. GBD 2016 Risk Factors Collaborators Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1345–1422.
    1. Vos T, Abajobir AA, Abate KH. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1211–1259.
    1. Hay SI, Abajobir AA, Abate KH. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1260–1344.
    1. WHO . World Health Organization; Geneva: 1992. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidlines.
    1. American Psychiatric Association . 5th edn. American Psychiatric Association; Washington DC: 2013. Diagnostic and statistical manual of mental disorders.
    1. Wu Y-T, Beiser AS, Breteler MMB. The changing prevalence and incidence of dementia over time—current evidence. Nat Rev Neurol. 2017;13:327.
    1. Satizabal CL, Beiser AS, Chouraki V, Chêne G, Dufouil C, Seshadri S. Incidence of dementia over three decades in the Framingham Heart Study. N Engl J Med. 2016;374:523–532.
    1. Rocca WA, Petersen RC, Knopman DS. Trends in the incidence and prevalence of Alzheimer's disease, dementia, and cognitive impairment in the United States. Alzheimers Dement. 2011;7:80–93.
    1. Foreman KJ, Lozano R, Lopez AD, Murray CJ. Modeling causes of death: an integrated approach using CODEm. Popul Health Metr. 2012;10:1.
    1. Flaxman AD, Vos T, Murray CJL. University of Washington Press; Seattle: 2015. An integrative metaregression framework for descriptive epidemiology.
    1. Caamaño-Isorna F, Corral M, Montes-Martínez A, Takkouche B. Education and dementia: a meta-analytic study. Neuroepidemiology. 2006;26:226–232.
    1. Anstey KJ, von Sanden C, Salim A, O'Kearney R. Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies. Am J Epidemiol. 2007;166:367–378.
    1. Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982;140:566–572.
    1. Salomon JA, Haagsma JA, Davis A. Disability weights for the Global Burden of Disease 2013 study. Lancet Glob Health. 2015;3:e712–e723.
    1. GBD 2016 Mortality Collaborators Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1084–1150.
    1. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385:117–171.
    1. Gauthier S, Albert M, Fox N. Why has therapy development for dementia failed in the last two decades? Alzheimers Dement. 2016;12:60–64.
    1. Cummings JL, Morstorf T, Zhong K. Alzheimer's disease drug-development pipeline: few candidates, frequent failures. Alzheimers Res Ther. 2014;6:37.
    1. Calcoen D, Elias L, Yu X. What does it take to produce a breakthrough drug? Nat Rev Drug Discov. 2015;14:161–162.
    1. Sperling RA, Aisen PS, Beckett LA. Toward defining the preclinical stages of Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011;7:280–292.
    1. Daviglus ML, Bell CC, Berrettini W. NIH state-of-the-science conference statement: preventing Alzheimer's disease and cognitive decline. NIH Consens State Sci Statements. 2010;27:1–30.
    1. WHO Guideline development group meeting for WHO guidelines on risk reduction of cognitive decline and dementia. Geneva: WHO.
    1. Brookmeyer R, Johnson E, Ziegler-Graham K, Arrighi HM. Forecasting the global burden of Alzheimer's disease. Alzheimers Dement. 2007;3:186–191.
    1. Wimo A, Guerchet M, Ali G-C. The worldwide costs of dementia 2015 and comparisons with 2010. Alzheimers Dement. 2017;13:1–7.
    1. Wu Y-T, Ali G-C, Guerchet M. Prevalence of dementia in mainland China, Hong Kong and Taiwan: an updated systematic review and meta-analysis. Int J Epidemiol. 2018;47:709–719.
    1. De Reuck J, Deramecourt V, Cordonnier C. The incidence of post-mortem neurodegenerative and cerebrovascular pathology in mixed dementia. J Neurol Sci. 2016;366:164–166.
    1. Jack CR, Bennett DA, Blennow K. A/T/N: An unbiased descriptive classification scheme for Alzheimer disease biomarkers. Neurology. 2016;87:539–547.
    1. Perneczky R, Tene O, Attems J. Is the time ripe for new diagnostic criteria of cognitive impairment due to cerebrovascular disease? Consensus report of the International Congress on Vascular Dementia working group. BMC Med. 2016;14:162.
    1. Perera G, Pedersen L, Ansel D. Dementia prevalence and incidence in a federation of European Electronic Health Record databases: the European Medical Informatics Framework resource. Alzheimers Dement. 2018;14:130–139.
    1. van Bussel EF, Richard E, Arts DL. Dementia incidence trend over 1992-2014 in the Netherlands: analysis of primary care data. PLoS Med. 2017;14:e1002235.
    1. Amra S, O'Horo JC, Singh TD. Derivation and validation of the automated search algorithms to identify cognitive impairment and dementia in electronic health records. J Crit Care. 2017;37:202–205.
    1. Bennett DA, Brayne C, Feigin VL. Development of the standards of reporting of neurological disorders (STROND) checklist: a guideline for the reporting of incidence and prevalence studies in neuroepidemiology. Eur J Epidemiol. 2015;30:569–576.

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