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Prince M, Ali GC, Guerchet M, Prina AM, Albanese E, Wu YT. Recent global trends in the prevalence and incidence of dementia, and survival with dementia. Alzheimers Res Ther 2016; 8:23. [PMID: 27473681 PMCID: PMC4967299 DOI: 10.1186/s13195-016-0188-8] [Citation(s) in RCA: 490] [Impact Index Per Article: 61.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 04/20/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND Current projections of the scale of the coming dementia epidemic assume that the age- and sex-specific prevalence of dementia will not vary over time, and that population ageing alone (increasing the number of older people at risk) drives the projected increases. The basis for this assumption is doubtful, and secular trends (that is, gradual decreases or increases in prevalence over long-term periods) are perfectly plausible. METHODS We carried out a systematic review of studies of trends in prevalence, incidence and mortality for people with dementia, conducted since 1980. RESULTS We identified nine studies that had tracked dementia prevalence, eight that had tracked dementia incidence, and four that had tracked mortality among people with dementia. There was some moderately consistent evidence to suggest that the incidence of dementia may be declining in high-income countries. Evidence on trends in the prevalence of dementia were inconsistent across studies and did not suggest any clear overall effect. Declining incidence may be balanced by longer survival with dementia, although mortality trends have been little studied. There is some evidence to suggest increasing prevalence in East Asia, consistent with worsening cardiovascular risk factor profiles, although secular changes in diagnostic criteria may also have contributed. CONCLUSIONS We found no evidence to suggest that the current assumption of constant age-specific prevalence of dementia over time is ill-founded. However, there remains some uncertainty as to the future scale of the dementia epidemic. Population ageing seems destined to play the greatest role, and prudent policymakers should plan future service provision based upon current prevalence projections. Additional priorities should include investing in brain health promotion and dementia prevention programs, and monitoring the future course of the epidemic to chart the effectiveness of these measures.
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Affiliation(s)
- Martin Prince
- The Global Observatory for Ageing and Dementia Care, Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, PO 36, David Goldberg Centre, De Crespigny Park, London, SE5 8AF, UK.
| | - Gemma-Claire Ali
- The Global Observatory for Ageing and Dementia Care, Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, PO 36, David Goldberg Centre, De Crespigny Park, London, SE5 8AF, UK.,Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Maëlenn Guerchet
- The Global Observatory for Ageing and Dementia Care, Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, PO 36, David Goldberg Centre, De Crespigny Park, London, SE5 8AF, UK
| | - A Matthew Prina
- The Global Observatory for Ageing and Dementia Care, Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, PO 36, David Goldberg Centre, De Crespigny Park, London, SE5 8AF, UK
| | | | - Yu-Tzu Wu
- Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
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