Lifetime risk and projected burden of dementia

doi:10.1038/s41591-024-03340-9

. 2025 Jan 13.

doi: 10.1038/s41591-024-03340-9. Online ahead of print.

Lifetime risk and projected burden of dementia

Michael Fang¹, Jiaqi Hu^{1

2}, Jordan Weiss³, David S Knopman⁴, Marilyn Albert⁵, B Gwen Windham⁶, Keenan A Walker⁷, A Richey Sharrett¹, Rebecca F Gottesman⁸, Pamela L Lutsey⁹, Thomas Mosley⁶, Elizabeth Selvin¹, Josef Coresh^{10

11}

Affiliations

¹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
² Institute for Hospital Management, Tsinghua University, Beijing, China.
³ Optimal Aging Institute and Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA.
⁴ Department of Neurology, Mayo Clinic, Rochester, MN, USA.
⁵ Department of Neurology, Johns Hopkins Medicine, Baltimore, MD, USA.
⁶ Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
⁷ Intramural Research Program, National Institute on Aging, Bethesda, MD, USA.
⁸ Intramural Research Program, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
⁹ Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA.
¹⁰ Optimal Aging Institute and Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA. [email protected].
¹¹ Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA. [email protected].

PMID: 39806070
DOI: 10.1038/s41591-024-03340-9

Lifetime risk and projected burden of dementia

Michael Fang et al. Nat Med. 2025.

. 2025 Jan 13.

doi: 10.1038/s41591-024-03340-9. Online ahead of print.

Authors

Affiliations

¹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
² Institute for Hospital Management, Tsinghua University, Beijing, China.
³ Optimal Aging Institute and Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA.
⁴ Department of Neurology, Mayo Clinic, Rochester, MN, USA.
⁵ Department of Neurology, Johns Hopkins Medicine, Baltimore, MD, USA.
⁶ Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
⁷ Intramural Research Program, National Institute on Aging, Bethesda, MD, USA.
⁸ Intramural Research Program, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
⁹ Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA.
¹⁰ Optimal Aging Institute and Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA. [email protected].
¹¹ Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA. [email protected].

PMID: 39806070
DOI: 10.1038/s41591-024-03340-9

Abstract

Understanding the lifetime risk of dementia can inform public health planning and improve patient engagement in prevention. Using data from a community-based, prospective cohort study (n = 15,043; 26.9% Black race, 55.1% women and 30.8% with at least one apolipoprotein E4 (APOE ε4) allele), we estimated the lifetime risk of dementia (from age 55 years to 95 years), with mortality treated as a competing event. We applied lifetime risk estimates to US Census projections to evaluate the annual number of incident dementia cases from 2020 to 2060. The lifetime risk of dementia after age 55 years was 42% (95% confidence interval: 41-43). Rates were substantially higher in women, Black adults and APOE ε4 carriers, with lifetime risks ranging from approximately 45% to 60% in these populations. The number of US adults who will develop dementia each year was projected to increase from approximately 514,000 in 2020 to approximately 1 million in 2060. The relative growth in new dementia cases was especially pronounced for Black adults. These results highlight the urgent need for policies that enhance healthy aging, with a focus on health equity.

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Conflict of interest statement

Competing interests: D.S.K. has no disclosures relevant to the current work. D.S.K. serves on a Data Safety Monitoring Board for the Dominantly Inherited Alzheimer Network Treatment Unit study. He was an investigator in Alzheimer clinical trials sponsored by Biogen, Eli Lilly Pharmaceuticals and the University of Southern California and is currently an investigator in a trial in frontotemporal degeneration with Alector. He has served as a consultant for Roche, AriBio, Linus Health, Biovie and Alzeca Biosciences but receives no personal compensation. He receives funding from the NIH. The other authors declare no competing interests.

References

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[1] Caplan, Z. US older population grew from 2010 to 2020 at fastest rate since 1880 to 1890. United States Census Bureau. https://www.census.gov/library/stories/2023/05/2020-census-united-states... (2023).

[2] Caplan, Z. US older population grew from 2010 to 2020 at fastest rate since 1880 to 1890. United States Census Bureau. https://www.census.gov/library/stories/2023/05/2020-census-united-states... (2023).

[3] Rajan, K. B. et al. Population estimate of people with clinical Alzheimer’s disease and mild cognitive impairment in the United States (2020–2060). Alzheimers Dement. 17, 1966–1975 (2021). - DOI - PubMed

[4] Rajan, K. B. et al. Population estimate of people with clinical Alzheimer’s disease and mild cognitive impairment in the United States (2020–2060). Alzheimers Dement. 17, 1966–1975 (2021). - DOI - PubMed

[5] Murphy, S., Kochanek, K., Xu, J. & Arias, E. Mortality in the United States, 2020. NCHS Data Brief, No. 427. National Center for Health Statistics. https://www.cdc.gov/nchs/data/databriefs/db427.pdf (2021).

[6] Murphy, S., Kochanek, K., Xu, J. & Arias, E. Mortality in the United States, 2020. NCHS Data Brief, No. 427. National Center for Health Statistics. https://www.cdc.gov/nchs/data/databriefs/db427.pdf (2021).

[7] Nandi, A. et al. Global and regional projections of the economic burden of Alzheimer’s disease and related dementias from 2019 to 2050: a value of statistical life approach. EClinicalMedicine 51, 101580 (2022). - DOI - PubMed - PMC

[8] Nandi, A. et al. Global and regional projections of the economic burden of Alzheimer’s disease and related dementias from 2019 to 2050: a value of statistical life approach. EClinicalMedicine 51, 101580 (2022). - DOI - PubMed - PMC

[9] 2023 Alzheimer’s disease facts and figures. Alzheimers Dement. 19, 1598–1695 (2023).

[10] 2023 Alzheimer’s disease facts and figures. Alzheimers Dement. 19, 1598–1695 (2023).

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Lifetime risk and projected burden of dementia

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Lifetime risk and projected burden of dementia

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