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. 2018 Feb;14(2):121-129.
doi: 10.1016/j.jalz.2017.10.009. Epub 2017 Dec 7.

Forecasting the prevalence of preclinical and clinical Alzheimer's disease in the United States

Ron Brookmeyer  1 , Nada Abdalla  2 , Claudia H Kawas  3 , María M Corrada  4
Affiliations

Forecasting the prevalence of preclinical and clinical Alzheimer's disease in the United States

Ron Brookmeyer et al. Alzheimers Dement. 2018 Feb.

Abstract

Introduction: We forecast the prevalence of preclinical and clinical Alzheimer's disease (AD) and evaluated potential impacts of primary and secondary preventions in the United States.

Methods: We used a multistate model incorporating biomarkers for preclinical AD with US population projections.

Results: Approximately 6.08 million Americans had either clinical AD or mild cognitive impairment due to AD in 2017 and that will grow to 15.0 million by 2060. In 2017, 46.7 million Americans had preclinical AD (amyloidosis, neurodegeneration, or both), although many may not progress to clinical disease during their lifetimes. Primary and secondary preventions have differential impact on future disease burden.

Discussion: Because large numbers of persons are living with preclinical AD, our results underscore the need for secondary preventions for persons with existing AD brain pathology who are likely to develop clinical disease during their lifetimes as well as primary preventions for persons without preclinical disease.

Keywords: Alzheimer's disease; Forecast; Intervention; Prediction; Prevalence; Prevention; Statistics.

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Conflict of interest statement

Declaration of Interests:

RB reports fees from Takeda Inc. for serving as a member of a data safety monitoring board. NA has nothing to disclose. CK has nothing to disclose. MMC has nothing to disclose.

Figures

Figure 1
Figure 1
Multistate model of the progression of Alzheimer’s disease through preclinical and clinical disease states.
Figure 2
Figure 2
Prevalence (in millions) of Alzheimer’s disease preclinical and clinical disease states in the United States in 2017 by single year of age. Note: The prevalence of MCI (due to AD) includes persons with MCI who have both amyloidosis and neurodegeneration, and also persons with MCI who have only neurodegeneration.
Figure 3
Figure 3
Forecasts of the numbers of persons (in millions) living with Alzheimer’s disease (early or late stage clinical disease) in the United States from 2017–2060 for three prevention intervention scenarios. Note: Primary prevention scenario I reduces the transition rates to amyloidosis by 75% (θ12=θ34=0.25); Secondary prevention scenario II reduces the transition rates to MCI by 50% (θ45=θ36=0.50); Secondary prevention scenario III reduces the transition rates from MCI to Alzheimer’s disease by 25% (θ57=θ67=0.75).
Figure 4
Figure 4
Comparison of age-specific Alzheimer’s disease incidence rates expressed as percent per year from a worldwide systematic review [12] (red curve) and from the multistate model (black curve) on a log scale. Also shown are the AD incidence rates from the multistate model based on the series of high and low transition rates that were used in the sensitivity analysis (black dotted curves).
See this image and copyright information in PMC

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