Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 14;104(11):e41836.
doi: 10.1097/MD.0000000000041836.

The global, regional, and national burdens of dementia in 204 countries and territories from 1990 to 2021: A trend analysis based on the Global Burden of Disease Study 2021

Songxin Zhong  1   2 , Chao Xiao  2 , Rida Li  1   2 , Yining Lan  2 , Chi Gong  1   2 , Changqiang Feng  1   2 , Hengchang Qi  1   2 , Yanni Lin  1 , Chao Qin  2
Affiliations

The global, regional, and national burdens of dementia in 204 countries and territories from 1990 to 2021: A trend analysis based on the Global Burden of Disease Study 2021

Songxin Zhong et al. Medicine (Baltimore). .

Abstract

The global population is aging, and as a consequence, the prevalence of dementia is increasing rapidly. This study aims to analyze trends in the Global Burden of Disease (GBD) and health inequalities for dementia over the period 1990 to 2021. The incidence, prevalence, and disability-adjusted life year rates of dementia in the GBD 2021 database were analyzed at the global, national, and regional levels for the period 1990 to 2021 using Joinpoint 4.9.1.0 software. The trends over the period were assessed using a combination of age-standardized rates, average annual percentage changes (AAPCs), and a sociodemographic index. The analysis revealed that, from 1990 to 2021, the global AAPC in dementia incidence, prevalence, and disability-adjusted life years amounted to 0.06 (95% confidence interval [CI]: 0.05-0.09), 0.09 (95% CI: 0.08-0.10), and 0.03 (95% CI: 0.01-0.05), respectively. Conversely, the mean AAPC in age-standardized mortality rate remained stable at 0 (95% CI: -0.02 to 0.03). The age-standardized incidence rate and age-standardized prevalence rate of dementia exhibited a positive association with sociodemographic index during the study period. The 3 regions with the highest mean AAPC in age-standardized mortality rate among the 21 GBD regions were South Africa, Central Sub-Saharan Africa, and Eastern Sub-Saharan Africa. The findings of the study indicate that the burden of dementia increases with age and is projected to remain on an upward trend until 2040. The GBD has increased significantly from 1990 to 2021, and the prevention and control of dementia represents a long-term and formidable challenge.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Trends in dementias prevalence, incidence, mortality, and disability-adjusted life-years from 1990 to 2021. DALY = disability-adjusted life year rate, SDI = sociodemographic index.
Figure 2.
Figure 2.
Regional age-standardized prevalence rate, age-standardized incidence rate, age-standardized mortality rate, and age-standardized disability-adjusted life-year rate of dementias in 2021. DALY = disability-adjusted life year rate.
Figure 3.
Figure 3.
The average annual percentage change (AAPC) of age-standardized prevalence rate, age-standardized incidence rate, age-standardized mortality rate, and age-standardized disability-adjusted life-year rate of dementias in 21 Global Burden of Disease (GBD) regions from 1990 to 2021. DALY = disability-adjusted life year rate.
Figure 4.
Figure 4.
Age-standardized burden rate attributable to dementias across 21 Global Burden of Disease regions ranked by sociodemographic index (SDI) for both sexes, 1990–2019. The black line was an adaptive association fitted with adaptive Loess regression based on all data points. ASDR = age-standardized disability-adjusted life-year rate, ASIR = age-standardized incidence rate, ASMR = age-standardized mortality rate, ASPR = age-standardized prevalence rate.
Figure 5.
Figure 5.
Cumulative fraction of population ranker by sociodemographic index (SDI) in 1990 and 2021. (A) Cumulative fraction of age-standardized prevalence rate. (B) Cumulative fraction of age-standardized incidence rate. (C) Cumulative fraction of age-standardized mortality rate. (D) Cumulative fraction of age-standardized disability-adjusted life-year rate. CI = confidence interval, DALY = disability-adjusted life year rate.
Figure 6.
Figure 6.
The global disease burden of dementias for both sexes in 204 countries and territories in 2021. (A) Prevalence, (B) incidence, (C) mortality, and (D) disability-adjusted life-years (DALYs).
Figure 7.
Figure 7.
The global disease burden of dementias for both sexes in 204 countries and territories from 1990 to 2021. (A) Average annual percentage change (AAPC) of age-standardized prevalence rate. (B) AAPC of age-standardized incidence rate. (C) AAPC of age-standardized mortality rate. (D) AAPC of age-standardized disability-adjusted life-year rate. DALY = disability-adjusted life-year.
Figure 8.
Figure 8.
The age-specific numbers and age-standardized prevalence rates (ASPRs) of dementias based by sociodemographic index (SDI) regions in 2021. (A) Prevalence, (B) incidence, (C) mortality, and (D) disability-adjusted life-years (DALYs). ASDR = age-standardized disability-adjusted life-year rate, ASIR = age-standardized incidence rate, ASMR = age-standardized mortality rate.
Figure 9.
Figure 9.
Impact of risk factors on the disease burden of Alzheimer disease by sociodemographic index (SDI) regions and gender in 2021. ASDR = age-standardized disability-adjusted life-year rate, ASMR = age-standardized mortality rate.
Figure 10.
Figure 10.
Future forecasts of global burden of dementias. (A) The forecasts of age-standardized prevalence rate. (B) The forecasts of age-standardized incidence rate. (C) The forecasts of age-standardized mortality rate. (D) The forecasts of age-standardized disability-adjusted life-year rate. ASR = age-standardized rate, DALY = disability-adjusted life-year.
See this image and copyright information in PMC

References

    1. Ritchie K, Lovestone S. The dementias. Lancet. 2002;360:1759–66. - PubMed
    1. Alzheimer’s Association. Alzheimer’s disease facts and figures 2023. Alzheimers Dement. 2023;19:1598–695. - PubMed
    1. Maloney B, Lahiri DK. Epigenetics of dementia: understanding the disease as a transformation rather than a state. Lancet Neurol. 2016;15:760–74. - PubMed
    1. Wimo A, Seeher K, Cataldi R, et al. The worldwide costs of dementia in 2019. Alzheimers Dement. 2023;19:2865–73. - PMC - PubMed
    1. Wang G, Qi J, Liu X, et al. China Alzheimer report 2024. J Diagn Concepts Pract. 2024;23:219–56.