A new global analysis of Alzheimer’s disease and other dementias (ADODs) has revealed significant cross-country disparities in the burden of these conditions, with various sociodemographic factors such as education, income, fertility, and health expenditure playing key roles. Published in the American Journal of Preventive Medicine, this comprehensive study highlights the rising global burden of ADODs over the past three decades, calling for tailored prevention and intervention strategies for different regions.
The study, which spans data from 1990 to 2021, integrates findings from the Global Burden of Disease 2021 study and the World Bank, covering 204 countries and territories. It identifies significant inequalities in the prevalence, rates, and disability-adjusted life years (DALYs) related to ADODs, with considerable variation between countries. Lead investigator Ya Fang, MD, PhD, of the School of Public Health at Xiamen University in China, emphasized the growing global challenge posed by ADODs, noting that the disease is a leading cause of functional loss and dependency among the elderly worldwide. However, Fang points out that there are no definitive treatments for ADODs, and research linking sociodemographic development factors with health disparities in ADODs remains underexplored.
The findings indicate that two-thirds of individuals with ADODs now reside in low- and lower-middle-income countries, where the disease burden is expected to rise at a faster pace than in high-income nations due to factors such as population growth, poverty, and limited healthcare access. Despite the challenges faced by low-income regions, the study also shows that high-income countries, including Luxembourg, Switzerland, and the United States, continue to experience significant ADOD burdens due to lifestyle factors such as obesity, poor diet, and diabetes.
A key takeaway from the study is the gender disparity in the burden of ADODs. Women, across all age groups, were found to carry a significantly higher burden than men, reinforcing previous research that suggests female sex as a risk factor for more rapid cognitive decline. Gender differences in ADOD risk may be linked to reproductive factors, including hormonal fluctuations during premenstrual, perinatal, and menopausal periods, as well as genetic and epigenetic factors. These hormonal changes, particularly fluctuations in estradiol and progesterone during pregnancy, can impact maternal brain structure and function, influencing brain aging and susceptibility to ADODs.
This analysis underscores the need for targeted policies and prevention strategies based on regional sociodemographic factors to effectively address the rising global burden of Alzheimer’s and other dementias. The study advocates for a more nuanced approach to ADOD prevention that considers the specific needs and risks of different populations, particularly in low- and middle-income countries where the disease burden is most pronounced.
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