January 6, 2022

expert reaction to forecasts of global prevalence of dementia by 2050

An analysis published in The Lancet Public Health provides an estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050.

Prof Dag Aarsland, Professor of Old Age Psychiatry at King’s College London’s Institute of psychiatry, Psychology & Neuroscience said:

“This paper, by estimating future changes in risk factors, confirms previous forecasts, suggesting that the number of people with dementia worldwide will increase from 50m in 2019 to more than 150m in 2050, with the largest increase in North Africa and the Middle East. This increase is entirely due to population aging and growth, whereas an increase in key risk factors, such as increasing BMI, were counterbalanced by increases in education attainment. This huge increase highlights the need to allocate sufficient resources for caring for people with dementia, as well as research on how to prevent dementia.”

Hilary Evans, Chief Executive of Alzheimer’s Research UK, said:

“Dementia is our greatest long-term medical challenge. These striking figures lay bare the shocking scale of dementia across the world. Today there are already 57 million people too many living with this devastating condition, and we need to see concerted global action to avoid this number tripling.

“Dementia doesn’t just affect individuals, it can devastate whole families and networks of friends and loved ones. The heartbreaking personal cost of dementia goes hand-in-hand with huge economic and societal impacts, strengthening the case to governments across the world to do more to protect lives now and in the future.

“During the pandemic, we’ve seen how the right investment and leadership can enable innovative approaches to fast-track life-saving vaccines for COVID-19. We must see that same bold, coordinated and ambitious action to make the UK a world-leader to overcome dementia. Today’s news only strengthens our call on the UK government to honour their manifesto pledge to double funding for dementia research, to bring about life-changing treatments.

“The news that almost 7 million new global cases could be down to poor heart health must act as a wakeup call for us all. There is robust evidence that what’s good for the heart is also good for the brain. Not smoking, only drinking within the recommended limits, staying mentally and physically active, eating a balanced diet, and keeping blood pressure and cholesterol levels in check can all help to keep our brains healthy as we age.

“With many thinking about new year resolutions, I would urge people to consider some simple steps we can all take to stay brain healthy. It’s never too early or too late to start and Alzheimer’s Research UK’s Think Brain Health Hub can show you how.”

Prof Bart De Strooper, Director, UK Dementia Research Institute, said:

“The new Global Burden of Disease study is a stark reminder of the growing global challenge of dementia, largely due to population growth and ageing.

“The study considers four recognisable risk factors for dementia – smoking, obesity, high blood sugar, and low education – in building estimates for dementia prevalence across the world. Whilst these play a role in healthier ageing, they are only a part of the bigger picture. For example, the genetic make-up of an individual is at least as great a risk factor for Alzheimer’s disease as lifestyle.

“Whilst stacking the odds in your favour with lifestyle choices is advisable, sadly we know millions of individuals will still go on to develop dementia, and that’s why we urgently need more discovery research that will bolster the race to cures.”

Prof Paul Matthews, Head of the UK Dementia Research Institute, Imperial College London, said:

“This report by a respected expert group extrapolates from recent trends to predict a 2-3 fold increase in the numbers of people living with dementia worldwide by 2050.  The estimate is based on trends in numbers of people with major risk factors such as low education, a history of smoking, obesity or high blood sugar.  

“It sends three clear messages: dementia is a major and rapidly growing threat to future health and social care systems, the problem is global and – even without major new breakthroughs – we can reduce future risks with action to improve educational attainment, eliminate smoking and improve diets and physical activity in our populations.”

Prof John Hardy, Professor of Neuroscience, UCL, said:

“This paper presents a clear prediction, that the aging and increasing populations, especially in non-European populations is going to cause enormous increases in the prevalence of Alzheimer’s and other dementias unless we either develop effective and inexpensive treatments or unless we develop lifestyle strategies which reduce the disease incidence.  This article clearly represents a call for more research in this area.  Epidemiologic analyses in the UK and north America have indicated that the incidence of disease has dropped somewhat over the last 30 years as vascular health has improved through blood pressure control and smoking reduction.  Health education should therefore be part of a mitigation strategy.  Such improvements will not be sufficient to deal with this ageing population driven increase.  Better treatments for this dementia epidemic are as vital as they have been for covid.”

Prof David Curtis, Honorary Professor, UCL Genetics Institute, said:

“The results reported from the modelling in this study are broadly in line with other predictions, that the number of people living with dementia worldwide will increase markedly over the next few decades. The main drivers for this are simply expected increases in population and life expectancy. Unfortunately it is not clear that public health measures to reduce risk factors could have much effect on this, especially because changes which could reduce risk of cerebrovascular dementia, such as improved diet and reduced smoking, would also lead to more people living long enough to develop Alzheimer’s disease. As the authors say, the findings underscore the need for research to find effective treatments for dementia, or better still to prevent it developing in the first place. Given the severity of this problem and the potential benefits, it makes sense to channel huge resources into this search for effective treatments.”

‘Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019’ by the GBD 2019 Dementia Forecasting Collaborators was published in The Lancet Public Health at 23:30 UK time on Thursday 6 January.

DOI: https://doi.org/10.1016/S2468-2667(21)00249-8

Declared interests

Hilary Evans: “No conflicts.”

Prof David Curtis: “I have no conflict of interest to declare.”

None others received.