Alzheimer's disease epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Overview

Alzheimer's disease is the most frequently observed form of dementia, and it typically develops in elderly patients. An estimated 5.5 million Americans of all ages have Alzheimer's disease. An estimated 10,000 per 100,000 individuals aged greater than 65 years have been known to be living with Alzheimer's disease in the United States. Alzheimer's disease has been known to affect females more than males. African Americans and Hispanics are more likely to develop Alzheimer's disease than older whites. AD is diagnosed in people over 65 years of age, although the less prevalent early-onset Alzheimer's can occur much earlier.

Epidemiology and Demographics

Alzheimer's disease (AD) is the most common type of dementia observed in the elderly; it affects almost half of all patients with dementia. Correspondingly, advancing age is the primary risk factor for the development of AD.[1][2]

Prevalence

  • An estimated 47 million people worldwide have Alzheimer's disease according to the World Health Organization (WHO).[3]
  • An estimated 5.5 million Americans of all ages have Alzheimer's disease[4]
  • An estimated 10,000 per 100,000 individuals aged greater than 65 years have been known to be living with Alzheimer's disease in the United States[4]

Trends in United states

  • The following table outlines the general prevalence trends according to age in the United States:[5][6][7]
Age (years) All dementia per 100,000 individuals Alzheimer's disease (AD) per 100,000 individuals
Combined Men Women Combined Men Women
71–79 4970 525 4760 2320 2300 2330
80–89 24190 17680 27840 18100 12330 21340
90+ 3720 44590 34690 2960 33890 28150
Total 13670 10800 15530 9510 6770 11290

Developing countries

  • Prevalence rates in developing regions are lower[8]
  • Low prevalence of dementia has been reported in India and sub-Saharan Africa

Trends in developing countries

Asia Year Diagnostic criteria Age Prevalence (All dementia)

per 100,000 individuals

Prevalence of Alzheimer's dementia per 100,000 individuals Causes of other dementia
China 2007 DSM-III, ICD-10 >65 3100 2000 Mixed, PDD, DLB,FTD
China (Beijing, Xian, Shanghai, Chengdu) 2005 DSM-IV >65 5000 3500 Mixed, PDD, DLB
Taiwan 1995-1998 DSM-IIIR, DSM-IV >65 3200 1900 Mixed
South Korea 1994-2005 DSM-III, DSM-IV >65 10100 5200 Mixed
Thailand 2001 DSM-III >60 3400 - -.
India 1996-2006 DSM-III, DSM-IV >65 2700 1300 Mixed, PDD, DLB, PSD
Sri Lanka 2003 DSM-IV >65 3980 2850 Mixed
Israel (Wadi Ara) 2002 DSM-IV >65 21100 20500 Mixed
Africa
Egypt 1998 DSM-IV >65 5930 2860 Mixed
Nigeria 1995 DSM-III, ICD-10 >65 2300 1400 Mixed, DLB
Latin America
Cuba 1999 DSM-IV >60 8.200 5100 Mixed, alcohol dementia
Argentina 1999 DSM-IV >65 11.500 - Age
Brazil 2002-2008 DSM-IIIR, DSM-IV >65 5300 2700 Mixed, PDD
Chile 1997 DSM-IIIR >65 4300 - -
Colombia 2000 DSM-IV >65 and >75 1800 - -
Peru 2007 DSM-IV >65 6700 - -
Venezuela 2002 DSM-IV >55 and >65 8000 4000 Mixed

Legend: PDD= Parkinson disease dementia, PSD= Post-stroke dementia, FTD= Fronto-temporal dementia, Mixed= Alzheimer's plus vascular dementia

  • The following bar-chart displays the prevalence of Alzheimer's dementia across different countries based on above data:
Prevalence of Alzheimer's dementia across different geographic locations


Gender

  • Alzheimer's disease has been known to affect females more than males
  • Out of the 5.5 million people age 65 and older with Alzheimer’s in the United States, 3.5 million are women and 2.0 million are men
  • The Framingham Heart Study suggests that because men in middle age have a higher mortality rate from cardiovascular disease than women in middle age, men who survive beyond age 65 may have a healthier cardiovascular risk profile and thus an apparent lower risk for dementia than women of the same age (survival bias)[22]
  • APOE-e4 genotype, has been known to have stronger association with Alzheimer’s dementia in women[23]

Race

  • African Americans and Hispanics are more likely to develop Alzheimer's disease than older whites[24]
  • Dementia incidence is known to be highest in African-Americans, intermediate in Hispanics and lowest for Asian-Americans
  • The prevalence of Alzheimer's disease and other dementias in the United States based on race has been found to be as follows:
    • 6900 per 100,000 of whites, 9400 per 100,000 of African-Americans and 11500 per 100,000 of Hispanics

Mortality rate

The following are the mortality rates for Alzheimer's dementia between 2001 and 2014:[25]

Year Mortality rate per 100,000 individuals
2001 18.9
2002 20.5
2003 21.9
2004 22.5
2005 24.2
2006 24.3
2007 24.8
2008 27.1
2009 25.8
2010 27.0
2011 27.3
2012 26.6
2013 26.8
2014 29.3
  • The following scatter-plot shows the above mentioned data:
Mortality rates of Alzheimer's dementia between 2001 and 2014 (per100,000 individuals)


Age

  • Generally, AD is diagnosed in people over 65 years of age,[26] although the less prevalent early-onset Alzheimer's can occur much earlier
  • The number of people with Alzheimer’s dementia increases with age:
    • 3000 per 100,000 individuals age 65-74
    • 17000 per 100,000 individuals age 75-84
    • 32000 per 100,000 individuals age 85 and older
AD incidence rates
after 65 years of age[27]
Age Incidence
(new affected)
per thousand
person–years
65–69  3
70–74  6
75–79  9
80–84 23
85–89 40
90–   69


References

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