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
- The following table outlines the general prevalence trends in major developing countries:[9][10][11][12][13][14][15][16][17][18][19][20][21]
| 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:
Gender
- 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:
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
| 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
- ↑ Gorelick P (2004). "Risk factors for vascular dementia and Alzheimer disease". Stroke. 35 (11 Suppl 1): 2620–2622. doi:10.1161/01.STR.0000143318.70292.47. PMID 15375299.
- ↑ Hebert L, Scherr P, Bienias J, Bennett D, Evans D (2003). "Alzheimer disease in the U.S. population: prevalence estimates using the 2000 census". Archives of Neurology. 60 (8): 1119–1122. doi:10.1001/archneur.60.8.1119. PMID 12925369.
- ↑ "WHO | Dementia".
- ↑ 4.0 4.1 Hebert LE, Weuve J, Scherr PA, Evans DA (2013). "Alzheimer disease in the United States (2010-2050) estimated using the 2010 census". Neurology. 80 (19): 1778–83. doi:10.1212/WNL.0b013e31828726f5. PMC 3719424. PMID 23390181.
- ↑ Evans DA (1990). "Estimated prevalence of Alzheimer's disease in the United States". Milbank Q. 68 (2): 267–89. PMID 2233632.
- ↑ Hebert LE, Scherr PA, Bienias JL, Bennett DA, Evans DA (2003). "Alzheimer disease in the US population: prevalence estimates using the 2000 census". Arch. Neurol. 60 (8): 1119–22. doi:10.1001/archneur.60.8.1119. PMID 12925369.
- ↑ Langa KM, Plassman BL, Wallace RB, Herzog AR, Heeringa SG, Ofstedal MB, Burke JR, Fisher GG, Fultz NH, Hurd MD, Potter GG, Rodgers WL, Steffens DC, Weir DR, Willis RJ (2005). "The Aging, Demographics, and Memory Study: study design and methods". Neuroepidemiology. 25 (4): 181–91. doi:10.1159/000087448. PMID 16103729.
- ↑ Ferri CP, Prince M, Brayne C; et al. "Global prevalence of dementia: a Delphi consensus study" (PDF). Lancet. 366 (9503): 2112–7. doi:10.1016/S0140-6736(05)67889-0. PMID 16360788. Retrieved 2008-06-13.
- ↑ Dong MJ, Peng B, Lin XT, Zhao J, Zhou YR, Wang RH (2007). "The prevalence of dementia in the People's Republic of China: a systematic analysis of 1980-2004 studies". Age Ageing. 36 (6): 619–24. doi:10.1093/ageing/afm128. PMID 17965036.
- ↑ Zhang ZX, Zahner GE, Román GC, Liu J, Hong Z, Qu QM, Liu XH, Zhang XJ, Zhou B, Wu CB, Tang MN, Hong X, Li H (2005). "Dementia subtypes in China: prevalence in Beijing, Xian, Shanghai, and Chengdu". Arch. Neurol. 62 (3): 447–53. doi:10.1001/archneur.62.3.447. PMID 15767510.
- ↑ Lin RT, Lai CL, Tai CT, Liu CK, Yen YY, Howng SL (1998). "Prevalence and subtypes of dementia in southern Taiwan: impact of age, sex, education, and urbanization". J. Neurol. Sci. 160 (1): 67–75. PMID 9804120.
- ↑ Liu HC, Wang SJ, Fuh JL, Liu CY, Lin KP, Lin CH, Wang PN, Lin KN, Wang HC, Chen HM, Chang R, Larson EB, Wu GS, Chou P, Teng EL (1997). "The Kinmen Neurological Disorders Survey (KINDS): a study of a Chinese population". Neuroepidemiology. 16 (2): 60–8. PMID 9057167.
- ↑ Suh GH, Kim JK, Cho MJ (2003). "Community study of dementia in the older Korean rural population". Aust N Z J Psychiatry. 37 (5): 606–12. doi:10.1046/j.1440-1614.2003.01237.x. PMID 14511090.
- ↑ Vas CJ, Pinto C, Panikker D, Noronha S, Deshpande N, Kulkarni L, Sachdeva S (2001). "Prevalence of dementia in an urban Indian population". Int Psychogeriatr. 13 (4): 439–50. PMID 12003250.
- ↑ de Silva HA, Gunatilake SB, Smith AD (2003). "Prevalence of dementia in a semi-urban population in Sri Lanka: report from a regional survey". Int J Geriatr Psychiatry. 18 (8): 711–5. doi:10.1002/gps.909. PMID 12891639.
- ↑ Bowirrat A, Friedland RP, Korczyn AD (2002). "Vascular dementia among elderly Arabs in Wadi Ara". J. Neurol. Sci. 203-204: 73–6. PMID 12417360.
- ↑ Llibre JJ, Guerra MA, Pérez-Cruz H, Bayarre H, Fernández-Ramírez S, González-Rodríguez M, Samper JA (1999). "[Dementia syndrome and risk factors in adults older than 60 years old residing in Habana]". Rev Neurol (in Spanish; Castilian). 29 (10): 908–11. PMID 10637837.
- ↑ Herrera E, Caramelli P, Silveira AS, Nitrini R (2002). "Epidemiologic survey of dementia in a community-dwelling Brazilian population". Alzheimer Dis Assoc Disord. 16 (2): 103–8. PMID 12040305.
- ↑ Quiroga P, Calvo C, Albala C, Urquidi J, Santos JL, Pérez H, Klaassen G (1999). "Apolipoprotein E polymorphism in elderly Chilean people with Alzheimer's disease". Neuroepidemiology. 18 (1): 48–52. PMID 9831815.
- ↑ Rosselli D, Ardila A, Pradilla G, Morillo L, Bautista L, Rey O, Camacho M (2000). "[The Mini-Mental State Examination as a selected diagnostic test for dementia: a Colombian population study. GENECO]". Rev Neurol (in Spanish; Castilian). 30 (5): 428–32. PMID 10775968.
- ↑ Pradilla G, Vesga BE, Leon-Sarmiento FE, Bautista LE, Núñez LC, Vesga E, Gamboa NR (2002). "[Neuroepidemiology in the eastern region of Colombia]". Rev Neurol (in Spanish; Castilian). 34 (11): 1035–43. PMID 12134301.
- ↑ Chêne G, Beiser A, Au R, Preis SR, Wolf PA, Dufouil C, Seshadri S (2015). "Gender and incidence of dementia in the Framingham Heart Study from mid-adult life". Alzheimers Dement. 11 (3): 310–320. doi:10.1016/j.jalz.2013.10.005. PMC 4092061. PMID 24418058.
- ↑ Altmann A, Tian L, Henderson VW, Greicius MD (2014). "Sex modifies the APOE-related risk of developing Alzheimer disease". Ann. Neurol. 75 (4): 563–73. doi:10.1002/ana.24135. PMC 4117990. PMID 24623176.
- ↑ Ungar L, Altmann A, Greicius MD (2014). "Apolipoprotein E, gender, and Alzheimer's disease: an overlooked, but potent and promising interaction". Brain Imaging Behav. 8 (2): 262–73. doi:10.1007/s11682-013-9272-x. PMC 4282773. PMID 24293121.
- ↑ "www.cdc.gov" (PDF).
- ↑ Brookmeyer R, Gray S, Kawas C. "Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset". Am J Public Health. 88 (9): 1337–42. PMC 1509089. PMID 9736873.
- ↑ Bermejo-Pareja F, Benito-León J, Vega S, Medrano MJ, Román GC. "Incidence and subtypes of dementia in three elderly populations of central Spain". Journal of the Neurological Sciences. 264 (1–2): 63–72. doi:10.1016/j.jns.2007.07.021. PMID 17727890. Retrieved 2012-08-15.