Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016

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dc.contributor.author GBD 2016 Dementia Collaborators
dc.contributor.author Nichols, Emma
dc.contributor.author Szoeke, Cassandra E. I.
dc.contributor.author Vollset, Stein Emil
dc.contributor.author Kivimäki, Mika
dc.contributor.author Meretoja, Atte
dc.date.accessioned 2019-01-07T10:55:01Z
dc.date.available 2019-01-07T10:55:01Z
dc.date.issued 2019-01
dc.identifier.citation GBD 2016 Dementia Collaborators , Nichols , E , Szoeke , C E I , Vollset , S E , Kivimäki , M & Meretoja , A 2019 , ' Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016 ' , Lancet Neurology , vol. 18 , no. 1 , pp. 88-106 . https://doi.org/10.1016/S1474-4422(18)30403-4
dc.identifier.other PURE: 120791988
dc.identifier.other PURE UUID: c67424d0-b3b2-4f0f-a098-0487ec7bdc68
dc.identifier.other WOS: 000453007700024
dc.identifier.other Scopus: 85058800972
dc.identifier.uri http://hdl.handle.net/10138/287673
dc.description.abstract Background The number of individuals living with dementia is increasing, negatively affecting families, communities, and health-care systems around the world. A successful response to these challenges requires an accurate understanding of the dementia disease burden. We aimed to present the first detailed analysis of the global prevalence, mortality, and overall burden of dementia as captured by the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016, and highlight the most important messages for clinicians and neurologists. Methods GBD 2016 obtained data on dementia from vital registration systems, published scientific literature and surveys, and data from health-service encounters on deaths, excess mortality, prevalence, and incidence from 195 countries and territories from 1990 to 2016, through systematic review and additional data-seeking efforts. To correct for differences in cause of death coding across time and locations, we modelled mortality due to dementia using prevalence data and estimates of excess mortality derived from countries that were most likely to code deaths to dementia relative to prevalence. Data were analysed by standardised methods to estimate deaths, prevalence, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs; computed as the sum of YLLs and YLDs), and the fractions of these metrics that were attributable to four risk factors that met GBD criteria for assessment (high body-mass index [BMI], high fasting plasma glucose, smoking, and a diet high in sugarsweetened beverages). Findings In 2016, the global number of individuals who lived with dementia was 43.8 million (95% uncertainty interval [UI] 3 7. 8-51.0), increased from 20.2 million (17. 4-23 5) in 1990. This increase of 117% (95% UI 114-121) contrasted with a minor increase in age-standardised prevalence of 1.7% (1.0-2.4), from 701 cases (95% UI 602-815) per 100 000 population in 1990 to 712 cases (614-828) per 100 000 population in 2016. More women than men had dementia in 2016 (27.0 million, 95% UI 23 .3-31. 4, vs 16.8 million, 14.4-19.6), and dementia was the fifth leading cause of death globally, accounting for 2.4 million (95% UI 2.1-2.8) deaths. Overall, 28.8 million (95% UI 24. 5-34. 0) DALYs were attributed to dementia; 6.4 million (95% UI 3 .4-10. 5) of these could be attributed to the modifiable GBD risk factors of high BMI, high fasting plasma glucose, smoking, and a high intake of sugar-sweetened beverages. Interpretation The global number of people living with dementia more than doubled from 1990 to 2016, mainly due to increases in population ageing and growth. Although differences in coding for causes of death and the heterogeneity in case-ascertainment methods constitute major challenges to the estimation of the burden of dementia, future analyses should improve on the methods for the correction of these biases. Until breakthroughs are made in prevention or curative treatment, dementia will constitute an increasing challenge to health-care systems worldwide. (C) 2018 The Author(s). Published by Elsevier Ltd. en
dc.format.extent 19
dc.language.iso eng
dc.relation.ispartof Lancet Neurology
dc.rights cc_by
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject RISK-FACTOR
dc.subject COGNITIVE IMPAIRMENT
dc.subject PREVALENCE
dc.subject METAANALYSIS
dc.subject DECLINE
dc.subject TRENDS
dc.subject 3112 Neurosciences
dc.subject 3124 Neurology and psychiatry
dc.title Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016 en
dc.type Article
dc.contributor.organization Department of Public Health
dc.contributor.organization Clinicum
dc.contributor.organization University of Helsinki
dc.contributor.organization Department of Neurosciences
dc.contributor.organization Neurologian yksikkö
dc.contributor.organization HUS Neurocenter
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1016/S1474-4422(18)30403-4
dc.relation.issn 1474-4422
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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