Global Burden of Alzheimer's disease and other dementias and Attributable to Risk factors, 1990–2019: An Analysis Based on the Global Burden of Disease Study 2019

Abstract Background The exposure to risk factors (Smoking, High fasting plasma glucose and High BMI) are considered a major health concern. However, previous studies focused on changes in the global age-specific incidence and mortality, failed to distinguish between cohort and period effects, and did not discuss risk factors separately. Methods This study to estimate the burden of Alzheimer's disease and other dementias stratified by gender, age, locations, and social-demographic status for 21 regions across the world from 1990 to 2019. Besides, trend analyzes were conducted for major regions and risk factors for DALYs were also analyzed using age-period-cohort model and Join-point model. Results Globally, the age standardized incidence rate(ASIR), age standardized death rate(ASDR), and age standardized DALY rates for Alzheimer's disease have an upward trend from 1990 to 2019.(percentage change: 1.5%,3.0%,3.5%, respectively) with average annual percent change. In most regions, indicators (incidence, mortality, and DALYs) increased steadily with SDI increased. By APC analysis, substantially increasing age effects were presented for Alzheimer's disease and other dementias from 40 to 95 years. The cohort effects RRs had a rapid reduction attribute to Smoking, High fasting plasma glucose and High BMI. Conclusions As the burden of Alzheimer's disease remains high in areas with low SDI. Therefore, rapid and effective government responses are needed to tackle and control dementia risk factors to reduce the disease burden in middle-low and low SDI countries.