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Publications

Journal Article Ahead of print

PubMed: 42862582 DOI: 10.1001/jamaneurol.2026.3540

Global Incidence of All-Cause Dementia: A Meta-Analysis.

JAMA Neurol

Authors: Ashleigh S Vella, Rachel Visontay, Darren M Lipnicki, Emma Nichols, Jaimie D Steinmetz, Theo Vos, Anh Thy H Nguyen, Juan J Llibre-Rodriguez, Jorge Llibre-Guerra, Richard B Lipton, Mindy J Katz, Nikolaos Scarmeas, Maëlenn Guerchet, Pierre-Marie Preux, Karen Ritchie, Maria Skaalum Petersen, Ingmar Skoog, Elena Rolandi, Annalisa Davin, Michele Rossi, Ki Woong Kim, Ji Won Han, Dae Jong Oh, Steffi G Riedel-Heller, Susanne Röhr, Alexander Pabst, Ding Ding, Qianhua Zhao, Xiaowen Zhou, Kaarin J Anstey, Moyra E Mortby, Nicolas Cherbuin, Antonio Lobo, Shifu Xiao, Hugh C Hendrie, Sujuan Gao, Sebastian Köhler, Pascual Sánchez-Juan, Teodoro Del Ser, Meritxell Valentí-Soler, Marcia Scazufca, Allison E Aiello, Jacqueline Dominguez, Roger Ho, John D Crawford, Henry Brodaty, Louise Mewton, Perminder S Sachdev

Affiliations

  • Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia.
  • The Matilda Centre for Research in Mental Health and Substance Use, the University of Sydney, Sydney, New South Wales, Australia.
  • Institute for Health Metrics and Evaluation, University of Washington, Seattle.
  • Center for Economic and Social Research & Leonard Davis School of Gerontology, University of Southern California, Los Angeles.
  • Leonard Davis School of Gerontology, University of Southern California, Los Angeles.
  • Dementia Research Unit, Medical University of Havana, Havana, Cuba.
  • Department of Neurology, School of Medicine, Washington University in St Louis, St Louis, Missouri.
  • Department of Neurology, Albert Einstein College of Medicine, Bronx, New York.
  • Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
  • First Department of Neurology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
  • Department of Neurology, Columbia University, New York, New York.
  • Laboratory of Epidemiology of Chronic and Neurological Diseases, University of Abomey-Calavi, Cotonou, Benin.
  • National Institute for Health and Medical Research U1094, Institut de Recherche pour le Developpement UMR270, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, University Limoges, Centre Hospitalier et Universitaire Limoges, Limoges, France.
  • Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Global Health - Michel Dumas, OmegaHealth, Limoges, France.
  • Institut for Neurosciences of Montpellier, National Institute for Health and Medical Research, Montpellier, France.
  • Department of Research, the National Hospital of the Faroe Islands, Tórshavn, Faroe Islands.
  • Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Centre for Ageing and Health at the University of Gothenburg, Gothenburg, Sweden.
  • Psychiatry, Cognition and Old Age Psychiatry Clinic, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
  • Golgi Cenci Foundation, Abbiategrasso, Italy.
  • Department of Brain and Cognitive Science, Seoul National University College of Natural Science, Seoul, Republic of Korea.
  • Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  • Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
  • Department of Health Science and Technology, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea.
  • Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany.
  • Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
  • School of Psychology, University of New South Wales, Sydney, New South Wales, Australia.
  • Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia.
  • Neuroscience Research Australia, Sydney, New South Wales, Australia.
  • National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.
  • Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain.
  • Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain.
  • Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.
  • Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
  • Department of Psychiatry, Indiana University School of Medicine, Indianapolis.
  • Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis.
  • Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands.
  • Reina Sofia Alzheimer Center, CIEN Foundation, ISCIII, Madrid, Spain.
  • Alzheimer's Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofia Foundation, Alzheimer Research Center, Madrid, Spain.
  • LIM-23 do Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Department of Epidemiology and Robert N Butler Columbia Aging Center, Columbia University, New York, New York.
  • Memory Center, Institute for Neurosciences, St Luke's Medical Center, Manila, Philippines.
  • Institute for Health Innovation and Technology, National University of Singapore, Singapore, Singapore.
  • School of Medicine, the Hong Kong University of Science and Technology, Clear Water Bay, New Territories, Hong Kong.

Abstract

IMPORTANCE

Global dementia incidence estimates are limited by underrepresentation of low- and middle-income countries and heterogeneous analytic methods. Due to these limitations, true understanding of the global dementia landscape remains incomplete.

OBJECTIVE

To identify dementia incidence rates by age and sex in various regions worldwide (high-income countries and low- and middle-income countries) where data on clinically based dementia diagnoses were available.

DATA SOURCES

Retrospective community-based cohorts from the Cohort Studies of Memory in an International Consortium (COSMIC); baseline recruitment commenced between January 1990 and December 2011 and follow-up data were collected through the end of 2021. Data were analyzed from June 2024 to June 2025.

STUDY SELECTION

Eligible studies included longitudinal COSMIC cohort studies with a clinically based diagnosis of dementia. Individual participant-level data from 22 population-based longitudinal cohorts (N = 38 418) spanning 18 countries or territories across 6 continents were included.

DATA EXTRACTION AND SYNTHESIS

Data extraction and assessment of study quality and validity were conducted according to Meta-Analyses of Observational Studies in Epidemiology (MOOSE) guidelines. Individual participant-level data were meta-analyzed in a 2-step process using random intercepts for country and study at the global and regional levels and by country income level.

MAIN OUTCOMES AND MEASURES

For each study with a clinically based diagnosis, incidence rates for all-cause dementia were calculated and a 2-step meta-analysis was conducted. Using a person-years at risk framework with inverse-probability censoring weights and Poisson models, age- and sex-specific incidence were estimated and then standardized to the 2023 global age-sex population structure.

RESULTS

Across 287 632 person-years at risk, 3001 participants developed dementia. Age- and sex-standardized incidence was 9.7 (95% CI, 7.89-11.97) per 1000 person-years at risk. Age-standardized incidence was higher in women than men (10.6; 95% CI, 8.61-13.11 vs 8.6; 95% CI, 6.94-10.72). Standardized incidence was higher in low- and middle-income countries (13.6; 95% CI, 9.67-19.24) than in high-income countries (8.3; 95% CI, 6.57-10.54). Applying age- and sex-specific rates to the projected 2050 population yielded a projected 24.7 million new cases, assuming constant incidence over time.

CONCLUSIONS AND RELEVANCE

The harmonized estimates presented in this study provide a comparable benchmark for global dementia incidence and inform planning for prevention, diagnosis, and memory-care services, particularly in underrepresented low- and middle-income country settings.

MeSH

Dementia, Incidence, Income, Sex, Diagnosis, Nervous System Diseases