ORIGINAL RESEARCH article
Front. Aging Neurosci.
Sec. Alzheimer's Disease and Related Dementias
Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1637029
This article is part of the Research TopicEmerging Global Population Health Risks: From Epidemiological Perspectives Volume IIView all 3 articles
Global Burden of Alzheimer's Diseaseand Other Dementias (1990– 2021): Inequality, Frontier, and Decomposition Analysis
Provisionally accepted
Haishou Fu*
Shuzhen Liao- Fuzhou University, Fuzhou, China
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Alzheimer’s disease and other dementias (ADOD) represent a growing global health crisis driven by the rapid aging of the population. Using data from the 2021 Global Burden of Disease (GBD) study, we provide updated global and national estimates of the ADOD burden from 1990 to 2021, quantify key risk factors, and offer evidence to guide resource allocation and prevention strategies. We analyzed age-standardized incidence, prevalence, mortality, and disability-adjusted life years rates, along with the burden attributable to ADOD-related risk factors. Health disparities were assessed using the slope index of inequality and concentration index. We used frontier analysis to evaluate outcomes relative to development levels. Decomposition analysis identified drivers of burden changes. All statistical analyses were performed in R (version 4.2.3). Globally, ADOD incidence, prevalence, and mortality increased significantly between 1990 and 2021(156.54%, 160.81%, and 194.39%, respectively). High fasting blood glucose was the leading modifiable risk factor, contributing to 14.70% of global ADOD mortality, followed by elevated BMI and tobacco use. Burden trends varied across Socio-Demographic Index (SDI) regions. High-middle SDI regions showed the highest prevalence. Gender-specific risk factor rankings showed high BMI as the second most significant factor in females, while tobacco use ranked second in males but declined over time. considerable potential to reduce ADOD burden in many countries. Decomposition analysis revealed the greatest increases in DALYs in middle-SDI regions. Although some metrics have stabilized or slowed in growth, significant inequalities remain, particularly in lower-SDI nations. Tailored strategies focusing on strengthening healthcare systems, targeting high-risk populations, and improving health education are essential to narrow these gaps. Greater international collaboration and open data sharing are also key to building a life-course management model for ADOD prevention and care, ultimately improving global health.
Keywords: Alzheimer's disease, Dementia, Global burden of disease, Incidence, Mortality, Risk factors, Frontier analysis
Received: 28 May 2025; Accepted: 02 Sep 2025.
Copyright: © 2025 Fu and Liao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Haishou Fu, Fuzhou University, Fuzhou, China
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