A systematic analysis of Alzheimer's disease and other dementias burden in Asia from 1990 to 2021 with projection to 2036: based on the global burden of disease 2021 data

Ziyang He¹Haoqin Zhang¹Guishan Hu¹Yinan Qiao¹Can Yin¹Jianqiao Li¹Hong Lin¹Anguo Wu¹Dalian Qin¹Betty Yuen-Kwan Law²Guangqiang Hu^1*Lu Yu^1*

• ¹Southwest Medical University, Luzhou, Sichuan, China
• ²Macau University of Science and Technology, Taipa, Macao, Macao, SAR China

Background: With global aging, Alzheimer's disease (AD) and other dementias have emerged as significant health threats to the elderly, garnering considerable attention regarding their impact on public health. Despite the substantial burden of dementia in Asia, targeted research remains limited. This study aims to assess the current burden, future trends, risk factors, and inequalities in Asia.The GBD 2021 study was utilized to evaluate the numbers and age-standardized rates (ASRs) of prevalence, mortality, and disability-adjusted life-years (DALYs) of AD and other dementias from 1990 to 2021. Joinpoint regression analysis was performed to assess the trends during this period, while the Autoregressive Integrated Moving Average (ARIMA) model was employed to predict future trends. Additionally, the relationship between disease burden and sociodemographic index (SDI) was also analyzed. Results: In 2021, Asia experienced a 250.44% increase in prevalent cases, a 297.34% rise in mortality, and a 249.54% surge in DALYs for AD and other dementias compared to 1990. Meanwhile, the age-standardized prevalence rate, age-standardized mortality rate, and agestandardized DALY rate also exhibited varying degrees of rise from 1990 to 2021. Demographically, the disease burden was higher in women and those aged 65 and above. Regionally, the burden was highest in East Asia and relatively low in South and Central Asia. Nationally, China, India, Japan, and Indonesia reported the most cases. Over the next 15 years, the age-standardized prevalence rate in Asia is expected to peak in 2028 before declining, while the age-standardized mortality rate is anticipated to keep rising. An overall " V " shaped association was found between sociodemographic index (SDI) and the age-standardized DALY rate in Asia. Only smoking, high fasting plasma glucose (FPG), and high BMI were identified as causal risk factors within the GBD framework.The burden of AD and other dementias in Asia has significantly increased over the past three decades and is expected to persistently impact Asian populations, particularly in developing countries experiencing rapid demographic shifts. Women and the elderly should be a focus of attention. It is imperative to implement targeted prevention and intervention strategies, enhance chronic disease management, and control risk factors.