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Estimating the global mortality from Alzheimer’s disease and other dementias: A new method and results from the Global Burden of Disease study 2019
Author(s) -
Nichols Emma,
Vos Theo
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.042236
Subject(s) - dementia , medicine , demography , disease , population , confidence interval , cause of death , excess mortality , gerontology , estimation , epidemiology , environmental health , management , sociology , economics
Abstract Background Alzheimer’s disease and other dementias (dementia) is currently a leading cause of mortality and morbidity globally, and the total number of individuals effected by dementia will likely increase in the future with corresponding increases in population growth and aging. However, inconsistencies in coding practices in vital registration systems both over time and between countries complicate the estimation of dementia mortality. This study updated and improved on previous methods developed for the Global Burden of Disease (GBD) study for the estimation of global dementia mortality. Method We conducted a systematic review on the excess risk of death in those with dementia, and analyzed these data using a Bayesian meta‐regression model. We calculated total excess deaths as the product of absolute risk and country‐by‐country prevalence estimates from the GBD study. We then multiplied the estimates of total excess deaths by the proportion of dementia deaths that occur in those with severe, end‐stage disease to calculate the total number of deaths that could be legitimately assigned to dementia as the underlying cause of death. Result Attributable risk of dementia increased with age, reaching 0.17 (95% uncertainty interval, 0.05 to 0.58) in the 95+ age group. We estimated there were 1.55 (0.35 to 4.54) million deaths globally due to dementia in 2019. Far more deaths occurred in women (1.02 million; 0.23 to 2.96) than men (0.54 million: 0.12 to 1.58), giving a female to male ratio of 1.90 (1.82 to 1.99). Due to population aging, the all‐age mortality rates increased by 38.0%; 33.1 to 43.7 between 1990 and 2019. Conclusion The increase in the number of dementia deaths will continue due to population aging. Given the rising volume of dementia mortality, the development of valid methods of mortality estimation for dementia is critical. This updated estimation method eliminated all dependency on estimates from vital registration systems, which are known to be biased. However, future efforts should aim to further strengthen this analysis in order to provide more accurate information on dementia mortality for use by both researchers and policy‐makers.