Lifetime risk and projected burden of dementia

Michael Fang; Jiaqi Hu; Jordan Weiss; David S Knopman; Marilyn Albert; B Gwen Windham; Keenan A Walker; A Richey Sharrett; Rebecca F Gottesman; Pamela L Lutsey; Thomas Mosley; Elizabeth Selvin; Josef Coresh

doi:10.1038/s41591-024-03340-9

Lifetime risk and projected burden of dementia

Nat Med. 2025 Jan 13. doi: 10.1038/s41591-024-03340-9. Online ahead of print.

Authors

Michael Fang¹, Jiaqi Hu^{1

2}, Jordan Weiss³, David S Knopman⁴, Marilyn Albert⁵, B Gwen Windham⁶, Keenan A Walker⁷, A Richey Sharrett¹, Rebecca F Gottesman⁸, Pamela L Lutsey⁹, Thomas Mosley⁶, Elizabeth Selvin¹, Josef Coresh^{10

11}

Affiliations

¹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
² Institute for Hospital Management, Tsinghua University, Beijing, China.
³ Optimal Aging Institute and Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA.
⁴ Department of Neurology, Mayo Clinic, Rochester, MN, USA.
⁵ Department of Neurology, Johns Hopkins Medicine, Baltimore, MD, USA.
⁶ Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
⁷ Intramural Research Program, National Institute on Aging, Bethesda, MD, USA.
⁸ Intramural Research Program, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
⁹ Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA.
¹⁰ Optimal Aging Institute and Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA. [email protected].
¹¹ Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA. [email protected].

PMID: 39806070
DOI: 10.1038/s41591-024-03340-9

Abstract

Understanding the lifetime risk of dementia can inform public health planning and improve patient engagement in prevention. Using data from a community-based, prospective cohort study (n = 15,043; 26.9% Black race, 55.1% women and 30.8% with at least one apolipoprotein E4 (APOE ε4) allele), we estimated the lifetime risk of dementia (from age 55 years to 95 years), with mortality treated as a competing event. We applied lifetime risk estimates to US Census projections to evaluate the annual number of incident dementia cases from 2020 to 2060. The lifetime risk of dementia after age 55 years was 42% (95% confidence interval: 41-43). Rates were substantially higher in women, Black adults and APOE ε4 carriers, with lifetime risks ranging from approximately 45% to 60% in these populations. The number of US adults who will develop dementia each year was projected to increase from approximately 514,000 in 2020 to approximately 1 million in 2060. The relative growth in new dementia cases was especially pronounced for Black adults. These results highlight the urgent need for policies that enhance healthy aging, with a focus on health equity.

Abstract

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