Global Transitions · Oct 2026
Burden of Alzheimer's Disease and Other Dementias in China (1990–2023): Temporal Changes, Age-Specific Patterns, and Risk Factor Contributions
By Deng R, Tang J, Wei X et al.
Objective To analyze the burden of Alzheimer's disease and other dementias (ADOD) and modifiable risk factors in China from 1990 to 2023, and quantify the driving forces underlying the burden growth. Methods Results of the global burden of disease (GBD) study 2023 were used to assess temporal changes in age-standardized rates (ASRs), annual average percentage changes (AAPC), absolute numbers, age-group-specific patterns, and risk factor exposure of ADOD. A demographic factor decomposition method was further adopted to distinguish the contributions of population growth, population aging, and age-specific rate changes to the total burden. Results From 1990 to 2023, The absolute numbers of incidence (from 755,780 to 3,476,644, +360.0%), prevalence (from 4,352,315 to 20,299,243, +366.4%), disability-adjusted life-years (DALYs) (from 2,813,268 to 11,646,909, +314.0%) surged. The ASRs of incidence (+23.62%), prevalence (+24.92%), DALYs (+5.98%), and mortality (+2.64%) of ADOD in China also increased. The AAPCs of incidence, prevalence, and DALYs were +0.4144%, +0.3950%, and +0.0908%, respectively (all p<0.05), while the AAPC of mortality was not significant (+0.0655%). Decomposition analysis revealed that population aging and age-specific rate changes were the two dominant drivers of burden growth, whereas population growth contributed minimally. Modifiable risk factors showed age-dependent temporal trends: high fasting plasma glucose (76.07 to 95.09/100,000) and high BMI (−0.31 to 8.83/100,000, with the largest absolute increases at 75–89 years), particulate matter pollution (211.99 to 201.39/100,000) and smoking (31.80 to 30.21/100,000) slightly decreased, and high alcohol use (−11.59 to −8.66/100,000) moved further below the theoretical minimum risk exposure level. Age-specifically, the 65–84 group carried the largest share of incident cases (63.61%), prevalent cases (60.68%) and DALYs (55.59%), whereas adults aged ≥85 years accounted for the majority of deaths (52.74%). Conclusion ADOD burden in China has grown substantially, predominantly driven by population aging and elevated age-specific disease rates, rather than population expansion.