The Evolving Global Epidemiology of Presenile Dementia in People Aged Under 65: A 40-year Cross-Sectional Study.

Aim: Despite presenile dementia substantial impact on patients, caregivers, and healthcare systems, comprehensive global assessments of its burden are lacking. This research aims to address this knowledge gap by investigating the trends in the epidemiology of presenile dementia since 1990 and forecast to 2030, providing essential evidence for healthcare policy and resource planning.

Methods: This cross-sectional, population-based study leveraged data for individuals aged 40-64 years of presenile dementia from the GBD study, which performed a detailed evaluation related metrics across 204 countries. We calculated age-standardized rates for incidence, mortality, and DALYs. Projections were generated using a Bayesian APC model based on historical trends. SDI quintiles were used to assess disparities across countries.

Results: The global age-standardized incidence rate of presenile dementia is expected to rise to 43.97 per 100,000 population by 2030 (EAPC, 0.07 [95% CI: -0.02-0.17]). However, age-standardized death and DALY rates are forecasted to decline to 2.61 (EAPC, -0.01 [95% CI: -0.07-0.05]) and 113.38 per 100,000 (EAPC, -0.05 [95% CI: -0.10-0.00]), respectively. Women are expected to exhibit higher incidence rates than men (47.13 vs 40.94 per 100,000 in 2030), reflecting consistent sex-based disparities. Incidence, death, and DALY rates are projected to continue to rise in low SDI countries.

Conclusion: The overall burden of presenile dementia remains substantial due to continued increases in incidence rates, particularly pronounced in low-resource settings. These findings underscore the urgent need for targeted prevention strategies, particularly in low-resource settings, and continued investments in health care infrastructure to address disparities. Expanding screening programs to younger populations globally could help reduce the associated burden of dementia.