Epidemiology

Dementia may not become as big a problem as thought

The number of people with dementia will not increase as much in the coming years as previously assumed. This was discovered by researchers at Erasmus MC who used a new, detailed computer model that looks beyond the effects of an aging population.

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The number of people with dementia will double between 2020 and 2050. That would mean over 400,000 people with dementia by 2050. This estimate pops up in almost all information about the brain disorder. However, new research using an advanced computer model suggests that the number of new dementia cases in 2050 may be up to 40 percent lower than this estimate. The scientists from Erasmus MC’s departments of Public Health and of Epidemiology published their study in the European Journal of Epidemiology.

More than age

The difference between the old and the new prediction is that the new numbers also include the improvement in brain health over the past few decades. ‘The old prediction was based only on the aging population. But the risk of dementia is determined by more things than age. The risk of someone aged 80 getting dementia in 2030 is smaller than the risk of someone aged 80 in 2000,’ explains research leader and epidemiologist Inge de Kok.

Dementia is a collective term for more than ten brain diseases, of which Alzheimer’s disease is the best known. Patients become forgetful, start to get lost and, for example, have problems speaking. Together with cancer and cardiovascular disease, dementia is one of the leading causes of death in the Netherlands.

Over the past decades, the risk of dementia has decreased by 13 percent every 10 years, earlier Erasmus MC research showed. This difference is due, for example, to the fact that in recent decades people have started smoking less, exercised more and the treatment of high blood pressure and cardiovascular disease – risk factors for dementia – has improved.

Brain health

The new computer model takes these effects into account, in order to make more accurate predictions. PhD student and econometrician Chiara Brück created the microsimulation model, as it is called. She modelled various scenarios, in which the beneficial effect of the brain health improvement remains the same over time, gradually gets stronger or gradually gets weaker.

In all scenarios, the number of people with dementia in 2050 is lower than in the earlier prediction based on aging alone. However, in order for the most favorable scenarios to become reality, it is a prerequisite that our brain health continues to improve. ‘An extra motivation to put all our efforts into better prevention’, says Brück.

Caregivers

The optimistic results do not detract from the fact that the impact of dementia remains great, emphasize the researchers. It still concerns between 280,000 and 340,000 patients in 2050. ‘This will put a great deal of pressure on health care professionals and caregivers. Thanks to these new insights, policymakers and health care professionals now have a better idea of how many people will need care and how that should be organized,’ says De Kok.

The researchers used data from the Rotterdam study, a large population study that has been conducted since 1990 in the Ommoord district of Rotterdam. They combined these data with data from Statistics Netherlands (CBS). They expect their results to be applicable to other European countries and North America.

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