Literature DB >> 34279544

Global Prevalence of Young-Onset Dementia: A Systematic Review and Meta-analysis.

Stevie Hendriks1, Kirsten Peetoom1, Christian Bakker2,3,4, Wiesje M van der Flier5,6, Janne M Papma7, Raymond Koopmans2,4, Frans R J Verhey1, Marjolein de Vugt1, Sebastian Köhler1, Adrienne Withall8, Juliette L Parlevliet9, Özgül Uysal-Bozkir9, Roger C Gibson10, Susanne M Neita10, Thomas Rune Nielsen11, Lise C Salem11, Jenny Nyberg12, Marcos Antonio Lopes13, Jacqueline C Dominguez14, Ma Fe De Guzman14, Alexander Egeberg15, Kylie Radford16, Tony Broe16, Mythily Subramaniam17, Edimansyah Abdin17, Amalia C Bruni18, Raffaele Di Lorenzo18, Kate Smith19, Leon Flicker19, Merel O Mol7, Maria Basta20, Doris Yu21, Golden Masika21, Maria S Petersen22, Luis Ruano23.   

Abstract

Importance: Reliable prevalence estimates are lacking for young-onset dementia (YOD), in which symptoms of dementia start before the age of 65 years. Such estimates are needed for policy makers to organize appropriate health care. Objective: To determine the global prevalence of YOD. Data Sources: The PubMed, Embase, CINAHL, and PsycInfo databases were systematically searched for population-based studies on the prevalence of YOD published between January 1, 1990, and March 31, 2020. Study Selection: Studies containing data on the prevalence of dementia in individuals younger than 65 years were screened by 2 researchers for inclusion in a systematic review and meta-analysis. Data Extraction and Synthesis: Prevalence estimates on 5-year age bands, from 30 to 34 years to 60 to 64 years, were extracted. Random-effects meta-analyses were conducted to pool prevalence estimates. Results were age standardized for the World Standard Population. Heterogeneity was assessed by subgroup analyses for sex, dementia subtype, study design, and economic status based on the World Bank classification and by meta-regression. Main Outcomes and Measures: Prevalence estimates of YOD for 5-year age bands.
Results: A total of 95 unique studies were included in this systematic review, of which 74 with 2 760 379 unique patients were also included in 5-year age band meta-analyses. Studies were mostly conducted in Europe and in older groups in Asia, North America, and Oceania. Age-standardized prevalence estimates increased from 1.1 per 100 000 population in the group aged 30 to 34 years to 77.4 per 100 000 population in the group aged 60 to 64 years. This gives an overall global age-standardized prevalence of 119.0 per 100 000 population in the age range of 30 to 64 years, corresponding to 3.9 million people aged 30 to 64 years living with YOD in the world. Subgroup analyses showed prevalence between men and women to be similar (crude estimates for men, 216.5 per 100 000 population; for women, 293.1 per 100 000 population), whereas prevalence was lower in high-income countries (crude estimate, 663.9 per 100 000 population) compared with upper-middle-income (crude estimate, 1873.6 per 100 000 population) and lower-middle-income (crude estimate, 764.2 per 100 000 population) countries. Meta-regression showed that age range (P < .001), sample size (P < .001), and study methodology (P = .02) significantly influenced heterogeneity between studies. Conclusions and Relevance: This systematic review and meta-analysis found an age-standardized prevalence of YOD of 119.0 per 100 000 population, although estimates of the prevalence in low-income countries and younger age ranges remain scarce. These results should help policy makers organize sufficient health care for this subgroup of individuals with dementia. Study Registration: PROSPERO CRD42019119288.

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Mesh:

Year:  2021        PMID: 34279544      PMCID: PMC8290331          DOI: 10.1001/jamaneurol.2021.2161

Source DB:  PubMed          Journal:  JAMA Neurol        ISSN: 2168-6149            Impact factor:   29.907


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