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Lifetime risk and projected burden of dementia
Fang M, Hu J, Weiss J, Knopman DS, Albert M, Windham BG, Walker KA, Sharrett AR, Gottesman RF, Lutsey PL, et al.. Nature Medicine, 2025-01-13
Topic: Risk, prevention and care in population studies
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.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Fang, M., Hu, J., Weiss, J., Knopman, D. S., Albert, M., Windham, B. G., et al. (2025). Lifetime risk and projected burden of dementia. Nature Medicine. https://doi.org/10.1038/s41591-024-03340-9
Vancouver
Fang M, Hu J, Weiss J, Knopman DS, Albert M, Windham BG, et al. Lifetime risk and projected burden of dementia. Nature Medicine. 2025. doi:10.1038/s41591-024-03340-9. PMID: 39806070.
BibTeX
@article{fang2025-39806070,
author = {Fang, M. and Hu, J. and Weiss, J. and Knopman, D. S. and Albert, M. and Windham, B. G. and Walker, K. A. and Sharrett, A. R. and Gottesman, R. F. and Lutsey, P. L. and others},
title = {{Lifetime risk and projected burden of dementia}},
journal = {Nature Medicine},
year = {2025},
doi = {10.1038/s41591-024-03340-9},
pmid = {39806070},
url = {https://doi.org/10.1038/s41591-024-03340-9}
}
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Key findings
- These results highlight the urgent need for policies that enhance healthy aging, with a focus on health equity.
Why it matters
This study estimates that about 42% of people who reach age 55 will develop dementia in their lifetime, with higher rates in women, Black adults, and APOE ε4 carriers. It projects that new dementia cases in the US will rise from about 514,000 a year in 2020 to about 1 million in 2060, which the authors say shows an urgent need for policies that support healthy aging and health equity.
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Study details
- Study designcohort
- Participants15,043
- Effect sizeLifetime dementia risk after age 55: 42% (95% CI 41-43%)
- Evidence strengthHigh
Limitations
Single US cohort from four communities; dementia ascertainment methods changed over decades; projections assume constant age-specific risk; higher estimate than prior studies partly reflects more complete case capture.
How this study scored 85/100
Published in a top-tier journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it. We have no data on free to read, so that was left out: it earned 83 of the 98 points we could judge it on, which is 85 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (Nature Medicine) |
| Journal's citation record | 4 / 4 | Nature Medicine: journal h-index 763 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 4 / 4 | 15,043 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 144 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 48.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 6 / 6 | Cited 90.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 18 other studies in this library |
| Still being cited | 3 / 4 | Cited 143 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Josef Coresh: h-index 193 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | National Institutes of Health: institution h-index 2,723 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 10 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39806070) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 83 / 98 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 83 of the 98 points we could judge it on is 85 out of 100. |
| Total | 85 / 100 | — |
What each of these 20 components measures, and what this score is not →
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