AUTHOR=Zou Yuexiao , Wang Qingxian , Zhang Qingxiang , Cheng Xiaorui 
  
TITLE=Divergent trends in Alzheimer’s disease burden: a comparative analysis of the US and G20 nations
  
JOURNAL=International Journal of Public Health
  
VOLUME=Volume 71 - 2026
  
YEAR=2026
  
URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2026.1609525
  
DOI=10.3389/ijph.2026.1609525
  
ISSN=1661-8564
  
ABSTRACT=ObjectiveAlzheimer’s disease and other dementias (ADOD) impose growing systemic stress. This study compared epidemiological trends and risk factors between the US and G20 to guide resource allocation.MethodsUsing GBD 2023 data, we analyzed incidence, mortality, and DALY rates with Joinpoint regression (1990–2023) and ARIMA forecasting (to 2040).ResultsIn 2023, US age-standardized incidence rate was 130 (95% CI: 110.5–147.3), mortality rate 30 (7.4–73.2), and DALY rate 510 (224.8–1059.6), all declining from 1990. G20 rates remained lower but showed an upward inflection after 2020. Joinpoint analysis revealed overall downward trends, with a transient US resurgence (1998–2004); projections suggest continued deceleration. Smoking and high fasting plasma glucose burdens in the US were disproportionately elevated compared to G20.ConclusionThe US achieved morbidity compression yet faced rising absolute caseloads due to demographic momentum. G20’s post-2020 upturn signals an emerging burden. A shift from smoking to metabolic drivers necessitates primary prevention for G20 and targeted metabolic management for the US.