The Present and Future Dementia Burden in China: Kinship-Based Projections and Global Comparisons

China has the largest number of patients with dementia in the world, and the rate of growth is expected to escalate further as the population ages. The majority of dementia patients rely on their families for care and assistance. Using demographic models of kinship, we provide quantitative estimates of the burden of dementia, from 1990 up to 2050, by illustrating the number of kin accessible to dementia patients, the dementia prevalence among kinship networks, and the dependency ratio of kin with dementia to working-age kin without dementia. We then compare the estimates of dementia burden across 194 countries and territories, accounting for historical trends in, and future projections of, mortality, fertility, and dementia prevalence. Our findings suggest that, unlike in other aging societies, China's aging crisis is exacerbated by the fact that, in addition to the alarming rise in the number of older adults in need of care, the number of potential family caregivers is also dropping at an unprecedented pace. The increase in dementia dependency ratio is expected to exceed the increases in most other countries across East Asia, Western Europe, and the United States. These findings have important implications for understanding the evolution of care networks for older adults in China over time and from a cross-country comparative perspective.