Future trends in dementia incidence and mortality: projecting the burden of dementia on long-term care in Finland by 2040

AIMS: We projected the future number of individuals with dementia and long-term care (LTC) residents in Finland by education level through 2040. We also examined the impact of different future scenarios regarding declining dementia and LTC trends, as well as the effect of past educational expansion on the future prevalence of dementia and LTC. METHODS: A multistate model tracks the population aged 65 years and over through states characterised by the presence of dementia, LTC residence, or death. We calculated age, gender, education and year-specific transition probabilities from Finnish registry data under various scenarios. RESULTS: Assuming constant transition probabilities, the number of individuals with dementia is projected to rise by 74% (from 123,800 to 215,900) between 2018 and 2040. The number of LTC residents is expected to increase by 58% (from 73,900 to 116,800). Driven mainly by shifts in population education distribution, the number of people with dementia is projected to decrease by 29% among those with basic education, while increasing by 215% and 260% among those with secondary and tertiary education, respectively. If both dementia incidence and mortality decrease as projected for overall mortality, the number of people with dementia and LTC residents would rise by 67% and 73%, respectively. If the declining trend in LTC use observed prior to 2018 persists, the number of LTC residents could decrease by 10% by 2040. CONCLUSIONS: Even under optimistic assumptions of declining dementia incidence and mortality, the burden of dementia on health and social care systems is projected to persist.