China is confronting an unprecedented Alzheimer’s disease challenge, with nearly 17 million people now living with Alzheimer’s and related dementias, almost one quarter of the global total. The newly released 2025 China Alzheimer Report, published in General Psychiatry, reveals sharp increases in prevalence and mortality since 1990 and outlines how new diagnostics, treatments, and public health policies are reshaping the nation’s response.
A Rapidly Growing Burden
The report, produced by researchers from Shanghai Jiao Tong University and partner institutions, draws on the Global Burden of Disease study and national health data. It shows that Alzheimer’s prevalence in China rose by more than 240% since 1990, reaching 16.99 million cases in 2021. Women are disproportionately affected, with rates nearly twice those of men. That year, 2.91 million new cases were diagnosed and almost half a million deaths were attributed to Alzheimer’s.
Eastern, southwestern, and northeastern provinces such as Shanghai, Sichuan, Liaoning, Jiangsu, and Chongqing carry the heaviest load. Overall, China accounts for nearly 30% of global cases, deaths, and disability-adjusted life years (DALYs) from Alzheimer’s.
How China Diagnoses Alzheimer’s
Standard tools such as magnetic resonance imaging (MRI) and computed tomography (CT) remain central for detecting brain atrophy. Positron emission tomography (PET) is gaining ground for early detection, although high costs and limited access hinder its use. Neuropsychological assessments, fluid biomarkers from cerebrospinal fluid and blood, and even emerging urine-based tests are expanding diagnostic capabilities.
Recent years have also seen the rise of digital screening tools and computer-assisted memory testing. Domestic platforms like CatCog and CoCoSc are being refined for older Chinese adults, alongside international systems such as Cogstate.
New and Emerging Treatments
Treatment in China is moving beyond symptomatic drugs like donepezil and memantine toward disease-modifying therapies (DMTs). Notable developments include:
- Lecanemab: Approved in China in 2024, this anti-amyloid antibody slows cognitive decline by about 27% in trials. Over 2,000 patients have received it so far.
- Donanemab: Gained approval in December 2024 after Phase III data showed a 35% reduction in cognitive decline rates.
- SHR-1707: The first domestically developed anti-amyloid antibody, now in Phase II trials.
- Neuromodulation therapies: Techniques like transcranial magnetic stimulation and near-infrared light therapy are showing promise for cognitive improvement.
- Traditional Chinese medicine: Acupuncture and herbal formulations remain active areas of clinical research.
Other innovative avenues include lymphatic-venous anastomosis surgery to enhance brain waste clearance and intranasal delivery of stem cell-derived exosomes, which early studies suggest may improve memory scores without major side effects.
Prevention, Policy, and Care Infrastructure
Government-backed initiatives such as the Healthy China 2030 Plan and the 2023–2025 Alzheimer’s prevention campaign are driving early screening and community-based care. The number of specialized memory clinics reached 273 by 2022, with public awareness rising sharply, 80% of patients and families now recognize early symptoms.
Long-term care insurance pilots have expanded to 49 cities, though coverage for dementia remains uneven. Cities like Qingdao and Shanghai have introduced dementia care units and in-home support, easing both the financial and emotional burden on families.
Global Significance
China’s Alzheimer’s epidemic is not just a national challenge. With nearly one third of the global disease burden, advancements in China’s diagnostics, drug development, and public health models will influence care strategies worldwide. The 2025 report underscores both the urgency of the crisis and the momentum building in scientific, medical, and policy responses.
“Our findings provide a comprehensive update on AD in China, including the latest diagnostic and treatment advancements, clinical outcomes, and an assessment of public health resources,” said Dr. Wang, corresponding author of the report.
Journal and Citation
Journal: General Psychiatry
DOI: 10.1136/gpsych-2024-102020
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