Semaglutide attenuates a proteomics-based dementia risk signature in older adults with overweight or obesity and cardiovascular disease without diabetes: A post hoc analysis of the SELECT phase 3 tria

We searched PubMed from database inception to Sept 15, 2025, for articles on the prevalence, mortality, and overall impact of all-cause dementia in Europe, using the search terms (“Prevalence” OR “Mortality” OR “Burden of disease”) AND (“Meta-analysis” OR “Systematic Review”) AND (“Dementia”) AND (“Europe”), with no language or time restrictions. Although several studies have examined dementia frequency and outcomes in Europe, we identified only a small number of systematic reviews and meta-analyses, many of which were limited to specific dementia subtypes, restricted age ranges, or based on older data. The provided prevalence estimates across European countries, drawing primarily on national survey and cohort data. However, it was restricted to prevalence, did not capture individuals younger than 60 years, and did not present comprehensive estimates of mortality or disability burden. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study has regularly reported dementia estimates for 204 countries and territories, including European countries, but no dedicated publication has systematically described GBD dementia findings in Europe. Updated and detailed estimates are particularly relevant given the recent approval of disease-targeted therapies for early symptomatic Alzheimer's disease and the urgent need for planning of health and social care services. This study provides the most recent and comprehensive assessment of dementia burden in Europe, presenting updated GBD 2023 estimates for prevalence, mortality, and disability-adjusted life years (DALYs) at both the country and subregional level (Western, Central, and Eastern Europe). By using the GBD framework, this study goes beyond a conventional systematic review and meta-analysis by harmonising heterogeneous data sources and generating internally consistent estimates across outcomes, countries, age groups, sex, and calendar years. We provide detailed age- and sex-specific estimates in 5-year age bands from age 40 years onwards, highlighting the steep increase in dementia burden at older ages and the disproportionate impact on women. We also present temporal trends from 1990 to 2023, enabling assessment of long-term changes. Furthermore, we report on the contribution of modifiable risk factors, identifying ambient air pollution as the leading contributor to dementia DALYs in Europe among the risk factors currently assessed within the GBD framework.