As the number of people living with dementia continues to rise, healthcare systems face increasing demand for medical and support services. Credit: Shutterstock

By Joseph Chamie
PORTLAND, USA, Oct 6 2026 (IPS)

Dementia is a rapidly growing global health challenge that affects many millions of people worldwide and places significant economic, healthcare, and social strains on societies, particularly as populations age.

Families, community organizations, and governments face growing difficulties in providing adequate care and support for older adults living with dementia.

A debilitating neurological condition, dementia is caused by various diseases or injuries that damage the brain and impair its functioning. Its increasing prevalence has made it a pressing global health concern.

Women are disproportionally affected by dementia, experiencing a greater burden of morbidity and disability than men. Women account for approximately two-thirds of deaths from Alzheimer’s disease and other forms of dementia worldwide and provide about 70% of informal care hours delivered by family and friends

Dementia can affect memory, thinking, communication, mood, and behavior, as well as a person’s ability to perform everyday activities. Symptoms generally worsen over time, often placing substantial emotional, physical, and financial burdens on individuals, families, caregivers, and health systems.

The number of people living with dementia is rising rapidly as populations age and life expectancies increase.

Dementia, however, is not a normal part of aging. Although some changes in memory and functioning are common among older adults, dementia can significantly impair memory, thinking, judgment, and the ability to perform everyday activities.

Dementia is the seventh leading cause of death worldwide and a major cause of disability and dependency among older adults.

Alzheimer’s disease is the most common type of dementia, accounting for roughly 60–70% of all dementia cases. Other types include vascular dementia, dementia with Lewy bodies, which is associated with abnormal protein deposits in nerve cells, and frontotemporal dementia, which involves degeneration of the brain’s frontal and temporal lobes.

Dementia affects not only individuals but also families, healthcare systems, and society as a whole. Its growing prevalence is creating substantial economic, healthcare, and social pressures worldwide.

As the number of people living with dementia continues to rise, healthcare systems face increasing demand for medical and support services. Governments and communities must devote additional resources to meet these needs, while families often assume significant and demanding caregiving responsibilities.

Hospitals and long-term care facilities also face growing pressure because people with advanced dementia may require intensive, around-the-clock supervision and assistance with everyday activities.

Beyond direct healthcare and long-term care expenses, dementia generates substantial indirect costs. These include lost productivity when people with dementia can no longer work and reduced workforce participation among family members who leave or reduce employment to provide unpaid care. Together, these direct and indirect costs add substantially to the broader economic and social burden of dementia.

Women are disproportionally affected by dementia, experiencing a greater burden of morbidity and disability than men. Women account for approximately two-thirds of deaths from Alzheimer’s disease and other forms of dementia worldwide and provide about 70% of informal care hours delivered by family and friends.

People who care for relatives with dementia face greater health risks than those caring for family members without dementia, and these risks can persist even after their relatives have died. Caring for people with dementia therefore places substantial burdens on families and society, while the growing global burden of dementia care remains largely underestimated.

In 2021, approximately 57 million people were living with dementia, according to the World Health Organization, and dementia caused about 2 million deaths. With nearly 10 million new cases of dementia occurring each year, largely reflecting population ageing and increasing longevity, the number of people living with dementia is projected to reach about 107 million by 2026 and more than 150 million by 2050 (Figure 1).

Source: World Health Organization.

Dementia can affect memory, thinking, communication, mood, and behavior. Early signs and symptoms of dementia are often observable and may involve difficulties with memory, attention, communication, reasoning, judgement, and processing visual information.

Possible early signs of dementia include forgetting recent events or familiar information, getting lost while walking or driving, becoming confused in familiar places, having difficulty following conversations, forgetting the names of close family members or friends, using unusual words to refer to familiar objects, and struggling to complete routine or familiar tasks independently (Table 1).

Source; U.S. Center for Disease Control.

Although there is currently no known cure for dementia, WHO guidelines report that up to 45% of dementia risk could potentially be prevented or delayed.

The WHO guidelines recommend several healthy behaviors and lifestyle interventions that may reduce dementia risk. These include cognitive training and stimulation, and participation in social activities for adults with normal cognition or mild cognitive impairment.

Other measures that may help reduce dementia risk and support quality of life and well-being include staying physically active, pursuing additional education, eating a healthy diet, drinking a couple of cups of coffee daily, quitting smoking, limiting alcohol consumption, reading regularly, engaging in mentally stimulating activities, and maintaining social connections. Keeping track of daily tasks, managing stress, and obtaining regular medical check-ups may also help people maintain independence and well-being (Table 2).

Source: World Health Organization and U.S. National Institutes of Health.

Some country studies report that each additional year of education is associated with a lower risk of dementia, with the protective association continuing beyond high school. In other words, additional years of education may provide cumulative protection against dementia. Recent research has also found that hearing aids can reduce the rate of cognitive decline in older adults at high risk of dementia by nearly 50%.

Much can also be done to support people living with dementia and those who care for them. Caring for a person with dementia, however, can be challenging and can affect caregivers’ own health and well-being.

Providing care requires patience, clear communication, and attention to the person’s emotional well-being.

Helpful caregiving tips include starting discussing care needs early, speaking calmly and clearly, avoiding arguments, providing reassurance, and avoiding questions such as “Don’t you remember?”. Other strategies include distracting an agitated person with a snack, photo album, humor, or soothing music; maintaining a consistent routine and familiar mealtime setting; encouraging independence and regular exercise; using written to-do lists and reminders; simplifying choices; and ensuring a safe environment.

Caregivers should also prioritize their own physical and emotional well-being. The demands of dementia caregiving can contribute to emotional stress, physical exhaustion, and burnout.

Helpful self-care strategies include taking regular breaks, seeking assistance from family members or others involved in caregiving, maintaining social connections, engaging in regular physical activity, and seeking mental health support when needed. These measures can help reduce stress and exhaustion and lower the risk of caregiver burnout.

Although age itself does not cause of dementia, it is the strongest known risk factor, with the likelihood of developing dementia generally increasing with age. Consequently, countries with older populations, such as Japan, Germany, Italy, and Greece, tend to report higher dementia rates (Figure 2).

Source: World Population Review.

In sum, dementia is a rapidly rising global health challenge, particularly as populations age. Countries face increasing difficulties in providing adequate care and support for older adults living with dementia.

Given the limited availability of effective treatments, there is an urgent need for comprehensive national strategies to prevent or delay dementia and address its broader social, economic, and health consequences. Such strategies should take a coordinated, long-term approach to strengthening prevention, improving care and support services, and reducing the burden on individuals, families, communities, and health systems.

Joseph Chamie is a consulting demographer, a former director of the United Nations Population Division, and author of numerous publications on population issues.

Smaller generations are entering the workforce as larger generations retire and begin receiving pension benefits. Credit: Shutterstock

By Joseph Chamie
PORTLAND, USA, Sep 28 2026 (IPS)

Dozens of government-funded pension programs providing benefits to hundreds of millions of men and women face growing fiscal strain and long-term sustainability challenges. These pressures are largely driven by rapid demographic transitions, including ageing populations, declining fertility, rising life expectancy, and shrinking workforces.

Many state pension systems rely on current workers to finance benefits for current retirees. In countries such as France, Germany, Italy, Spain, and the United States, these systems face increasing financial pressure as the number of workers supporting each retiree declines, while retirees live longer and collect benefits for more years.

Smaller generations are entering the workforce as larger generations retire and begin receiving pension benefits. This demographic shift is placing growing pressure on pension systems and raising concerns about their ability to meet future obligations.

As a result of these significant demographic changes, relatively fewer workers are paying into pension systems to support growing numbers of retirees who are living longer and collecting benefits for more years.

At the same time, extended families, local communities, and other traditional forms of support for retirees are weakening. Moreover, formal pension systems, including government-backed programs, have proven to be difficult to reform and, in some cases, financially unsustainable. In a growing number of countries, government pension programs are also facing insolvency.

Global life expectancy at age 65, for example, has reached 18 years, a 50% increase from 12 years in 1960. At the same time, the share of the world’s population aged 65 and older has more than doubled, from 5% in 1960 to 11% today. Global fertility has also fallen sharply, from 4.7 births per woman in 1960 to 2.2 today. Moreover, these demographic trends are expected to continue well into the 21st century (Table 1).

Source: United Nations.

Population ageing is particularly evident in some more developed countries. For example, a quarter or more of the populations of Germany, Italy, and Japan are aged 65 and older.

Moreover, the proportion of older persons is expected to increase significantly in many countries in the coming decades. By mid-century, for example, about a third or more of the populations of China, Italy, Japan, the Republic of Korea, and Spain are projected to be aged 65 and older (Figure 1).

Source: United Nations.

As a result of significant demographic changes in age structure, longevity, fertility, and the workforce, the number of pension beneficiaries is growing relative to the number of workers whose payroll taxes often finance these programs.

By 2050, the ratios of workers to retirees are expected to decline significantly in many of the world’s largest economies. In 2020, these ratios ranged from about 2 workers per retiree in Japan to about 5 in China. By 2050, the ratios are projected to fall to between 1 to 2 workers per retiree in these countries.

Furthermore, despite population ageing, increased longevity among older persons, and fewer workers per retiree, official retirement ages for receiving government pension benefits have remained largely unchanged.

Countries are moving closer to the point when their pension programs may be unable to pay full scheduled benefits. Unless governments take action, pension revenues will become insufficient in many countries to cover scheduled benefits, with financial shortfalls expected to grow substantially over the coming years

Consequently, pension costs are projected to rise as more workers reach retirement age, while slower population and economic growth constrain the tax bases that support many of the pension programs.

As the ratio of workers to retirees worsens, government officials face difficult choices about raising retirement ages, adjusting benefits, and increasing taxes.

Countries are moving closer to the point when their pension programs may be unable to pay full scheduled benefits. Unless governments take action, pension revenues will become insufficient in many countries to cover scheduled benefits, with financial shortfalls expected to grow substantially over the coming years.

The longer governments delay necessary reforms, the larger the adjustments are likely to be to close these financing gaps. Such adjustments could involve changes to revenue, benefits, retirement ages, or other program provisions.

Despite repeated warnings from pension officials and approaching financial shortfalls, pension reform has received relatively little government attention. Policymakers have generally avoided proposing comprehensive legislation to ensure the long-term financial solvency of their pension programs.

The growing pension peril underscores the urgency of addressing these financial challenges well before programs reach their projected insolvency dates. Acting sooner would give policymakers more time to make gradual changes and restore long-term financial balance.

As some countries have done in the past, governments could establish national commissions to examine the long-term finances of their pension programs. These commissions could develop recommendations and present them to government officials well before projected insolvency dates, giving policymakers adequate time to consider and implement reforms.

Governments have several options for addressing expected pension shortfalls. Policymakers could eliminate or raise the ceiling on earnings subject to payroll taxes, increase payroll tax rates paid by employers and employees, reduce cost-of-living adjustments for high-income beneficiaries, and gradually raise the retirement age as life expectancy increases.

Many of these measures, however, are politically difficult and unpopular with much of the public. Some countries, for example, are considering raising their official retirement ages, but such proposals are opposed by large proportions of the public.

Opinion surveys also indicate a preference for lower retirement ages. For example, respondents in 18 mostly middle-income countries say, on average, that the best age to retire is around 58 (Figure 2).

Source: Pew Research Center.

In sum, many national pension systems are in peril. Significant demographic changes – especially population ageing, increased longevity, declining fertility, and shrinking workforces – are placing growing financial pressure on many government pension programs and threatening their long-term sustainability.

Despite these well-known challenges and the prospect of growing financial shortfalls, government leaders have shown limited willingness to make the difficult policy choices needed to address them. Unless policymakers act, many national pension programs could face serious funding gaps, potentially leading to significant reductions in scheduled benefits for retirees and other beneficiaries.

Joseph Chamie is a consulting demographer, a former director of the United Nations Population Division, and author of many publications on population issues.

Despite the overall trend toward older populations, substantial differences in age structures exist among countries. Credit: Shutterstock.

By Joseph Chamie
PORTLAND, USA, Sep 1 2026 (IPS)

The age structures of populations vary considerably across countries. Some countries have relatively young populations, with large proportions consisting of children and adolescents. Other countries have much older age structures, with a substantial proportion of people aged 65 years or older.

The world’s current population of approximately 8.3 billion has a median age of about 31 years. This is substantially higher than during much of the 20th century, when the global median age was generally below 25 years. The world’s median age was 22 years in 1950, declined to 20 years in 1970, and then increased to nearly 25 years by 1999.

Population ageing is expected to continue worldwide in the coming decades, The median age of the world’s population, currently about 31 years, is projected to increase to approximately 36 years by 2050.

Despite the overall trend toward older populations, substantial differences in age structures exist among countries.

In 2026, approximately 50 countries and territories have populations with median ages of 21 years or younger, reflecting highly youthful age structures. At the other end of the age spectrum, a similar number of countries and territories have median ages of 42 years or older, indicating comparatively old populations.

These wide differences in median age illustrate the striking demographic diversity among countries and the contrasting social and economic challenges associated with youthful and older populations.

Most countries with highly youthful populations are located in Africa. For example, the Central African Republic, Chad, the Democratic Republic of the Congo, Mali, Niger, and Somalia have median ages of 16 years or younger.

In contrast, countries with comparatively older populations are concentrated primarily in Europe and East Asia. France, Germany, Italy, Japan, the Republic of Korea, Spain, and Switzerland, for example, have median ages of 42 years or older. The highest median ages – about 50 years – are found in Italy and Japan (Table 1).

Source: United Nations.

In addition, the median age is expected to rise in virtually all countries, in both more developed and less developed regions. By 2050, for example, the median ages of several countries – including China, Italy, Japan, the Republic of Korea, and Spain – are projected to reach 50 years or more.

The substantial variations in age structures of national populations are also evident in the proportions of people under age 18 and those aged 65 and older.

Once again, countries in which approximately half or more of their population is below age 18, while only a few percent are aged 65 years and older, are concentrated primarily in Africa.

In 2026, for example, 56% of the population in the Central African Republic is under age 18, while the corresponding proportions are approximately 53% in Chad, the Democratic Republic of the Congo, Niger, and Somalia. In each of these countries, only about 3% of the population is age 65 years and older.

In contrast, many developed countries – including Greece, Italy, Japan, Portugal, and the Republic of Korea – have much older population age structures. In some of these countries, such as Italy and Japan, approximately 14% of the population is under age 18, while nearly twice that proportion – between 25% and 30% – is aged 65 years and older (Figure 1).

Source: United Nations.

The ongoing changes in countries’ population age structures will have far-reaching implications, particularly for population growth, labor markets, employment, education, healthcare systems, retirement programs, and long-term care.

Many developing countries have relatively young populations and, because of their age structures and population momentum, generally experience relatively high rates of population growth. In contrast, countries with comparatively older populations tend to have slower rates of population growth, with many developed countries already experiencing population decline.

As many developed countries with ageing and declining populations face growing labor shortages, countries with youthful populations continue to have large numbers of young people entering the labor market, often in excess of available employment opportunities

By midcentury, several African countries with particularly young age structures are expected to experience particularly rapid population growth. For example, the populations of Chad, the Central African Republic, the Democratic Republic of the Congo, Niger, and Somalia are projected to increase by more than 80%.

Such rapid population growth can pose major challenges to social and economic development, particularly in providing adequate education, employment, housing, healthcare, and other essential services. Governments will need to expand infrastructure and public services rapidly simply to keep pace with the growing number of people.

Countries with young and rapidly growing populations may also face greater difficulties in reducing hunger and inequality, advancing women’s rights, expanding access to healthcare, creating decent employment opportunities, preventing social unrest, and addressing internal conflicts.

These demographic pressures underscore the importance of government policies that strengthen human capital, create productive employment, expand social services, and improve infrastructure. Such measures will be essential for ensuring that rapidly growing populations can achieve sustainable improvements in their living standards.

The slow pace of socio-economic development, high rates of unemployment, and limited educational and employment opportunities for many young people are contributing to social unrest, discontent, and political upheaval.

As a result, increasing numbers of young men and women seek to emigrate to developed countries in search of employment, greater security, and better prospects for themselves and their families. While many use regular migration channels, others increasingly resort to irregular migration, including unauthorized entry, overstaying visas, or seeking asylum and refugee protection.

In several African countries, including the Democratic Republic of the Congo, Sierra Leone and Liberia, half or more of the population reportedly would like to emigrate to another country, typically in Europe and North America. These migration aspirations reflect not only economic motivations but also broader concerns about employment opportunities, personal security, governance, and prospects for the future.

Nigeria, Africa’s most populous nation, provides a particularly striking example. Approximately half of its population reportedly would like to leave the country and resettle abroad, preferably in an English-speaking country. Economic hardship, unemployment, limited opportunities, and insecurity have contributed to this strong desire to emigrate. Many Nigerians have already moved abroad through regular migration channels, while others have undertaken irregular journeys or sought asylum and refugee protection.

The persistence of such strong migration aspirations in many less developed countries highlights the close relationship between demographic pressures, socioeconomic conditions, and international migration. Where large youthful populations confront limited employment, educational, and economic opportunities, migration can become an increasingly attractive option for seeking a better future.

Unauthorized migration has consequently become a major political issue in many destination countries. Governments in numerous migrant-receiving countries have introduced or strengthened measures to deter unauthorized migration, including increased border enforcement, arrest and detention of unauthorized migrants, deportation, and the return of people who have entered without authorization or overstayed their visas.

At the same time, the demographic circumstances of migrant-sending and migrant-receiving countries differ considerably. Many less developed countries have relatively young populations and high rates of demographic growth, whereas many developed countries have substantially older age structures and are expected to experience population decline over the coming decades. By 2050, for example, the populations of countries such as Italy, Japan, and the Republic of Korea, are projected to decline by approximately 13% (Figure 2).

Source: United Nations.

These contrasting demographic trends are likely to increase the economic and political importance of international migration. As many developed countries with ageing and declining populations face growing labor shortages, countries with youthful populations continue to have large numbers of young people entering the labor market, often in excess of available employment opportunities.

The consequences of population ageing are becoming increasingly significant for a growing number more developed countries and are also emerging as an important concern for some less developed countries as well. These demographic changes are prompting governments to reconsider existing economic and social policies, programs, and benefits in order to adapt to population realities.

Population ageing, combined with increasing longevity, is reducing the number of workers available to support each retiree while increasing the fiscal burden on the working-age populations that finances pensions, healthcare, and other age-related government programs.

Longer lifespans also mean that many older men and women may outlive their personal savings or retirement benefits. As longevity continues to increase, pension systems are paying benefits for substantially longer periods than anticipated when many of these systems were established during the 20thcentury.

Consequently, governments are facing growing pressure to reform retirement systems, healthcare services, and long-term care programs to ensure their financial sustainability while maintaining adequate support for ageing populations.

In addition to placing greater strains on government finances, the rising costs of medical treatment and care for growing numbers of older persons are placing increasing pressures on family budgets, capacities, and expectations.

Financing and providing long-term care for older persons is a major challenge for societies and families. In many countries, public provision for long-term care remains inadequate or largely unavailable to significant proportions of the population. At the same time, the growing number of older men and women is placing increasing stress on traditional safety nets, including families, friends, and local communities.

Powerful and largely irreversible demographic trends are driving population ageing, with growing numbers and proportions of people – especially women, who typically live longer than men – spending more years in old age. These trends will have profound implications for the organization and financing of societies.

The contrasting age structures of populations in developing and developed countries require significant social and economic adjustments. Countries with youthful populations need to expand education, employment, healthcare, and other services to meet the needs of growing numbers of young people. In contrast, countries with substantially older populations must prepare for rising demands on pension systems, healthcare, and long-term care.

In light of these demographic realities, governments need to revamp policies and programs affecting their populations. Unfortunately, many governments appear to be postponing these necessary adjustments. The longer governments delay adapting policies and programs to changing demographic conditions, the more difficult and costly the consequences are likely to become for their populations.

Joseph Chamie is a consulting demographer, a former director of the United Nations Population Division, and author of many publications on population issues.