Epidemiology and risk factors of Alzheimer’s disease and related dementias in South and Southeast Asia: a systematic review and meta-analysis protocol

Background Alzheimer’s disease (AD) impacts over 55 million individuals worldwide and remains the leading cause of dementia (60–70% of cases). By 2050, South and Southeast Asia are projected to have an older adult population more than double, bearing a major share of Alzheimer’s disease burden. This...

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Main Authors: Zhahirul Islam, Israt Jahan, Sharmin Sultana, Nowshin Papri, Mantaka Rahman, Imran Hasan, Tamal Saha, Shoma Hayat, Ashiqa Tabassum, Md Abu Jaher Nayeem
Format: Article
Language:English
Published: BMJ Publishing Group 2025-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/8/e105955.full
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author Zhahirul Islam
Israt Jahan
Sharmin Sultana
Nowshin Papri
Mantaka Rahman
Imran Hasan
Tamal Saha
Shoma Hayat
Ashiqa Tabassum
Md Abu Jaher Nayeem
author_facet Zhahirul Islam
Israt Jahan
Sharmin Sultana
Nowshin Papri
Mantaka Rahman
Imran Hasan
Tamal Saha
Shoma Hayat
Ashiqa Tabassum
Md Abu Jaher Nayeem
author_sort Zhahirul Islam
collection DOAJ
description Background Alzheimer’s disease (AD) impacts over 55 million individuals worldwide and remains the leading cause of dementia (60–70% of cases). By 2050, South and Southeast Asia are projected to have an older adult population more than double, bearing a major share of Alzheimer’s disease burden. This will exert a heavy strain on healthcare systems, particularly in resource-limited countries where support and infrastructure are already stretched. Despite this, no review has yet explored the regional epidemiology and associated risk factors in this context. Thus, this study protocol outlines to synthesise prevailing evidence from these densely populated regions, particularly low- and middle-income nations within South and Southeast Asia.Methods This review will include studies that reported epidemiological characteristics including prevalence, age of onset, mortality, and risk factors of AD and related dementias comprising in South and Southeast Asian regions. Studies published in any language from inception to date will be extracted from PubMed, Scopus, CINAHL, EMBASE and APA PsycNet, following Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. We will also search grey literature sources and screen the reference lists of the articles selected for full-text review to identify additional relevant studies. Observational studies including case–control, cohort, and cross-sectional designs reporting desired outcomes will be included and appraised for quality assessment with the modified Newcastle-Ottawa Scale (mNOS). The included articles will be appraised by two independent reviewers, with a third resolving any conflicts. Pooled estimates of prevalence, age of onset and mortality will be analysed using random effect meta-analysis (REML) model. Associated risk factors, including modifiable and non-modifiable will be narratively synthesised. Forest plots will be used to visualise the findings, and heterogeneity across the included studies will be assessed using the I² and Cochrane’s Q statistics. Potential publication bias will be assessed using a funnel plot along with the Begg’s and Egger’s tests. Sensitivity and subgroup analyses will also be conducted to assess the robustness of pooled estimates and to explore potential sources of heterogeneity. Statistical analysis will be conducted using Rstudio (v.4.3.2) and GraphPad Prism V.9.0.2.Ethics and disseminations The systematic review is focused on the analysis of secondary data from published literature; thus, no ethical approval will be needed. The protocol will follow international standard guidelines, findings will be reported in a reputed journal and disseminated through (inter)national conferences, webinars and key stakeholders to inform policy, research and AD management strategies.PROSPERO registration number CRD 420251047105.
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spelling doaj-art-8be9f4f0133741eeacbba4e81484a50d2025-08-21T10:10:13ZengBMJ Publishing GroupBMJ Open2044-60552025-08-0115810.1136/bmjopen-2025-105955Epidemiology and risk factors of Alzheimer’s disease and related dementias in South and Southeast Asia: a systematic review and meta-analysis protocolZhahirul Islam0Israt Jahan1Sharmin Sultana2Nowshin Papri3Mantaka Rahman4Imran Hasan5Tamal Saha6Shoma Hayat7Ashiqa Tabassum8Md Abu Jaher Nayeem9Department of Laboratory Sciences and Services Division, The International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh1 Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia1 International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh6 Laboratory of Gut-Brain Signaling, Laboratory Sciences and Services Division (LSSD), International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh1 International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshGut-Brain Axis, ICDDRB, Dhaka, BangladeshGut-Brain Axis, ICDDRB, Dhaka, BangladeshGut-Brain Axis, ICDDRB, Dhaka, BangladeshGut Brain Axis Laboratory, icddr,b, Dhaka, BangladeshGut Brain Axis Laboratory, icddr,b, Dhaka, BangladeshBackground Alzheimer’s disease (AD) impacts over 55 million individuals worldwide and remains the leading cause of dementia (60–70% of cases). By 2050, South and Southeast Asia are projected to have an older adult population more than double, bearing a major share of Alzheimer’s disease burden. This will exert a heavy strain on healthcare systems, particularly in resource-limited countries where support and infrastructure are already stretched. Despite this, no review has yet explored the regional epidemiology and associated risk factors in this context. Thus, this study protocol outlines to synthesise prevailing evidence from these densely populated regions, particularly low- and middle-income nations within South and Southeast Asia.Methods This review will include studies that reported epidemiological characteristics including prevalence, age of onset, mortality, and risk factors of AD and related dementias comprising in South and Southeast Asian regions. Studies published in any language from inception to date will be extracted from PubMed, Scopus, CINAHL, EMBASE and APA PsycNet, following Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. We will also search grey literature sources and screen the reference lists of the articles selected for full-text review to identify additional relevant studies. Observational studies including case–control, cohort, and cross-sectional designs reporting desired outcomes will be included and appraised for quality assessment with the modified Newcastle-Ottawa Scale (mNOS). The included articles will be appraised by two independent reviewers, with a third resolving any conflicts. Pooled estimates of prevalence, age of onset and mortality will be analysed using random effect meta-analysis (REML) model. Associated risk factors, including modifiable and non-modifiable will be narratively synthesised. Forest plots will be used to visualise the findings, and heterogeneity across the included studies will be assessed using the I² and Cochrane’s Q statistics. Potential publication bias will be assessed using a funnel plot along with the Begg’s and Egger’s tests. Sensitivity and subgroup analyses will also be conducted to assess the robustness of pooled estimates and to explore potential sources of heterogeneity. Statistical analysis will be conducted using Rstudio (v.4.3.2) and GraphPad Prism V.9.0.2.Ethics and disseminations The systematic review is focused on the analysis of secondary data from published literature; thus, no ethical approval will be needed. The protocol will follow international standard guidelines, findings will be reported in a reputed journal and disseminated through (inter)national conferences, webinars and key stakeholders to inform policy, research and AD management strategies.PROSPERO registration number CRD 420251047105.https://bmjopen.bmj.com/content/15/8/e105955.full
spellingShingle Zhahirul Islam
Israt Jahan
Sharmin Sultana
Nowshin Papri
Mantaka Rahman
Imran Hasan
Tamal Saha
Shoma Hayat
Ashiqa Tabassum
Md Abu Jaher Nayeem
Epidemiology and risk factors of Alzheimer’s disease and related dementias in South and Southeast Asia: a systematic review and meta-analysis protocol
BMJ Open
title Epidemiology and risk factors of Alzheimer’s disease and related dementias in South and Southeast Asia: a systematic review and meta-analysis protocol
title_full Epidemiology and risk factors of Alzheimer’s disease and related dementias in South and Southeast Asia: a systematic review and meta-analysis protocol
title_fullStr Epidemiology and risk factors of Alzheimer’s disease and related dementias in South and Southeast Asia: a systematic review and meta-analysis protocol
title_full_unstemmed Epidemiology and risk factors of Alzheimer’s disease and related dementias in South and Southeast Asia: a systematic review and meta-analysis protocol
title_short Epidemiology and risk factors of Alzheimer’s disease and related dementias in South and Southeast Asia: a systematic review and meta-analysis protocol
title_sort epidemiology and risk factors of alzheimer s disease and related dementias in south and southeast asia a systematic review and meta analysis protocol
url https://bmjopen.bmj.com/content/15/8/e105955.full
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