ASTANA — With more than 55 million people living with dementia globally, Kazakhstan is seeing an upward trajectory in Alzheimer’s disease incidence. Experts say the increase reflects demographic ageing, improved recognition of cognitive decline and more systematic case registration.
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“It was once believed that Alzheimer’s disease or dementia was becoming younger, but in fact, it turned out that we simply began to detect it better. Doctors have become more aware of cognitive decline and pay more attention to identifying these disorders. (…) Most likely, this reflects better detection rather than the disease truly becoming younger,” candidate of medical sciences and psychotherapist Zhibek Zholdasova told The Astana Times.
She added that many countries are only now strengthening early identification practices, which affects official statistics.
According to the World Health Organization (WHO), 57 million people were living with dementia worldwide in 2021, with nearly 10 million new cases annually. Alzheimer’s disease accounts for an estimated 60-70% of cases and is currently the seventh leading cause of death globally. In 2019, the global economic cost of dementia reached $1.3 trillion.
Alzheimer’s Disease International (ADI), the worldwide federation of Alzheimer associations, projects continued growth. The organization estimates that the number of people living with dementia could reach 78 million by 2030 and 139 million by 2050, with the fastest increases expected in low- and middle-income countries.
Registered Alzheimer’s cases increased from 496 in 2021 to 3,706 in 2025, with interim figures of 1,346 in 2022, 2,279 in 2023 and 2,992 in 2024, according to figures cited by the Salidat Kairbekova National Scientific Center for Health Development at the Kazakh Health Ministry.
The broader dementia category showed a similar pattern, rising from 8,921 registered cases in 2021 to 11,087 in 2025. In 2025, 928 Alzheimer’s patients were aged 60-69, 1,710 were 70-79, and 817 were 80 and older. Another 520 cases were recorded among working-age adults between 18 and 63.
While global estimates point to significant economic consequences, the national center reported that no economic assessment of the burden of Alzheimer’s disease or other forms of dementia has yet been conducted in Kazakhstan. The center also noted that the country does not have a standalone state program dedicated exclusively to Alzheimer’s disease or dementia. Prevention, diagnosis and treatment are provided within the broader healthcare system, and Kazakhstan currently operates 20 mental health centers nationwide.
What Alzheimer’s disease is, and is not
Alzheimer’s disease is a progressive, irreversible neurological disorder and the most common form of dementia. According to the WHO, dementia results from diseases that damage the brain and cause a decline in cognitive function beyond what would be expected from typical age-related changes.
Early signs of Alzheimer’s may include memory loss, disorientation in familiar places, difficulty managing finances, repeating questions, losing items and mood changes. As the disease progresses, individuals may require increasing assistance with daily living.
WHO emphasizes that Alzheimer’s disease and other forms of dementia are medical conditions, not an inevitable consequence of growing older.
However, the misconception remains widespread. The ADI’s 2024 World Alzheimer Report found that nearly 80% of the general public believes dementia is a normal part of ageing, up from 66% in 2019. Among health and care professionals, 65% hold the same view. ADI warned that such misunderstandings can delay diagnosis and limit access to treatment and support.
Zholdasova said that in Kazakhstan’s clinical practice, many patients seek care at more advanced stages.
“Most often, patients come to my appointment at the moderate or severe stage of Alzheimer’s disease, and very rarely does someone come at the mild stage. This problem exists almost everywhere in the world. Only recently have doctors begun to be trained to focus on early detection. And only in the last couple of years have early biomarkers for identifying pre-dementia and mild stages of dementia been informally approved by science,” she said.
“We are entering a new phase of early detection over the past year or two, but globally, there are still complaints that patients come very late,” she added.
Early detection and access to treatment
Zholdasova highlighted that access to early diagnosis remains limited at the primary healthcare level.
She said a new blood test capable of identifying early stages of Alzheimer’s disease may become available in Kazakhstan by the end of this year or next year, which would allow physicians to prescribe new treatments earlier. She added that treatments approved by the United States Food and Drug Administration (FDA) that slow early-stage Alzheimer’s, including lecanemab and donanemab, are not yet available in Kazakhstan. These therapies are currently used in the U.S., parts of Europe, South Korea, the United Arab Emirates and Japan.
Under Kazakhstan’s guaranteed volume of free medical care and compulsory social health insurance system, adults under dynamic observation with the diagnosis code G30 (Alzheimer’s disease) are eligible for donepezil and memantine. These medications are intended to manage symptoms rather than reverse the disease.
“Today, Alzheimer’s disease is considered incurable. It is a chronic, progressive decline in cognitive functions that, at advanced stages, leads to a complete loss of self-care. Over the course of the illness, typically over five, seven or even ten years, depending on how long a person lives after diagnosis, individuals gradually lose their knowledge, their skills and their accumulated experience,” Zholdasova said.
“At the same time, I recently received a message with a link to a study indicating that 138 new drugs are currently undergoing various stages of clinical trials. There is already a substantial number of ongoing studies, which may eventually show that Alzheimer’s disease could become a treatable condition,” she said.
Zholdasova noted that approximately 70% of patients experience improvement or stabilization with these medications.
“Unfortunately, there are always 20-30% of patients who do not respond to treatment,” she said.
Risk factors: global evidence and local patterns
WHO identifies age as the strongest risk factor for dementia. Other established factors include hypertension, diabetes, obesity, smoking, harmful alcohol use, physical inactivity, social isolation and depression.
Zholdasova said these factors are commonly observed among patients in Kazakhstan.
“Control of chronic diseases such as arterial hypertension and diabetes is extremely important. I often see elderly patients with 10-20 years of uncontrolled high blood pressure and diabetes. About half of the patients have both conditions,” she said.
She added that air pollution, particularly in large cities such as Almaty, may also contribute to increased risk.
According to the WHO, managing cardiovascular health, maintaining physical activity and social engagement, and avoiding harmful lifestyle factors may reduce the risk of cognitive decline.
