Dementia as a Leading Cause of Death: What the Rankings Show and Miss

Dementia is now one of the main causes of death in the world. The World Health Organization’s latest estimates rank Alzheimer’s disease and other dementias fifth worldwide in 2023, with 2.1 million deaths, and third in high-income countries^[1]. In England and Wales and in Australia it is the leading cause of death^[2][3]. Where it ranks, though, depends a great deal on how each country records and counts it.

Behind these rankings are people who lived for years with a progressive condition, and families who cared for them to the end. Dementia does not always appear on a death certificate, and when it does, it is not always recorded as the cause. That matters, because death statistics shape how governments see a condition and what they spend on it. This article sets out what death statistics from several countries show, and why they need careful reading.

Worldwide, dementia is now the fifth leading cause of death, and third in high-income countries

WHO’s Global Health Estimates, released in 2026, cover more than 160 diseases and injuries each year from 2000 to 2023^[1]. Of the 61 million deaths worldwide in 2023, the ten leading causes accounted for 33 million, or 54%. Ischaemic heart disease remained the largest single cause, at 16% of all deaths. Alzheimer’s disease and other forms of dementia ranked fifth, with 2.1 million deaths^[1].

The picture varies with country income. In high-income countries, WHO reports that deaths from Alzheimer’s disease and other dementias nearly quadrupled between 2000 and 2023, and in 2023 the conditions became the third leading cause of death there, up from seventh in 2000 and ahead of lung cancer. In upper-middle-income countries, dementia rose from sixteenth place in 2000 to fifth in 2023, and deaths more than tripled^[1].

WHO Global Health Estimates, 2000–2023. The fact sheet does not give a 2000 world rank for dementia or a dementia rank for low- and lower-middle-income countries.

Other estimates give somewhat different answers. WHO’s own dementia fact sheet, dated July 2026, still describes dementia as “currently the seventh leading cause of death”^[4], a ranking from earlier estimates. The Global Burden of Disease (GBD) 2019 study, which used a different method to correct for inconsistent coding between countries, estimated 1.62 million dementia deaths worldwide in 2019, with a wide uncertainty range of 0.41 to 4.21 million. It ranked dementia seventh at all ages and fourth among people aged 70 and over^[5].

In England and Wales and in Australia, dementia now heads the list

In England and Wales, the Office for National Statistics (ONS) reported 72,272 deaths registered in 2025 with dementia and Alzheimer’s disease as the underlying cause, 12.7% of all deaths. It has been the leading cause every year since 2022, and the ordering of the leading causes was the same in England and in Wales^[2]. In 2024, the gap was clear: 68,273 dementia deaths (12.1%), against 54,097 (9.6%) from ischaemic heart diseases, the next cause on the list^[6].

In Australia, dementia, including Alzheimer’s disease, became the leading cause of death in 2024, accounting for 9.4% of deaths against 8.7% for ischaemic heart diseases. The Australian Bureau of Statistics (ABS) noted that 2024 was the first year in which dementia caused over 1,000 more deaths than ischaemic heart diseases; in 2023 the two had been close, at 9.1% and 9.3%^[3]. The median age at death from dementia in Australia in 2024 was 88.7 years^[3].

A rise to first place does not mean dementia has suddenly become more deadly. Much of the change comes from the other side of the table. Between 2015 and 2024, the number of Australian deaths from dementia rose by 38.8%, while deaths from ischaemic heart diseases fell by 18.3% and from cerebrovascular diseases by 15.9%. The ABS points out that the age-standardised death rate for dementia has been more stable than the number of deaths, which reflects an aging population^[3]. The chart shows the two rates converging: dementia’s stayed between 40.5 and 45.2 deaths per 100,000, while heart disease’s fell from 67.0 to 43.4.

Falling deaths from heart disease and stroke, alongside an aging population, help to explain why dementia is moving up the rankings in high-income countries. Our study of how many people live with dementia and how that may change sets out the population side of the story.

Where dementia ranks depends on which causes are counted together

National rankings are not directly comparable, because countries group causes of death differently. Dementia is spread across several codes in the International Classification of Diseases (ICD-10): vascular dementia (F01) and unspecified dementia (F03) sit in the chapter on mental and behavioural disorders, while Alzheimer’s disease (G30) sits with diseases of the nervous system^[7].

England and Wales and Australia group dementia and Alzheimer’s disease together; the ABS uses F01, F03 and G30^[3]. The United States and Canada rank Alzheimer’s disease (G30) by itself. On that basis, Alzheimer’s disease was the sixth leading cause of death in the US in 2024, with 116,022 deaths and an age-adjusted rate of 27.1 per 100,000, down 2.2% from 2023^[8]. In Canada it was eighth in 2024, with 5,294 deaths, 1.6% of the total; Canada’s ranking list has no separate category for other dementias^[9].

When US statisticians count all dementia codes together, the scale looks very different. The National Center for Health Statistics, counting vascular dementia, unspecified dementia, Alzheimer’s disease and other degenerative diseases of the nervous system (G31), found that 288,436 deaths of US adults aged 65 and over in 2022 had dementia as the underlying cause^[10], well over twice the number of all ages ranked under Alzheimer’s disease alone two years later.

Certification habits differ too. A study of 38 countries, looking at deaths among people aged 75 to 84, found that, among deaths coded to either dementia or Alzheimer’s disease, some countries record almost all as “dementia” and others as “Alzheimer’s disease”. In Taiwan and Latvia, 92% and 88% of these deaths were coded to dementia; in Slovenia, Turkey and Poland, 100%, 99% and 89% were recorded as Alzheimer’s disease. The authors found these habits had moderate effects on international differences in recorded death rates^[11]. A country’s place in an Alzheimer’s-only ranking therefore partly reflects how its doctors certify deaths, not only how common the condition is.

Women are more likely to die of dementia, and not only because they live longer

The sources here that report by sex all find more dementia deaths among women. Worldwide, WHO reports that 66% of deaths from Alzheimer’s disease and other forms of dementia are of women^[1]. In England and Wales in 2025, dementia and Alzheimer’s disease accounted for 16.5% of women’s deaths, and was their leading cause of death, compared with 9.1% of men’s; among men, ischaemic heart diseases led, at 12.2%^[2].

Women live longer on average, but the gap remains when age is taken into account. The GBD 2019 study estimated 1.06 million dementia deaths among women and 0.56 million among men in 2019, and found that the age-standardised rate for women was 1.19 times that for men, which the authors described as “largely but not entirely” due to women’s higher life expectancy^[5]. In the United States, the age-adjusted dementia death rate among adults aged 65 and over was higher for women than for men in every year from 2018 to 2022: 599.6 against 464.6 deaths per 100,000 in 2022^[10].

These differences are a reason to plan dementia care, including care at the end of life, with older women in mind; our study of end-of-life care for people with dementia looks at where and how people die. The figures do not tell us about any individual’s risk.

Changes in certification and coding drive part of the rise, and death certificates still miss many deaths

Death statistics record the “underlying cause”: the condition that started the chain of events leading to death, chosen by international ICD rules from everything the doctor writes on the certificate^[2]. When those rules change, or doctors change how they fill in certificates, dementia figures can move without any change in the condition itself.

England and Wales offer a clear example. When ONS moved to new coding software in 2014, deaths that mentioned both a chest infection and dementia began to be coded to dementia rather than to the infection, and dementia was added to the list of conditions that affect swallowing, so that aspiration pneumonia could be treated as its consequence. ONS estimated that these rule changes alone increased the number of deaths with dementia as the underlying cause by 7.1%. That followed a “large increase” in dementia deaths when an earlier ICD-10 update was introduced in 2011^[7].

Doctors’ habits matter as well. A study of multiple-cause-of-death data from Australia (2006–2016) and the US (2006–2017) adjusted for the growing tendency of certifiers to record dementia as a direct cause of death. Compared with official statistics, the adjusted rise in age-standardised dementia death rates was less than half as large in Australia and about two-thirds as large in the US. The authors concluded that this increasing likelihood of reporting dementia as leading to death “largely explains” the recent rises in both countries^[12].

Yet the same authors note that dementia on death certificates “remains low” compared with how common it is in clinical studies^[12]. The clearest evidence comes from a US study that linked 7,342 adults aged 70 to 99 in the Health and Retirement Study to their death records. It estimated that 13.6% of deaths between 2000 and 2009 were attributable to dementia, while death certificates recorded dementia as the underlying cause in only 5.0%: an underestimate by a factor of 2.7. The attributable share was 24.7% among non-Hispanic Black participants, against 12.2% among non-Hispanic White participants, and 16.2% among adults without a high-school education, against 9.8% among college graduates^[13].

So the official figures point two ways. Some of the recent rise reflects better recognition of dementia on certificates, yet the true contribution of dementia to deaths is likely to be larger than vital statistics show, and the US study suggests dementia’s share of deaths is higher among Black Americans and people with less formal education. Our study of dementia diagnosis rates looks at who goes undiagnosed in life.

What the evidence asks of us

• Plan for dementia as a leading cause of death. With dementia now the third leading cause of death in high-income countries and fifth worldwide^[1], health systems need palliative and end-of-life care that is designed around people with dementia, in care homes and at home as well as in hospital, and funded at a scale that matches the death statistics.
• Strengthen how dementia deaths are recorded. WHO’s global action plan on dementia names “strengthening information systems for dementia” as one of its action areas^[14]. The researchers who analysed Australian and US data called for improved guidance and training for doctors who certify deaths, to make statistics comparable within and between countries^[12].
• Publish dementia as one group, and say what is in it. Ranking Alzheimer’s disease alone, as the US and Canada do^[8][9], leaves many dementia deaths out of headline tables. Statistics agencies can publish a combined dementia figure alongside their standard rankings, with the ICD-10 codes stated, as the ABS does^[3].
• Flag breaks in the series. Coding changes in England and Wales in 2011 and 2014 raised recorded dementia deaths^[7]. Charities, journalists and governments quoting long-term trends should say so, rather than presenting the rise as a change in the disease alone.
• Count the deaths certificates miss. Linked survey and death records suggest US death certificates understate dementia’s contribution to deaths by a factor of 2.7^[13]. Research funders can support linked cohort and multiple-cause-of-death studies in more countries, so that the real scale of dementia mortality, and its unequal spread, is known.

Dementia’s place at the top of these tables is not a reason for alarm. It is a reason to make sure that people living with dementia, and those who care for them, get the care and support they need, including at the end of life.

Language: this piece uses person-first language ("people living with dementia", "people with dementia"), as most dementia organisations and people with lived experience prefer, and uses clinical terms such as "Alzheimer's disease" or "mild cognitive impairment" only where a study, dataset or diagnosis refers to that specific condition.

Why we're publishing this

Dementia organisations are often asked whether dementia really is a leading cause of death, and why one country’s ranking looks so different from another’s. We brought the official figures and the research on certification together so that charities, carers’ groups and campaigners can answer that question accurately, and make the case for end-of-life care, research and better data on firm ground. The case belongs to people living with dementia and the families who care for them; our part is to set out plainly what the figures show. This article is part of our Dementia & Health research library.

How to read this data

Most figures here are official death registration statistics, which record the underlying cause of death chosen from the death certificate. They count deaths due to dementia as the underlying cause, not every death involving dementia, so they are lower than the number of people who had dementia when they died. Rankings depend on how causes are grouped: England and Wales and Australia combine dementia and Alzheimer’s disease, while the US and Canada rank Alzheimer’s disease alone. Counts of deaths rise as populations age; age-standardised or age-adjusted rates are better for comparing years, but the published rates use different standard populations and cannot be compared between countries. Coding changes (in England and Wales in 2011 and 2014) and changes in how doctors complete certificates affect trends. The WHO and GBD figures are modelled estimates that correct for some of these differences, and they carry wide uncertainty. The US linked-records study covers 2000–2009 and one country.

Use this data

Free to cite with attribution to Understanding Aging. Charities, carers' groups, campaigners and journalists are welcome to reuse these figures and charts. For the underlying figures as a spreadsheet, get in touch.

Important: This article summarises published research and statistics for general information. It is not medical, care or financial advice and cannot be used to diagnose, treat or predict anything about an individual. If you have concerns about your own or someone else's memory or health, please speak to a GP or another qualified health professional.

Sources

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2. Office for National Statistics. Deaths registration summary statistics, England and Wales: 2025. ONS, 2026. ons.gov.uk/…/deathsregistrationsummarytables/2025
3. Australian Bureau of Statistics. Causes of Death, Australia, 2024. ABS, 2025. abs.gov.au/statistics/health/causes-death/causes-death-australia/latest-release
4. World Health Organization. Dementia (fact sheet). WHO, 2026. who.int/news-room/fact-sheets/detail/dementia
5. GBD 2019 Collaborators. Global mortality from dementia: application of a new method and results from the Global Burden of Disease Study 2019. Alzheimer’s & Dementia: Translational Research & Clinical Interventions, 2021. europepmc.org/article/MED/34337138
6. Office for National Statistics. Deaths registration summary statistics, England and Wales: 2024. ONS, 2025. ons.gov.uk/…/deathsregistrationsummarytables/2024
7. Office for National Statistics. Impact of the implementation of IRIS software for ICD-10 cause of death coding on mortality statistics, England and Wales. ONS, 2014. ons.gov.uk/…/impactoftheimplementationofirissoftware…
8. National Center for Health Statistics. Mortality in the United States, 2024. NCHS Data Brief No. 548. National Center for Health Statistics, 2026. cdc.gov/nchs/products/databriefs/db548.htm
9. Statistics Canada. Table 13-10-0394-01, leading causes of death (2024 data). Statistics Canada, 2026. www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310039401
10. National Center for Health Statistics. Dementia mortality in adults age 65 and older: United States, 2018–2022. Health E-Stat. CDC, 2024. cdc.gov/nchs/data/hestat/dementia/dementia-mortality-adults-age-65.htm
11. Chi YC, Chu WM, Chang HY, Lu TH. International variations in dementia and Alzheimer disease diagnosis and certification habits and their associations with dementia and Alzheimer disease mortality: a cross-sectional study of 38 countries. Alzheimer Disease & Associated Disorders, 2023. europepmc.org/article/MED/37615486
12. Adair T, Temple J, Anstey KJ, Lopez AD. Is the rise in reported dementia mortality real? Analysis of multiple-cause-of-death data for Australia and the United States. American Journal of Epidemiology, 2022. europepmc.org/article/MED/35279713
13. Stokes AC, Weiss J, Lundberg DJ, et al. Estimates of the association of dementia with US mortality levels using linked survey and mortality records. JAMA Neurology, 2020. europepmc.org/article/MED/32852519
14. World Health Organization. Global action plan on the public health response to dementia 2017–2025. WHO, 2017. who.int/publications/i/item/global-action-plan-on-the-public-health-response-to-dementia-2017---2025