文献类型：期刊文献

中文题名：1992至2021年中国居民老年痴呆症疾病负担变化状况及预测

英文题名：Changes and forecast of the disease burden of senile dementias among Chinese residents from 1992 to 2021

作者：张勰[1];潘萌萌[2]

第一作者：张勰

机构：[1]甘肃中医药大学卫生管理学院,兰州730000;[2]甘肃中医药大学公共卫生学院,兰州730000

第一机构：甘肃中医药大学

年份：2025

卷号：50

期号：11

起止页码：2071

中文期刊名：中南大学学报(医学版)

外文期刊名：Journal of Central South University (Medical Science)

收录：;北大核心:【北大核心2023】；

基金：甘肃省高校教师创新基金(2025A-103)。

语种：中文

中文关键词：老年人痴呆症;疾病负担;贝叶斯年龄-时期-队列模型;发病率;伤残调整生命年;疾病防控

外文关键词：senile dementia;disease burden;Bayesian age-period-cohort model;incidence;disabilityadjusted life years;disease prevention and control

摘要：目的:《中国阿尔茨海默病报告2024》显示,中国因阿尔茨海默病(Alzheimer’s disease,AD)及其他类型痴呆导致的死亡人数为320715例,占全球相关死亡总数的19.8%,其社会经济负担日益突出,对中国居民健康构成严重威胁。本研究旨在分析1992至2021年中国居民老年痴呆症疾病负担的变化状况并预测其变化趋势,为老年痴呆症防控提供参考。方法:基于2021年全球疾病负担研究(Global Burden of Disease,GBD)数据,采用联结点(Joinpoint)回归模型分析1992至2021年中国60岁及以上居民老年痴呆症的发病人数及标化发病率、死亡人数及标化死亡率、伤残调整生命年(disability-adjusted life years,DALY)及标化DALY率;采用年龄-时期-队列模型,分析不同效应下的发病率和病死率;采用贝叶斯年龄-时期-队列模型,对2022至2031年中国居民老年痴呆症的标化发病率进行预测。结果:1992至2021年中国居民老年痴呆症的疾病负担逐年加重,标化发病率与标化DALY率波动上升,标化死亡率下降,标化发病率、标化死亡率、标化DALY率的平均年度变化百分比(average annual percent change,AAPC)分别为0.57%、-0.07%、0.09%(均P<0.05)。2019至2021年,中国60岁及以上居民老年痴呆症发病人数、死亡人数和DALY均显著增加,且女性高于男性。年龄-时期-队列模型显示其发病和死亡风险与年龄增长相关,70岁以上增幅显著;发病风险随时期推移呈先升后降再升的“波浪形”,死亡风险呈先降后升的变化趋势;发病风险随出生队列推移波动上升,死亡风险波动下降。贝叶斯年龄-时期-队列模型预测结果表明,2022至2031年中国的标化发病率可能将持续增长,至2031年,总人群、男性、女性的标化发病率可分别达1616.87/10万、1304.71/10万、1809.09/10万。结论:1992至2021年中国老年痴呆症的疾病负担呈逐年增加的趋势,尤其在老年女性中格外沉重,仍是重大的公共卫生问题,且未来其疾病负担可能持续加重。建议推动高危人群早期筛查,并通过广泛的健康教育提升公众认知,降低发病风险,全面提升老年痴呆症的防控效果。
Objective:The China Alzheimer’s Disease Report 2024 reveals that the number of deaths in China due to Alzheimer’s disease(AD)and other types of dementia reached 320715,accounting for 19.8%of global dementia-related deaths.The socioeconomic burden is increasingly prominent and poses a serious threat to the health of Chinese residents.This study aims to analyze the changes in the disease burden of dementias among Chinese residents from 1992 to 2021 and to predict future trends,so as to provide a reference for dementia prevention and control.Methods:Based on data from the Global Burden of Disease(GBD)Study 2021,Joinpoint regression models were used to analyze the incidence and age-standardized incidence rate,deaths and age-standardized mortality rate,disability-adjusted life year(DALY)and agestandardized DALY rate of senile dementia among Chinese residents aged 60 years and above from 1992 to 2021.Age-period-cohort models were used to analyze incidence and mortality under different effects.Bayesian age-period-cohort models were applied to predict the age-standardized incidence rate of dementias among Chinese residents from 2022 to 2031.Results:From 1992 to 2021,the disease burden of senile dementia among Chinese residents increased year by year.The age-standardized incidence rate and age-standardized DALY rate showed fluctuating upward trends,while the age-standardized mortality rate declined.The average annual percent change(AAPC)of the age-standardized incidence rate,age-standardized mortality rate,and age-standardized DALY rate were 0.57%,?0.07%,and 0.09%,respectively(all P<0.05).From 2019 to 2021,the numbers of incident cases,deaths,and DALY of dementia among Chinese residents aged 60 years and above increased significantly,with higher values in females than in males.The age-period-cohort model indicated that incidence and mortality risks increased with age,with a marked increase after 70 years of age;incidence risk showed a“wave-like”pattern of increasedecrease-increase over periods,while mortality risk showed a trend of decrease followed by increase;incidence risk fluctuated upward across birth cohorts,whereas mortality risk fluctuated downward.Predictions from the Bayesian age-period-cohort model indicate that from 2022 to 2031,the age-standardized incidence rate of dementia in China may continue to increase,reaching 1616.87 per 100000 in the total population,1304.71 per 100000 in males,and 1809.09 per 100000 in females by 2031.Conclusion:From 1992 to 2021,the disease burden of senile dementia in China has increased year by year,with a particularly heavy burden among older women.Senile dementia remains a major public health problem,and its disease burden may continue to increase in the future.It is recommended to promote early screening to promote early screening among high-risk populations and to enhance public awareness through extensive health education to reduce incidence risk and comprehensively improve the effectiveness of senile dementia prevention and control.