Ferri Cleusa P, Prince Martin, Brayne Carol, Brodaty Henry, Fratiglioni Laura, Ganguli Mary, Hall Kathleen, Hasegawa Kazuo, Hendrie Hugh, Huang Yueqin, Jorm Anthony, Mathers Colin, Menezes Paulo R, Rimmer Elizabeth, Scazufca Marcia
Section of Epidemiology, Institute of Psychiatry, King's College, London, UK.
Lancet. 2005 Dec 17;366(9503):2112-7. doi: 10.1016/S0140-6736(05)67889-0.
100 years after the first description, Alzheimer's disease is one of the most disabling and burdensome health conditions worldwide. We used the Delphi consensus method to determine dementia prevalence for each world region.
12 international experts were provided with a systematic review of published studies on dementia and were asked to provide prevalence estimates for every WHO world region, for men and women combined, in 5-year age bands from 60 to 84 years, and for those aged 85 years and older. UN population estimates and projections were used to estimate numbers of people with dementia in 2001, 2020, and 2040. We estimated incidence rates from prevalence, remission, and mortality.
Evidence from well-planned, representative epidemiological surveys is scarce in many regions. We estimate that 24.3 million people have dementia today, with 4.6 million new cases of dementia every year (one new case every 7 seconds). The number of people affected will double every 20 years to 81.1 million by 2040. Most people with dementia live in developing countries (60% in 2001, rising to 71% by 2040). Rates of increase are not uniform; numbers in developed countries are forecast to increase by 100% between 2001 and 2040, but by more than 300% in India, China, and their south Asian and western Pacific neighbours.
We believe that the detailed estimates in this paper constitute the best currently available basis for policymaking, planning, and allocation of health and welfare resources.
在首次描述阿尔茨海默病100年后，它已成为全球最具致残性和负担最重的健康问题之一。我们采用德尔菲共识方法来确定每个世界区域的痴呆症患病率。
向12位国际专家提供了已发表的关于痴呆症研究的系统综述，并要求他们提供世卫组织每个世界区域、60至84岁按5岁年龄组划分的男性和女性合并患病率估计值，以及85岁及以上人群的患病率估计值。利用联合国人口估计数和预测数来估计2001年、2020年和2040年的痴呆症患者人数。我们根据患病率、缓解率和死亡率来估计发病率。
许多地区缺乏精心规划的、具有代表性的流行病学调查证据。我们估计目前有2430万人患有痴呆症，每年有460万新的痴呆症病例（每7秒新增1例）。受影响人数将每20年翻一番，到2040年将增至8110万。大多数痴呆症患者生活在发展中国家（2001年为60%，到2040年将升至71%）。增长速度并不一致；预计发达国家的人数在2001年至2040年期间将增加100%，但在印度、中国及其南亚和西太平洋邻国将增加超过300%。
我们认为本文中的详细估计数构成了目前政策制定、规划以及卫生和福利资源分配的最佳可用依据。
