全球痴呆症患病率:系统评价和荟萃分析。

The global prevalence of dementia: a systematic review and metaanalysis.

机构信息

Institute of Psychiatry, King's College London, London, UK.

出版信息

Alzheimers Dement. 2013 Jan;9(1):63-75.e2. doi: 10.1016/j.jalz.2012.11.007.

Abstract

BACKGROUND

The evidence base on the prevalence of dementia is expanding rapidly, particularly in countries with low and middle incomes. A reappraisal of global prevalence and numbers is due, given the significant implications for social and public policy and planning.

METHODS

In this study we provide a systematic review of the global literature on the prevalence of dementia (1980-2009) and metaanalysis to estimate the prevalence and numbers of those affected, aged ≥60 years in 21 Global Burden of Disease regions.

RESULTS

Age-standardized prevalence for those aged ≥60 years varied in a narrow band, 5%-7% in most world regions, with a higher prevalence in Latin America (8.5%), and a distinctively lower prevalence in the four sub-Saharan African regions (2%-4%). It was estimated that 35.6 million people lived with dementia worldwide in 2010, with numbers expected to almost double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050. In 2010, 58% of all people with dementia lived in countries with low or middle incomes, with this proportion anticipated to rise to 63% in 2030 and 71% in 2050.

CONCLUSION

The detailed estimates in this study constitute the best current basis for policymaking, planning, and allocation of health and welfare resources in dementia care. The age-specific prevalence of dementia varies little between world regions, and may converge further. Future projections of numbers of people with dementia may be modified substantially by preventive interventions (lowering incidence), improvements in treatment and care (prolonging survival), and disease-modifying interventions (preventing or slowing progression). All countries need to commission nationally representative surveys that are repeated regularly to monitor trends.

摘要

背景

痴呆症的患病率证据基础正在迅速扩大,特别是在低收入和中等收入国家。鉴于这对社会和公共政策与规划有重大影响,需要重新评估全球的患病率和患者人数。

方法

本研究对 1980 年至 2009 年全球痴呆症患病率的文献进行了系统回顾和荟萃分析,以估计 21 个全球疾病负担区域 60 岁及以上人群的患病率和患者人数。

结果

60 岁及以上人群的年龄标准化患病率在较窄的范围内变化,大多数世界区域为 5%-7%,拉丁美洲的患病率较高(8.5%),而四个撒哈拉以南非洲区域的患病率明显较低(2%-4%)。据估计,2010 年全球有 3560 万人患有痴呆症,预计每 20 年将几乎翻一番,到 2030 年将达到 6570 万,到 2050 年将达到 1.154 亿。2010 年,所有痴呆症患者中有 58%生活在低收入和中等收入国家,预计这一比例在 2030 年将上升至 63%,在 2050 年将上升至 71%。

结论

本研究中的详细估计为痴呆症护理的决策制定、规划和卫生与福利资源分配提供了当前最佳基础。全球各区域之间的痴呆症特定年龄患病率差异不大,并且可能进一步趋同。未来痴呆症患者人数的预测可能会因预防干预措施(降低发病率)、治疗和护理的改善(延长生存)以及疾病修饰干预措施(预防或减缓进展)而发生重大改变。所有国家都需要委托进行全国代表性调查,并定期重复调查以监测趋势。

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