Department of Biostatistics, University of California, Los Angeles, CA, USA.
Department of Biostatistics, University of California, Los Angeles, CA, USA.
Alzheimers Dement. 2018 Feb;14(2):121-129. doi: 10.1016/j.jalz.2017.10.009. Epub 2017 Dec 7.
We forecast the prevalence of preclinical and clinical Alzheimer's disease (AD) and evaluated potential impacts of primary and secondary preventions in the United States.
We used a multistate model incorporating biomarkers for preclinical AD with US population projections.
Approximately 6.08 million Americans had either clinical AD or mild cognitive impairment due to AD in 2017 and that will grow to 15.0 million by 2060. In 2017, 46.7 million Americans had preclinical AD (amyloidosis, neurodegeneration, or both), although many may not progress to clinical disease during their lifetimes. Primary and secondary preventions have differential impact on future disease burden.
Because large numbers of persons are living with preclinical AD, our results underscore the need for secondary preventions for persons with existing AD brain pathology who are likely to develop clinical disease during their lifetimes as well as primary preventions for persons without preclinical disease.
我们预测了美国临床前和临床阿尔茨海默病（AD）的流行情况，并评估了初级和二级预防的潜在影响。
我们使用了一种多状态模型，该模型结合了 AD 的临床前生物标志物和美国人口预测。
2017 年，约有 608 万美国人患有临床 AD 或 AD 引起的轻度认知障碍，到 2060 年将增至 1500 万。2017 年，有 4670 万美国人患有临床前 AD（淀粉样变性、神经退行性变或两者兼有），尽管许多人在有生之年可能不会发展为临床疾病。初级和二级预防对未来疾病负担有不同的影响。
由于大量的人患有临床前 AD，我们的结果强调了对已经患有 AD 脑病理的人进行二级预防的必要性，这些人在有生之年可能会发展为临床疾病，同时也需要对没有临床前疾病的人进行一级预防。
