Avan Abolfazl, Hachinski Vladimir
Department of Public Health, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Family Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Alzheimers Dement. 2023 Apr;19(4):1281-1291. doi: 10.1002/alz.12764. Epub 2022 Aug 31.
An ample literature documents the growing prevalence of dementia and associated costs. Less attention has been paid to decreased dementia incidence in some countries.
We analyzed trends in age-standardized dementia, stroke, and ischemic heart disease (the triple threat) incidence rates and population attributable fraction of death and disability attributable to 12 risk factors in 204 countries and territories and 51 regions using Global Burden of Disease 2019 data.
During 1990 to 2019, dementia incidence declined in 71 countries; 18 showed statistically significant declines, ranging from -12.1% (95% uncertainty intervals -16.9 to -6.8) to -2.4% (-4.6 to -0.5). During 2010 to 2019, 16 countries showed non-significant declines. Globally, the burden of the triple threat attributable to air pollution, dietary risks, non-optimal temperature, lead exposure, and tobacco use decreased from 1990 to 2019.
The declining incidence of dementia in some countries, despite growing prevalence, is encouraging and urges further investigation.
大量文献记载了痴呆症患病率的不断上升及其相关成本。一些国家痴呆症发病率下降的情况较少受到关注。
我们使用2019年全球疾病负担数据，分析了204个国家和地区以及51个区域的年龄标准化痴呆症、中风和缺血性心脏病（三大威胁）发病率趋势，以及12种风险因素导致的死亡和残疾的人群归因分数。
在1990年至2019年期间，71个国家的痴呆症发病率下降；18个国家出现了统计学上的显著下降，降幅从-12.1%（95%不确定区间为-16.9至-6.8）到-2.4%（-4.6至-0.5）。在2010年至2019年期间，16个国家出现了不显著的下降。在全球范围内，1990年至2019年期间，空气污染、饮食风险、温度不适、铅暴露和烟草使用导致的三大威胁负担有所下降。
尽管痴呆症患病率在上升，但一些国家痴呆症发病率下降的情况令人鼓舞，并促使进一步调查。
