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21 世纪英国和主要西方国家加速的神经退行性疾病死亡:-人口统计学和/或多种交互环境因素?

21st century accelerating neurological deaths in UK and major Western countries: - Demographic and/or multiple-interactive-environmental causes?

机构信息

Southampton University, UK.

Southampton University, UK.

出版信息

J Neurol Sci. 2024 Jul 15;462:123094. doi: 10.1016/j.jns.2024.123094. Epub 2024 Jun 13.

Abstract

OBJECTIVE

We examine whether the rise in neurological death rates over the 21st century are solely explained by the Gompertzian hypothesis.

STUDY DESIGN

We examine two data-sets. First, Office of National Statistics (ONS, 2022) for nineteen mortality categories in England/Wales, including Alzheimer's, Dementias and Parkinson's Disease. Secondly, WHO (2020) Combined Neurological Mortality (CNM), from WHO Global mortality categories, Nervous Disease Deaths, and Alzheimer's & Other Dementias.

METHODS

Based on ONS data we investigate trends in Age-Standardised Mortality Rates (ASMR) of CNM 2000-2022. Based on WHO data we examine rates of Early Deaths (55-74) and ASMR, for CNM between 2000 and 2015 in the ten Major 'Western' economies: Australia, Canada, France, Germany, Italy, Japan, Netherlands, Spain, UK, and the USA.

RESULTS

In England & Wales death rates have increased 348% for Alzheimer's, 235% for Dementias, and 105% for Parkinson's Disease in contrast with falls in most other cause mortality. Early Adults Deaths CNM rates increased in eight countries, an average of 19%. Neurological ASMR rose in every country, averaging 43%, the highest was the UK 95%.

CONCLUSION

We reject the Gompertzian hypothesis as an all-encompassing explanation for these marked increases in ASMR. Increases in early adult neurological deaths suggests this cannot be solely explained by an aging population. Furthermore, increases in mortality could be related to an increased prevalence of neurological conditions in this age group. Action is urgently needed to investigate factors - whether environmental, lifestyle or health systems - that could explain these findings.

摘要

目的

我们研究 21 世纪神经死亡率的上升是否仅能用龚柏兹假设来解释。

研究设计

我们研究了两个数据集。首先,英格兰和威尔士的国家统计局(ONS,2022 年)的 19 项死亡率类别,包括阿尔茨海默病、痴呆症和帕金森病。其次,世界卫生组织(WHO,2020 年)的综合神经死亡率(CNM),来自 WHO 全球死亡率类别、神经疾病死亡和阿尔茨海默病和其他痴呆症。

方法

基于 ONS 数据,我们研究了 2000-2022 年 CNM 的年龄标准化死亡率(ASMR)趋势。基于 WHO 数据,我们检查了 2000-2015 年在澳大利亚、加拿大、法国、德国、意大利、日本、荷兰、西班牙、英国和美国这十个主要“西方”经济体中 CNM 的早期死亡(55-74 岁)和 ASMR 率。

结果

在英格兰和威尔士,阿尔茨海默病的死亡率增加了 348%,痴呆症的死亡率增加了 235%,帕金森病的死亡率增加了 105%,而大多数其他死因的死亡率却下降了。在八个国家,早期成年人的 CNM 死亡率上升,平均上升了 19%。每个国家的神经 ASMR 都有所上升,平均上升了 43%,最高的是英国,上升了 95%。

结论

我们拒绝龚柏兹假设作为解释这些 ASMR 显著上升的全面解释。早期成年神经死亡人数的增加表明,这不能仅仅用人口老龄化来解释。此外,死亡率的增加可能与该年龄段神经疾病的患病率增加有关。迫切需要采取行动,调查可能解释这些发现的因素,无论是环境、生活方式还是卫生系统。

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