Department of Life Sciences, University of Siena, via Aldo Moro 2, Siena, 53100, SI, Italy.
Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Policlinico Le Scotte, University of Siena, Siena, Italy.
Neurol Sci. 2024 Dec;45(12):5731-5737. doi: 10.1007/s10072-024-07791-3. Epub 2024 Oct 15.
To evaluate mortality for Alzheimer's Disease (AD) in Italy over more than three decades (1980-2015) and discuss the possible role of general and specific contributing factors.
Mortality data were extracted by the Italian National Institute of Statistics: crude mortality rates were computed for sex and age, considering the whole country and its five main geographical sub-areas. Rates were standardized in two ways: directly (annual mortality rates AMRs) and indirectly (standardized mortality rates, SMRs). SMRs were then used to evaluate geographical differences; to study mortality trend, AMRs and joinpoint linear regression analysis were used.
Considering the entire period and the whole country, mortality rates were similar for females and males and for geographical regions, with the exception of the older age groups where mortality for AD in females slightly prevailed. In these older patients, a steep increase of mortality was seen starting from the current century. The increase in male mortality mirrored the national trend in North-West and Central Italy, but not in North-East, South, and the Islands, where it did not surge until the mid to late 1990s.
the general increase of mortality is in line with international data and it reflects the increasing prevalence of the disease, likely due to increasing longevity, and to improvements in diagnostic accuracy. In addition, the accuracy of death certificate compilation could account for both geographical and temporal differences. Currently available drugs for AD do not seem to have an impact on mortality rates.
评估意大利超过三十年(1980-2015 年)阿尔茨海默病(AD)的死亡率,并讨论可能的一般和特定促成因素的作用。
意大利国家统计局提取了死亡率数据:考虑到整个国家及其五个主要地理分区,计算了性别和年龄的粗死亡率。死亡率通过两种方式进行标准化:直接(年度死亡率 AMRs)和间接(标准化死亡率 SMRs)。然后使用 SMRs 来评估地理差异;为了研究死亡率趋势,使用了 AMRs 和连接点线性回归分析。
考虑整个时期和整个国家,女性和男性以及地理区域的死亡率相似,但在年龄较大的群体中,女性 AD 的死亡率略占优势。在这些年龄较大的患者中,自本世纪以来,死亡率急剧上升。男性死亡率的增加反映了意大利西北部和中部的全国趋势,但在东北部、南部和岛屿地区并非如此,直到 20 世纪 90 年代中期至后期,死亡率才飙升。
死亡率的普遍增加与国际数据一致,反映了疾病的患病率不断增加,可能是由于寿命延长和诊断准确性提高所致。此外,死亡证明编制的准确性可能是造成地理和时间差异的原因。目前用于 AD 的药物似乎对死亡率没有影响。