Zhou H Y, Wu L T, Yang H L, Zhang W, Yang X M
Laboratory Medicine,Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing100700, China.
Material and Equipment Department,Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing100700, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2024 Dec 6;58(12):2010-2016. doi: 10.3760/cma.j.cn112150-20240814-00655.
To analyze the disease burden of Alzheimer's disease (AD) in China from 1990 to 2021 and its trend of change, providing evidence for targeted interventions to reduce the burden of AD. A descriptive analysis of AD and its main risk factors among males and females of different ages in China from 1990 to 2021 was conducted using the Global Burden of Disease (GBD) 2021 database. The evaluation indicators were incidence rate, prevalence rate, mortality rate, and disability-adjusted life years (DALYs). The risk factors included high body mass index (BMI), high fasting plasma glucose, and smoking. The results showed that in 2021, the number of AD incidence among the Chinese population was 2 914 112 (204.8/100 000), the number of prevalence was 16 990 827 (1 194.2/100 000), the number of DALYs was 10 072 477 (708.0/100 000), and the number of deaths was 491 773 (34.6/100 000), which increased by 242.7%, 249.1%, 208.2%, and 239.4% respectively compared with 1990. In 2021, the AD incidence rate (264.4/100 000), prevalence rate (1 558.9/100 000), DALYs rate (935.8/100 000), and mortality rate (47.3/100 000) were all higher in women than in men. All rates showed a clear age-dependent trend. In 2021, the DALYs attributable to smoking, high BMI, and high fasting plasma glucose in the AD population in China were 602 501.1 (42.3/100 000), 466 728.7 (32.8/100 000), and 1 204 039.4 (84.6/100 000), respectively, with death tolls of 24 897.3 (1.7/100 000), 20 856.3 (1.5/100 000), and 58 838.2 (4.1/100 000). The proportion of DALYs attributable to high BMI showed an upward trend during 1990-2021, while the proportion of DALYs attributable to smoking showed a gradual decrease. The difference in the attributable risk factors between the genders was significant. In 2021, the highest risk among men was attributed to smoking, with DALYs rate and mortality rate of 68.3/100 000 and 2.7/100 000, respectively. In contrast, the highest risk among women was attributed to high fasting blood sugar, with DALYs rate and mortality rate of 111.1/100 000 and 5.6/100 000, respectively. In conclusion,the disease burden of AD is still increasing, and targeted interventions should be taken for both males and females to reduce the burden of AD by reducing unhealthy lifestyles.
分析1990年至2021年中国阿尔茨海默病(AD)的疾病负担及其变化趋势,为采取针对性干预措施减轻AD负担提供依据。利用《2021年全球疾病负担》(GBD 2021)数据库,对1990年至2021年中国不同年龄男性和女性中的AD及其主要危险因素进行描述性分析。评估指标为发病率、患病率、死亡率和伤残调整生命年(DALYs)。危险因素包括高体重指数(BMI)、高空腹血糖和吸烟。结果显示,2021年,中国人群中AD发病数为2914112例(204.8/10万),患病例数为16990827例(1194.2/10万),DALYs数为10072477例(708.0/10万),死亡数为491773例(34.6/10万),与1990年相比分别增长了242.7%、249.1%、208.2%和239.4%。2021年,女性的AD发病率(264.4/10万)、患病率(1558.9/10万)、DALYs率(935.8/10万)和死亡率(47.3/10万)均高于男性。所有率均呈现明显的年龄依赖性趋势。2021年,中国AD人群中归因于吸烟、高BMI和高空腹血糖的DALYs分别为602501.1例(42.3/10万)、466728.7例(32.8/10万)和1204039.4例(84.6/10万),死亡数分别为24897.3例(1.7/10万)、20856.3例(1.5/10万)和58838.2例(4.1/10万)。1990年至2021年期间,归因于高BMI的DALYs比例呈上升趋势,而归因于吸烟的DALYs比例呈逐渐下降趋势。性别间归因危险因素的差异显著。2021年,男性中最高风险归因于吸烟,DALYs率和死亡率分别为68.3/10万和2.7/10万。相比之下,女性中最高风险归因于高空腹血糖,DALYs率和死亡率分别为111.1/10万和5.6/10万。总之,AD的疾病负担仍在增加,应针对男性和女性采取针对性干预措施,通过减少不健康生活方式减轻AD负担。