Yu Dong-Ting, Li Rui-Xuan, Sun Jing-Ran, Rong Xue-Wen, Guo Xu-Guang, Zhu Guo-Dong
Institute of Gerontology, Guangzhou Geriatric Hospital, Guangzhou Medical University, Guangzhou, 511495, China.
State Key Laboratory of Respiratory Disease, Guangzhou Geriatric Hospital, Guangzhou Medical University, Guangzhou, 511495, China.
BMC Psychiatry. 2025 May 19;25(1):503. doi: 10.1186/s12888-025-06661-2.
Alzheimer's disease (AD) and other dementias are major public health concerns with an increasing global impact. The burden of these conditions varies by region, age, and gender, and the COVID-19 pandemic has further exacerbated these disparities, potentially influencing disease prevalence, mortality, and disability burden. This study aimed to assess the global and regional burden and trends of Alzheimer's disease and other dementias in adults aged 60 years or older from 1990 to 2021, with a particular focus on the impact of the COVID-19 pandemic on mortality, prevalence, and disability-adjusted life years.
Using Global Burden of Disease (GBD 2021) data, we analyzed age-standardized death rates (ASDR), incidence rates (ASIR), prevalence rates (ASPR), and disability-adjusted life years (DALYs) from 1990 to 2021. Temporal trends were assessed using the Estimated Annual Percentage Change (EAPC). Projections were modeled using Bayesian Age-Period-Cohort (BAPC) techniques. We evaluated excess mortality by comparing actual versus expected deaths during the pandemic. Decomposition analysis examined the contributions of population growth, aging, and epidemiological shifts. We analyzed health inequality to highlight and address disparities in health status and resource access across regions. All plots and tables were created using Joinpoint Regression model (Version 4.8.0.1), StataMP 18, and R statistical packages (Version 4.4.1).
In 2021, global mortality from AD and other dementias among individuals aged 60 and older reached approximately 1,922,970.75 cases (95% CI: 480,348.08 to 5,104,315.95), and the prevalence was 52,560,253.51 cases (95% CI: 41,399,948.84 to 65,633,448.71). High Body Mass Index (BMI) and High Fasting Plasma Glucose (FPG) were prominent risk factors. Projections suggest a near fourfold increase in AD cases by 2050, driven by population growth and aging, with females disproportionately affected. Health inequalities persist, with higher disease burdens in high-SDI regions. The pandemic impacted mortality unevenly, highlighting regional disparities.
Although incidence rates declined from 1990 to 2021, the overall burden of AD and dementias remains substantial and is expected to rise significantly by 2050. The findings underscore the need for targeted interventions addressing risk factors like High FPG, gender disparities, and the socioeconomic effects of COVID-19, particularly in high-SDI countries.
阿尔茨海默病（AD）和其他痴呆症是重大的公共卫生问题，对全球的影响日益增加。这些疾病的负担因地区、年龄和性别而异，而新冠疫情进一步加剧了这些差异，可能影响疾病的患病率、死亡率和残疾负担。本研究旨在评估1990年至2021年60岁及以上成年人中阿尔茨海默病和其他痴呆症的全球和区域负担及趋势，特别关注新冠疫情对死亡率、患病率和伤残调整生命年的影响。
利用全球疾病负担（GBD 2021）数据，我们分析了1990年至2021年的年龄标准化死亡率（ASDR）、发病率（ASIR）、患病率（ASPR）和伤残调整生命年（DALY）。使用估计年度百分比变化（EAPC）评估时间趋势。采用贝叶斯年龄-时期-队列（BAPC）技术进行预测建模。我们通过比较疫情期间的实际死亡人数与预期死亡人数来评估超额死亡率。分解分析考察了人口增长、老龄化和流行病学转变的贡献。我们分析了健康不平等问题，以突出和解决各地区在健康状况和资源获取方面的差异。所有图表均使用Joinpoint回归模型（版本4.8.0.1）、StataMP 18和R统计软件包（版本4.4.1）创建。
2021年，60岁及以上人群中因AD和其他痴呆症导致的全球死亡人数约为1,922,970.75例（95%置信区间：480,348.08至5,104,315.95），患病率为52,560,253.51例（95%置信区间：41,399,948.84至65,633,448.71）。高体重指数（BMI）和高空腹血糖（FPG）是突出的危险因素。预测表明，到2050年，AD病例数将增加近四倍，这是由人口增长和老龄化推动的，女性受到的影响尤为严重。健康不平等现象依然存在，高社会人口指数（SDI）地区的疾病负担更高。疫情对死亡率的影响不均衡，突出了地区差异。
尽管1990年至2021年发病率有所下降，但AD和痴呆症的总体负担仍然很大，预计到2050年将显著上升。研究结果强调了需要采取有针对性的干预措施，以应对高FPG等危险因素、性别差异以及新冠疫情的社会经济影响，特别是在高SDI国家。
