Xu Libo, Wang Zhenhao, Li Mao, Li Qingsong
The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
University of California, Davis, California, USA.
J Glob Health. 2025 May 23;15:04156. doi: 10.7189/jogh.15.04156.
Alzheimer disease (AD) is a growing global health issue, with incidence varying by gender, age, and region. Understanding these trends is essential for developing effective prevention strategies as the population ages. Unlike previous Global Burden of Disease (GBD) studies that primarily focussed on prevalence and mortality, we offer a novel perspective by examining historical incidence trends and projecting future patterns of AD and other dementias using advanced analytical approaches.
We used data from 204 countries and 21 global regions from the GBD 2021 database. We applied the age-period-cohort (APC) model to analyse historical incidence trends, and the Bayesian APC (BAPC) model to forecast future incidence from 2022-36. These models help reveal changes related to age, period, and birth cohort and enable forecasting of future trends - analytical perspectives not provided in the original GBD data sets or their supplementary documents.
Between 1992-2021, global AD cases increased from 4.078 million to 9.837 million, while the global age-standardised incidence rate (ASIR) remained relatively stable, rising slightly from 117.7 to 119.8 per 100 000. ASIR increased significantly in high-middle and middle-sociodemographic index regions, but declined in the low-sociodemographic index regions. Women consistently exhibited higher incidence rates than men across all regions. Projections indicate that 2036 global AD cases will reach 19.117 million, with an ASIR of 418.92 per 100 000.
While global ASIR has remained stable, the number of AD cases continues to rise due to population ageing, particularly in middle- and high-income regions. Low-income regions face additional challenges due to limited health care resources. Gender disparities and unequal access to health care contribute to the variations in disease burden. These findings emphasise the need to prioritise early diagnosis and implement targeted interventions to reduce future disease burdens and address global health care inequalities.
阿尔茨海默病（AD）是一个日益严重的全球健康问题，其发病率因性别、年龄和地区而异。随着人口老龄化，了解这些趋势对于制定有效的预防策略至关重要。与以往主要关注患病率和死亡率的全球疾病负担（GBD）研究不同，我们通过使用先进的分析方法研究AD和其他痴呆症的历史发病率趋势并预测未来模式，提供了一个全新的视角。
我们使用了来自全球疾病负担2021数据库中204个国家和21个全球区域的数据。我们应用年龄-时期-队列（APC）模型分析历史发病率趋势，并使用贝叶斯APC（BAPC）模型预测2022年至2036年的未来发病率。这些模型有助于揭示与年龄、时期和出生队列相关的变化，并能够预测未来趋势——这是原始GBD数据集或其补充文件中未提供的分析视角。
1992年至2021年间，全球AD病例从407.8万增加到983.7万，而全球年龄标准化发病率（ASIR）保持相对稳定，从每10万人117.7例略微上升至119.8例。高中社会人口指数地区和中社会人口指数地区的ASIR显著上升，但低社会人口指数地区的ASIR有所下降。在所有地区，女性的发病率始终高于男性。预测表明，到2036年全球AD病例将达到1911.7万，ASIR为每10万人418.92例。
虽然全球ASIR保持稳定，但由于人口老龄化，AD病例数量持续上升，尤其是在中高收入地区。低收入地区由于医疗资源有限面临额外挑战。性别差异和医疗保健获取机会不平等导致了疾病负担的差异。这些发现强调需要优先进行早期诊断并实施有针对性的干预措施，以减轻未来的疾病负担并解决全球医疗保健不平等问题。
