Xu Changqing, Jiang Chuanping, Liu Xiaoxue, Shi Wenqi, Bai Jianjun, Mubarik Sumaira, Wang Fang
Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
Department of Outpatient Office, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, 221100, Jiangsu, China.
Int J Equity Health. 2025 May 24;24(1):149. doi: 10.1186/s12939-025-02530-2.
The study aimed to analyze the long-term trends in the global burden of Alzheimer's disease and other dementias(ADOD) in different regions, and assess the association between socio-demographic index(SDI) and disease burden.
We extracted data on the incidence, mortality, disability-adjusted life-years(DALYs), and age-standardized rates related to ADOD, as disease burden measures from 1990 to 2021. The joinpoint regression, quantile regression and restricted cubic splines were adopted to estimate the temporal trends and relationships with SDI. Risk factors for deaths and DALYs were also analyzed.
Globally, 9.84 million cases of ADOD occurred in 2021, with 1.95 million ADOD-related deaths, causing 36.33 million DALYs. ADOD incidence, mortality and DALYs all increased from 1990 to 2021. Regional and sex variations persisted, with the fastest increase in age-standardized death rate in low-middle SDI quintiles, experienced the highest estimated annual percentage changes (0.41[0.31,0.52]). The incidence of ADOD increased more rapidly as SDI increased in areas that have historically shown lower incidence compared to other areas. In regions with higher mortality or DALYs burden, these indicators decreased relatively faster as SDI increased. High fasting plasma glucose was the main risk factor, particularly in high SDI region, with an increasing trend in attributable burden. The burden attributable to high BMI was increasing, whereas the burden associated with smoking steadily decreased.
ADOD poses a significant and escalating challenge to healthcare sustainability, with persistent regional and gender disparities. By learning from successful ADOD management in certain nations, we can proactively reduce health burdens and bridge disparities between countries at various developmental levels.
本研究旨在分析不同地区阿尔茨海默病和其他痴呆症（ADOD）全球负担的长期趋势，并评估社会人口指数（SDI）与疾病负担之间的关联。
我们提取了1990年至2021年期间与ADOD相关的发病率、死亡率、伤残调整生命年（DALYs）以及年龄标准化率等数据，作为疾病负担指标。采用连接点回归、分位数回归和受限立方样条来估计时间趋势以及与SDI的关系。还分析了死亡和DALYs的危险因素。
2021年全球发生了984万例ADOD病例，有195万例与ADOD相关的死亡，导致3633万DALYs。1990年至2021年期间，ADOD的发病率、死亡率和DALYs均有所上升。区域和性别差异持续存在，中低SDI五分位数地区的年龄标准化死亡率增长最快，估计年百分比变化最高（0.41[0.31,0.52]）。与其他地区相比，历史上发病率较低的地区，ADOD发病率随SDI的增加上升得更快。在死亡率或DALYs负担较高的地区，随着SDI的增加，这些指标下降相对较快。空腹血糖高是主要危险因素，尤其是在高SDI地区，可归因负担呈上升趋势。高BMI所致负担在增加，而与吸烟相关的负担稳步下降。
ADOD对医疗保健的可持续性构成了重大且不断升级的挑战，区域和性别差异持续存在。通过借鉴某些国家成功的ADOD管理经验，我们可以积极减轻健康负担，弥合不同发展水平国家之间的差距。
