Fang Hongjuan, Li Letong, Ai Juntao, Wang Qiang
Department of Endocrinology, Aviation General Hospital, Beijing, China.
Chinese PLA Center for Disease Control and Prevention, Beijing, China.
Int J Surg. 2025 Jul 1;111(7):4830-4841. doi: 10.1097/JS9.0000000000002460. Epub 2025 May 28.
Dementia is a leading cause of death worldwide. This study examines trends and risk factors for dementia mortality in India and projects the future burden. Mortality and risk factors for Alzheimer's disease and other dementias (ADOD) in India between 1990 and 2021 were extracted from the Global Burden of Disease (GBD) 2021 database. Spatial autocorrelation analysis was calculated using ArcGIS 10.8. The age-period-cohort (APC) model was applied to analyze the independent effects of age, period and cohort. A bidirectional Mendelian randomization (MR) analysis assessed causality between risk factors and ADOD. The Bayesian APC model was conducted to predict future trends. From 1990 to 2021, deaths, crude mortality rates (CMRs) and age-standardized mortality rates (ASMRs) for ADOD increased gradually. Females had higher CMRs and ASMRs than males, and the burden persisted mainly in the elderly. In 2021, Uttar Pradesh, Maharashtra and Tamil Nadu were the top three states for deaths, but the top three states for ASMR were Meghalaya, Orissa and Telangana. Moreover, Meghalaya, Orissa and Telangana were also the three fastest growing states for ASMR. High fasting plasma glucose (FPG), high body mass index (BMI) and tobacco were the primary drivers of this increase. The MR analysis showed a statistically significant causal association of these three risk factors with ADOD. Projections showed that mortality in the elderly would continue to rise until 2050. Overall, the burden of dementia mortality in India has increased dramatically. There is an urgent need for targeted prevention and control strategies to reduce this burden.
痴呆症是全球主要死因之一。本研究调查了印度痴呆症死亡率的趋势和风险因素，并预测了未来的负担。1990年至2021年期间印度阿尔茨海默病和其他痴呆症（ADOD）的死亡率及风险因素数据来自《2021年全球疾病负担（GBD）》数据库。使用ArcGIS 10.8进行空间自相关分析。应用年龄-时期-队列（APC）模型分析年龄、时期和队列的独立影响。进行双向孟德尔随机化（MR）分析以评估风险因素与ADOD之间的因果关系。采用贝叶斯APC模型预测未来趋势。1990年至2021年期间，ADOD的死亡人数、粗死亡率（CMR）和年龄标准化死亡率（ASMR）逐渐上升。女性的CMR和ASMR高于男性，且负担主要集中在老年人中。2021年，北方邦、马哈拉施特拉邦和泰米尔纳德邦是死亡人数最多的三个邦，但ASMR最高的三个邦是梅加拉亚邦、奥里萨邦和特伦甘纳邦。此外，梅加拉亚邦、奥里萨邦和特伦甘纳邦也是ASMR增长最快的三个邦。空腹血糖（FPG）升高、体重指数（BMI）升高和吸烟是这一增长的主要驱动因素。MR分析显示这三个风险因素与ADOD之间存在统计学上显著的因果关联。预测表明，老年人的死亡率将持续上升至2050年。总体而言，印度痴呆症死亡率负担急剧增加。迫切需要针对性的预防和控制策略来减轻这一负担。
