Dai Pinyuan, Yu Jie, Lin Yongxing, Zhou Xiaoyan, Wang Hao, Gong Weiwei, Pan Jin, Guan Yunqi, Zhong Jieming, Li Na, Liu Zuyun
Zhejiang Provincial Center for Diseases Control and Prevention, Hangzhou, China.
Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China.
Front Public Health. 2025 Jun 18;13:1584386. doi: 10.3389/fpubh.2025.1584386. eCollection 2025.
The Global Burden of Diseases Study systematically updates the dementia burden attributable to high fasting plasma glucose (HFPG) to investigate the temporal trends of dementia burden and promote comparisons between countries, sexes, and age groups. In this study, we aimed to estimate the disease burden of dementia attributable to HFPG using an age-period-cohort model in adults aged >60 years from 1990 to 2021 and forecast the mortality and disability-adjusted life-years (DALYs) rates in China and globally in 2040.
Data on the mortality and DALYs rates of dementia attributable to HFPG in China and globally were extracted from the Global Burden of Disease Study 2021. An age-period-cohort model was used to estimate the net drift, local drift, fitted longitudinal age-specific rates, and period/cohort relative risks from 1990 to 2021. The Bayesian age-period-cohort model was used to predict future mortality and DALYs rates from 2022 to 2040.
The net drifts showed an overall upward trend in the dementia burden attributable to HFPG in China and globally from 1990 to 2021, with a much slower trend in China. A constantly rising risk for age and birth cohort effects was observed, while period effects presented a globally constantly increasing risk and two inflection points in China, probably due to healthcare reform. The forecasted disease burden by 2040 demonstrated an increasing trend globally and a declining trend in China.
The burden of dementia attributable to HFPG has consistently increased globally over the past 30 years but has gradually declined in China in recent years. China's strategies for preventing and managing diabetes and dementia may provide valuable insights for other regions. Further targeted policies are required to reduce the burden on females and older adults, particularly to improve their quality of life.
全球疾病负担研究系统地更新了高空腹血糖（HFPG）所致痴呆负担，以研究痴呆负担的时间趋势，并促进各国、各性别和各年龄组之间的比较。在本研究中，我们旨在使用年龄-时期-队列模型估计1990年至2021年60岁以上成年人中HFPG所致痴呆的疾病负担，并预测2040年中国和全球的死亡率及伤残调整生命年（DALY）率。
从《2021年全球疾病负担研究》中提取中国和全球HFPG所致痴呆的死亡率及DALY率数据。使用年龄-时期-队列模型估计1990年至2021年的净漂移、局部漂移、拟合的纵向年龄别率以及时期/队列相对风险。使用贝叶斯年龄-时期-队列模型预测2022年至2040年的未来死亡率及DALY率。
净漂移显示，1990年至2021年中国和全球HFPG所致痴呆负担总体呈上升趋势，中国的趋势要慢得多。观察到年龄和出生队列效应的风险持续上升，而时期效应在全球呈现持续增加的风险，在中国有两个转折点，这可能归因于医疗改革。到2040年预测的疾病负担在全球呈上升趋势，在中国呈下降趋势。
过去30年全球HFPG所致痴呆负担持续增加，但近年来中国已逐渐下降。中国预防和管理糖尿病及痴呆的策略可能为其他地区提供宝贵的见解。需要进一步制定针对性政策以减轻女性和老年人的负担，特别是提高他们的生活质量。
