Lu Ke-Qiang, Lu Ke-Jia, Ji Zheng-Jun
Institute of Liver Diseases, Shuguang Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China.
Ko Chi Ming Centre for Parkinson's Disease Research (CPDR), School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, PR China; Institute for Research and Continuing Education, Hong Kong Baptist University, Shenzhen, PR China.
J Prev Alzheimers Dis. 2025 Nov;12(9):100307. doi: 10.1016/j.tjpad.2025.100307. Epub 2025 Jul 24.
Most epidemiological studies on dementia in China have focused on the elderly population, with a lack of systematic comparisons between the burden of young-onset dementia (YOD) and late-onset dementia (LOD).
Based on data from the Global Burden of Disease (GBD) study, this research systematically evaluated changes in the burden of YOD and LOD in China over different time periods. The analysis employed average annual percentage change (AAPC), Bayesian age-period-cohort (BAPC) modeling, decomposition analysis, risk factor attribution analysis, health inequality analysis, and frontier analysis.
AAPC analysis showed that the growth rate of YOD has significantly outpaced that of LOD since 2012. Forecasting results indicated that the age-standardized rates for both YOD and LOD are expected to continue rising in the future. Decomposition analysis revealed that between 1990 and 2021, the main drivers of the increasing YOD burden shifted from population growth to epidemiological changes and population aging, whereas population growth remained the dominant driver for LOD. Risk factor analysis indicated that the impact of high BMI on both YOD and LOD has become increasingly pronounced. Health inequality and frontier analyses suggested that, although disparities in YOD and LOD burden across different SDI regions were not significant, there remains substantial room for improvement in managing both conditions in China.
In recent years, YOD has exhibited a more rapid increase compared to LOD, with its driving forces gradually shifting from population-related factors to epidemiological transitions. This highlights the need to strengthen identification and intervention strategies targeting younger and middle-aged populations. Tobacco use, high fasting plasma glucose, and high BMI are key modifiable risk factors shared by both YOD and LOD, with particular attention needed on the sustained impact of high BMI. Although international disparities in health inequality are not pronounced, China still holds considerable potential for improvement in the prevention and control of both YOD and LOD. Future interventions should be more forward-looking, systematic, and tailored to specific population groups.
中国大多数关于痴呆症的流行病学研究都集中在老年人群体，缺乏对早发型痴呆（YOD）和晚发型痴呆（LOD）负担的系统比较。
基于全球疾病负担（GBD）研究的数据，本研究系统评估了中国不同时间段内YOD和LOD负担的变化。分析采用平均年度百分比变化（AAPC）、贝叶斯年龄-时期-队列（BAPC）建模、分解分析、风险因素归因分析、健康不平等分析和前沿分析。
AAPC分析表明，自2012年以来，YOD的增长率显著超过LOD。预测结果表明，YOD和LOD的年龄标准化率未来预计将继续上升。分解分析显示，1990年至2021年期间，YOD负担增加的主要驱动因素从人口增长转向了流行病学变化和人口老龄化，而人口增长仍然是LOD的主要驱动因素。风险因素分析表明，高体重指数对YOD和LOD的影响越来越显著。健康不平等和前沿分析表明，尽管不同社会人口指数（SDI）地区的YOD和LOD负担差异不显著，但中国在这两种疾病的管理方面仍有很大的改善空间。
近年来，与LOD相比，YOD呈现出更快的增长速度，其驱动因素逐渐从与人口相关的因素转向流行病学转变。这凸显了加强针对中青年人群的识别和干预策略的必要性。吸烟、高空腹血糖和高体重指数是YOD和LOD共同的关键可改变风险因素，尤其需要关注高体重指数的持续影响。尽管国际上健康不平等差异不明显，但中国在YOD和LOD的预防和控制方面仍有很大的改善潜力。未来的干预措施应更具前瞻性、系统性，并针对特定人群量身定制。
