Hou Mingxuan, Yang Ling
Department of Geriatrics, Shanghai Fourth People's Hospital Affiliated to Tongji University, Shanghai, China.
School of Exercise and Health, Shanghai University of Sport, Shanghai, China.
Front Public Health. 2025 Jul 22;13:1616232. doi: 10.3389/fpubh.2025.1616232. eCollection 2025.
As one of the most aging populations in the world, China has experienced a continuous increase in the disease burden of Alzheimer's Disease (AD) and other dementia (ADRD). This study aims to analyze the trends in prevalence and mortality rates of AD and related dementia in China from 1990 to 2021 and to predict the disease burden by 2040.
Data was extracted from the Global Burden of Disease Study 2021 (GBD 2021). Joinpoint regression was used to identify significant changes in trends, while Age-Period-Cohort (APC) models were applied to disentangle age, period, and cohort effects. Bayesian Age-Period-Cohort (BAPC) modeling was used for future projections. In addition, we conducted a risk factor analysis of AD-related mortality attributable to smoking, high body mass index (BMI), and high fasting plasma glucose (FPG).
In 2021, the age-standardized prevalence of AD and other dementia in China was 1,194 per 100,000 (95% CI: 1018-1,383), and the mortality rate was 35 per 100,000 (95% CI: 9-93). The disease burden was significantly higher in females compared to males (prevalence: females 1,559 per 100,000 vs. males 846 per 100,000). Joinpoint analysis showed a significant increase in both prevalence and mortality rates after 2019 (male APC = 2.81%, female APC = 3.76%). Risk factor analysis highlighted obesity (AAPC = 9.87%) as the leading contributor to AD mortality in China, surpassing global averages. The BAPC model predicted that by 2040, the prevalence in females would increase to 1,180 per 100,000, while the mortality rate for males would stabilize at 17.6 per 100,000. Our results indicate a substantial increase in disease burden, underscoring the urgent need for strategic interventions and resource allocation to mitigate the future impact of dementia-related conditions in China.
The disease burden of AD and related dementia in China continues to rise, necessitating enhanced early screening, optimized healthcare resource allocation, and targeted intervention strategies for high-risk female populations.
作为世界上老龄化程度最高的国家之一，中国阿尔茨海默病（AD）和其他痴呆症（ADRD）的疾病负担持续增加。本研究旨在分析1990年至2021年中国AD及相关痴呆症的患病率和死亡率趋势，并预测到2040年的疾病负担。
数据来自《2021年全球疾病负担研究》（GBD 2021）。采用Joinpoint回归确定趋势的显著变化，同时应用年龄-时期-队列（APC）模型分解年龄、时期和队列效应。采用贝叶斯年龄-时期-队列（BAPC）模型进行未来预测。此外，我们对归因于吸烟、高体重指数（BMI）和高空腹血糖（FPG）的AD相关死亡率进行了风险因素分析。
2021年，中国AD和其他痴呆症的年龄标准化患病率为每10万人1194例（95%CI：1018-1383），死亡率为每10万人35例（95%CI：9-93）。女性的疾病负担显著高于男性（患病率：女性每10万人1559例，男性每10万人846例）。Joinpoint分析显示，2019年后患病率和死亡率均显著上升（男性APC = 2.81%，女性APC = 3.76%）。风险因素分析突出了肥胖（AAPC = 9.87%）是中国AD死亡率的主要贡献因素，超过了全球平均水平。BAPC模型预测，到2040年，女性患病率将增至每10万人1180例，而男性死亡率将稳定在每10万人17.6例。我们的结果表明疾病负担大幅增加，凸显了在中国采取战略干预措施和资源分配以减轻痴呆症相关疾病未来影响的迫切需求。
中国AD和相关痴呆症的疾病负担持续上升，需要加强早期筛查、优化医疗资源分配，并针对高危女性人群制定有针对性的干预策略。
