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中国降低痴呆症风险:特定国家可改变风险因素及人群归因分数(PAFs)的估计

Dementia risk reduction in China: Country-specific estimates of modifiable risk factors and population attributable fractions (PAFs).

作者信息

Zhou Yujing, Liao Jing, Wu Yu-Tzu

机构信息

Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, PR China.

Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, PR China.

出版信息

Alzheimers Dement. 2025 Aug;21(8):e70542. doi: 10.1002/alz.70542.


DOI:10.1002/alz.70542
PMID:40879658
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12329568/
Abstract

INTRODUCTION: This study updates the population attributable fractions (PAFs) for 12 dementia risk factors in China, categorized as early life (education), midlife (obesity, hypertension, hearing loss, alcohol abuse, and traumatic brain injury), and later life (smoking, depression, social isolation, physical inactivity, air pollution, and diabetes). METHOD: Relative risks and communality were calculated from literature. The prevalence was estimated using the latest Chinese Health and Retirement Longitudinal Study (CHARLS); other nationwide surveys substitute for lacking CHARLS factors. RESULTS: The 12 risk factors account for 60.3% of dementia cases in China, including 14.0% in early life, 8.8% in midlife, and 37.5% in later life. Some factors (e.g., alcohol abuse, depression) showed wide confidence intervals indicating lack of evidence. DISCUSSION: This study highlights the potential for dementia prevention in China, but more evidence is needed to estimate PAFs for specific risk factors (e.g., midlife factors). HIGHLIGHTS: We used the most recent and nationally representative data to calculate population attributable fractions (PAFs) for dementia risk factors in China. In China, 60.3% of dementia cases were attributed to the 12 modifiable risk factors. Education was estimated to contribute 14.0% of dementia cases, and 37.5% was attributed to later-life lifestyle and health factors in China. It is necessary to consider incorporating China-specific factors and updating the PAF calculation method.

摘要

引言:本研究更新了中国12种痴呆风险因素的人群归因分数(PAF),这些因素分为早年(教育)、中年(肥胖、高血压、听力损失、酒精滥用和创伤性脑损伤)和晚年(吸烟、抑郁、社会隔离、身体活动不足、空气污染和糖尿病)。 方法:从文献中计算相对风险和共性。患病率使用最新的中国健康与养老追踪调查(CHARLS)进行估计;其他全国性调查用于替代缺乏的CHARLS因素。 结果:这12种风险因素占中国痴呆病例的60.3%,其中早年因素占14.0%,中年因素占8.8%,晚年因素占37.5%。一些因素(如酒精滥用、抑郁)的置信区间较宽,表明缺乏证据。 讨论:本研究凸显了中国预防痴呆的潜力,但需要更多证据来估计特定风险因素(如中年因素)的PAF。 要点:我们使用了最新的全国代表性数据来计算中国痴呆风险因素的人群归因分数(PAF)。在中国,60.3%的痴呆病例归因于12种可改变的风险因素。据估计,教育因素导致14.0%的痴呆病例,37.5%归因于中国的晚年生活方式和健康因素。有必要考虑纳入中国特定因素并更新PAF计算方法。

相似文献

[1]
Dementia risk reduction in China: Country-specific estimates of modifiable risk factors and population attributable fractions (PAFs).

Alzheimers Dement. 2025-8

[2]
Temporal trends in population attributable fractions of modifiable risk factors for dementia: a time-series study of the English Longitudinal Study of Ageing (2004-2019).

BMC Med. 2024-6-26

[3]
Temporal trends and disparities of population attributable fractions of modifiable risk factors for dementia in China: a time-series study of the China health and retirement longitudinal study (2011-2018).

Lancet Reg Health West Pac. 2024-5-29

[4]
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Dementia (London). 2025-6-29

[5]
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J Prev Alzheimers Dis. 2025-1-13

[6]
Prevalence and population attributable fractions of potentially modifiable risk factors for dementia in Canada: A cross-sectional analysis of the Canadian Longitudinal Study on Aging.

Can J Public Health. 2024-12

[7]
The association between hearing loss and depression in the China health and retirement longitudinal study.

Sci Rep. 2025-7-1

[8]
The potential for dementia prevention in Brazil: a population attributable fraction calculation for 14 modifiable risk factors.

Lancet Reg Health Am. 2025-8-7

[9]
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[10]
Assessing modifiable risk factors for dementia in the Czech Republic: findings from the Survey of Health, Ageing and Retirement in Europe study.

Eur J Public Health. 2025-8-1

本文引用的文献

[1]
Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission.

Lancet. 2024-8-10

[2]
Temporal trends and disparities of population attributable fractions of modifiable risk factors for dementia in China: a time-series study of the China health and retirement longitudinal study (2011-2018).

Lancet Reg Health West Pac. 2024-5-29

[3]
Population attributable fractions of modifiable risk factors for dementia: a systematic review and meta-analysis.

Lancet Healthy Longev. 2024-6

[4]
Bias assessment and correction for Levin's population attributable fraction in the presence of confounding.

Eur J Epidemiol. 2024-2

[5]
Dementia prevention: the Mendelian randomisation perspective.

J Neurol Neurosurg Psychiatry. 2024-3-13

[6]
Prevalence of dementia and the attributable contributions of modifiable risk factors in China.

Gen Psychiatr. 2023-6-26

[7]
Prevalence and risk factors of hearing loss among the middle-aged and older population in China: a systematic review and meta-analysis.

Eur Arch Otorhinolaryngol. 2023-11

[8]
Have We Been Underestimating Modifiable Dementia Risk? An Alternative Approach for Calculating the Combined Population Attributable Fraction for Modifiable Dementia Risk Factors.

Am J Epidemiol. 2023-10-10

[9]
Social participation and risk of developing dementia.

Nat Aging. 2023-5

[10]
Ambient air pollution and clinical dementia: systematic review and meta-analysis.

BMJ. 2023-4-5

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