Zhang Qianqian, Deng Yanwen, Xue Mo, Ni Zihan, Luo Guangyan, Tian Kan
School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China.
School of Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
PLoS One. 2025 Aug 29;20(8):e0331204. doi: 10.1371/journal.pone.0331204. eCollection 2025.
Alzheimer's disease and other dementias (ADOD) are growing global health challenges. While existing studies primarily focus on dementia prevention and management in individuals aged 65 and older, evidence suggests that cognitive decline and pathological changes begin earlier (≥55 years). This study focuses on this younger group to enable earlier risk identification and preventive interventions.
This study used GBD 2021 data to extract incidence, prevalence, mortality, and DALYs related to ADOD. Trends from 1992 to 2021 were assessed using the Age-Period-Cohort (APC) model. Future burden from 2022 to 2046 was projected with the Nordpred model and validated using the Bayesian Age-Period-Cohort (BAPC) model.
From 1992 to 2021, ADOD incidence among individuals aged ≥55 increased by 143.88%. The age-standardized prevalence rate (ASPR) rose from 3,870.6 to 3,975.8 per 100,000. Deaths in 2021 were 1.75 times higher than in 1992. The age-standardized DALY rate was consistently higher in females, while males showed an upward trend (net drift, 0.05). APC analysis revealed the steepest incidence increase in the 60-64 age group, with earlier rises in males. Period effects indicated unfavorable incidence trends in high-middle SDI and middle-SDI regions, and similarly adverse mortality trends in high-middle and low-middle SDI regions. Projections suggest a slight increase in ASIR and ASMR by 2046, with females maintaining higher rates than males.
The global burden of ADOD among individuals aged 55 years and above remains substantial, particularly in East Asia and among females. Given regional heterogeneity, this study recommends developing and implementing region-specific interventions for more effective improvements.
阿尔茨海默病和其他痴呆症(ADOD)是日益严峻的全球健康挑战。虽然现有研究主要关注65岁及以上人群的痴呆症预防和管理,但有证据表明认知能力下降和病理变化开始得更早(≥55岁)。本研究聚焦于这一年轻群体,以便更早地识别风险并进行预防性干预。
本研究使用全球疾病负担研究(GBD)2021数据提取与ADOD相关的发病率、患病率、死亡率和伤残调整生命年(DALY)。使用年龄-时期-队列(APC)模型评估1992年至2021年的趋势。使用Nordpred模型预测2022年至2046年的未来负担,并使用贝叶斯年龄-时期-队列(BAPC)模型进行验证。
1992年至2021年,55岁及以上人群中ADOD的发病率增加了143.88%。年龄标准化患病率(ASPR)从每10万人3870.6例升至3975.8例。2021年的死亡人数比1992年高出1.75倍。年龄标准化DALY率女性始终较高,而男性呈上升趋势(净漂移率为0.05)。APC分析显示,60-64岁年龄组的发病率增长最为陡峭,男性上升更早。时期效应表明,高中等社会人口指数(SDI)和中等SDI地区的发病率趋势不利,高中等和低中等SDI地区的死亡率趋势同样不利。预测表明,到2046年,年龄标准化发病率(ASIR)和年龄标准化死亡率(ASMR)将略有上升,女性的发病率和死亡率仍高于男性。
55岁及以上人群的全球ADOD负担仍然很重,尤其是在东亚和女性群体中。鉴于地区差异,本研究建议制定和实施针对特定地区的干预措施,以更有效地改善情况。