目的 分析1990-2019年中国阿尔茨海默病(Alzheimer disease,AD)与其他痴呆症的疾病负担变化趋势及其危险因素,为合理配置卫生资源和制定针对AD与其他痴呆症防治策略提供依据.方法 收集2019年全球疾病负担(global burden of disease 2019,GBD 2019)研究中1990、2000、2010和2019年中国AD与其他痴呆症疾病负担的相关数据,采用伤残损失健康寿命年(years lived with disability,YLD)、死亡损失寿命年(years of life lost,YLL)、伤残调整寿命年(disability adjusted life years,DALY)、人群归因分值(population attributable fraction,PAF)等指标对1990-2019年中国AD与其他痴呆症及其危险因素疾病负担进行描述,并对比分析与全球AD疾病负担的差异性.结果 2019年中国AD的YLD率、YLL率和DALY率均随年龄增大而升高,其中≥95岁人群疾病负担最重.中国1990-2019年AD的标化YLD率、YLL率和DALY率分别增加了 1.35％、-0.12％和0.29％,全球的标化YLD率、YLL率和DALY率分别增加了 0.28％、0.15％和0.19％.1990-2019年中国AD危险归因分析可见,行为因素和代谢因素均导致AD疾病负担的增加.女性由行为因素造成的疾病风险高于男性,而由代谢因素造成的疾病风险低于男性.结论 尽管AD的疾病负担仍持续增加,但可以通过对包括行为和代谢因素等危险因素制定有针对性的预防和控制策略来进行有效控制.
Analysis of disease burden and risk factors of Alzheimer disease in China from 1990 to 2019
Objective To analyze the trend and their risk factors of the burden of Alzheimer disease(AD)and other dementia in China from 1990 to 2019,and to provide theoretical foundation for rational allocation of health resources and developing strategies for the prevention and treatment of AD and other dementias.Methods The data of disease burden of AD and other dementias in China in 1990,2000,2010,and 2019 were collected from the global burden of disease 2019 study(GBD 2019).Indicators such as years lived with disability(YLD),years of life lost(YLL),disability adjusted life years(DALY)and population attributable fraction(PAF)were used to describe the disease burden and risk factors of AD and other dementias in China from 1990 to 2019.The differences in disease burden of AD between China and the world were compared.Results In 2019,disease burden such as YLD,YLL and DALY of AD in China increased with age,and the highest disease burden was found in people over 95 years old.From 1990 to 2019,the age standardized YLD rate,YLL rate,and DALY rate of AD in China increased by I.35％,-0.12％,and 0.29％,respectively.However,the global standardized YLD rate,YLL rate and DALY rate increased by 0.28％,0.15％and 0.19％,respectively.The risk attribution analysis of AD in China from 1990 to 2019 showed that both behavioral and metabolic factors contributed to the increase of the disease burden of AD.The risk of disease due to behavioral factors was higher in females than in males.However,the risk of disease due to metabolic factors was higher in males.Conclusions Although the burden of AD continues to increase,it can still be effectively controlled through the development of targeted prevention and control strategies for risk factors,including behavioral and metabolic factors.
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