首页|1992-2021年中国老年人群阿尔茨海默症及相关痴呆的疾病负担变化趋势及预测研究

1992-2021年中国老年人群阿尔茨海默症及相关痴呆的疾病负担变化趋势及预测研究

Analysis of Disease Burden Trends and Forecast of Alzheimer's Disease and Other Dementias among the Elderly in China from 1992 to 2021

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背景 老龄化社会背景下,我国老年阿尔茨海默症及相关痴呆(ADRD)患者数量逐年增加,给其主要家庭照顾者带来了沉重的照护压力,受到了国内外广泛关注.目的 分析中国老年人ADRD疾病负担变化趋势,探究年龄、时期和队列因素对ADRD发病率和患病率的影响,并对 2021 年以后中国老年人群ADRD发病率进行预测,为相关部门制订防制措施提供依据.方法 利用 2021 年全球疾病负担数据库(GBD 2021)中ADRD数据为数据来源,提取 1992-2021 年中国老年人ADRD粗发病率、粗患病率、粗死亡率及粗伤残调整寿命年(DALY)率,按照年龄标准化(简称标化)后运用Joinpoint回归模型分析变化趋势,并计算年度变化百分比(APC)与平均年度变化百分比(AAPC).采用年龄-时期-队列模型分析年龄、时期及队列因素对中国老年人ADRD发病率和患病率的影响,并使用贝叶斯年龄-时期-队列-模型预测其 2022-2030 年的发病率.结果 1992-2021 年中国老年人群的ADRD标化发病率、标化患病率总体均呈上升趋势(发病率:AAPC=0.57%,95%CI=0.41%~0.72%;患病率:AAPC=0.64%,95%CI=0.60%~0.68%).其中男性标化发病率增速高于女性(AAPC:0.63%>0.60%),女性标化患病率增长高于男性(AAPC:0.68%>0.66%).1992-2019年的三个区段中国老年人ADRD标化死亡率均呈下降趋势(APC分别为-0.11%、-0.41%、-0.08%),2019-2021 年标化死亡率呈升高趋势(APC=1.96%,95%CI=0.78%~3.15%).年龄效应:60 岁以上男性和女性ADRD的发病、患病风险均随着年龄的增长而增加.男、女性 95 岁以上人群发病风险分别为 60~64岁组的 13.24 倍和 13.53 倍,患病风险是 60~64 岁组的 13.55 倍和 16.05 倍.时期效应:ADRD在男性和女性的发病、患病风险随年份推移而增加,均在 2017-2021 年达到最高.队列效应:男性和女性的ADRD的发病、患病风险在队列效应方面,均随着出生年份的推移而逐步下降.贝叶斯年龄-时期-队列模型预测结果显示,2022-2030 年中国男性与女性ADRD的标化发病率呈现上升趋势,女性标化发病率高于男性,女性ADRD的标化发病率将从 2021 年的1 267.77/10 万上升至 1 820.80/10 万,增幅约为 43.62%;男性从 2021 年的 920.22/10 万增至 2030 年的 1256.30/10 万,增幅约为 36.52%,男、女性 2022-2030 年的ADRD发病人数也在持续升高,2021-2030 年男、女性发病人数增长幅度分别为 89.74%和 105.06%.结论 中国老年人群ADRD的负担严重且呈现上升趋势,建议相关部门积极采取有效措施减轻患者的疾病负担,特别是加强对老年女性人群的防护.
Background In the context of an aging society,the number of elderly Alzheimer's disease and related dementia(ADRD)patients in China has been increasing year by year,placing a heavy caregiving burden on their primary family caregivers and garnering extensive attention both domestically and internationally.Objective This study aims to analyze the burden of ADRD among Chinese elderly individuals,explore the influence of age,period,and cohort factors on its incidence and prevalence,and predict its incidence post-2021,providing a basis for the development of preventive and curative measures by relevant authorities.Methods Using ADRD data from the Global Burden of Disease Study 2021(GBD 2021),we extracted the crude incidence rate,crude prevalence rate,crude mortality rate,and crude DALY rate of ADRD among Chinese elderly individuals from 1992 to 2021.After age standardization,we analyzed trends using the Joinpoint regression model and calculated the annual percentage change(APC)and average annual percentage change(AAPC).Age-period-cohort models were used to analyze the effects of age,period,and cohort factors on the incidence and prevalence of ADRD,while Bayesian age-period-cohort models were employed to predict incidence rates from 2022 to 2030.Results The age-standardized incidence and prevalence of ADRD among China's elderly population from 1992 to 2021 showed an overall increasing trend(incidence:AAPC=0.57%,95%CI=0.41%-0.72%;prevalence:AAPC=0.64%,95%CI=0.60%-0.68%).The growth rate of standardized incidence was higher in men than in women(AAPC:0.63%vs.0.60%),while the growth in standardized prevalence was higher in women than in men(AAPC:0.68%vs.0.66%).The standardized mortality rate decreased across three intervals(1992-2019:APC of-0.11%,-0.41%,and-0.08%)but increased from 2019 to 2021(APC=1.96%,95%CI=0.78%-3.15%).The effects of age,period,and cohort factors on ADRD incidence and prevalence were significant.Specifically,the risk of incidence and prevalence increased with age in both men and women over 60 years old,with individuals aged 95 years and older having 13.24 and 13.53 times higher risk of incidence in men and women,respectively,compared to the 60-64 age group.The corresponding prevalence risks were 13.55 and 16.05 times higher.Over time,the risk increased,peaking during 2017-2021.In contrast,cohort effects revealed a progressive decrease in risk with later birth cohorts.By 2030,the standardized incidence rate is projected to increase by approximately 43.62%in women(from 1 267.77 to 1 820.80 per 100 000)and by 36.52%in men(from 920.22 to 1 256.30 per 100 000).Additionally,the number of ADRD cases among men and women was expected to rise significantly,with increases of 89.74%and 105.06%,respectively,between 2021 and 2030.Conclusion The increasing burden of ADRD in China's elderly population highlights the need for effective measures,particularly to protect elderly women.

Alzheimer's diseaseDementiaDisease burdenAgedChinaForecasting

韩树奎、任义涛、马昕、宋盼盼、马金祥、张紫钰、陈虹汝

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810008 青海省西宁市,青海大学医学院公共卫生系

810016 青海省西宁市,青海卫生职业技术学院医学技术系

810016 青海省西宁市,青海卫生职业技术学院临床医学系

阿尔茨海默病 痴呆 疾病负担 老年人 中国 预测

2025

中国全科医学
中国医院协会

中国全科医学

北大核心
影响因子:2.04
ISSN:1007-9572
年,卷(期):2025.28(8)