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

作　　者：韩树奎 任义涛 马昕 宋盼盼 马金祥 张紫钰 陈虹汝 HAN Shukui;REN Yitao;MA Xin;SONG Panpan;MA Jinxiang;ZHANG Ziyu;CHEN Hongru(Department of Public Health,Qinghai University Medical College,Xining 810008,China;Department of Health Technology,Qinghai Institute of Health Sciences,Xining 810016,China;Department of Clinical Medicine,Qinghai Institute of Health Sciences,Xining 810016,China)

机构地区：[1]青海大学医学院公共卫生系,青海省西宁市810008 [2]青海卫生职业技术学院医学技术系,青海省西宁市810016 [3]青海卫生职业技术学院临床医学系,青海省西宁市810016

出　　处：《中国全科医学》2025年第8期996-1003,共8页Chinese General Practice

基　　金：青海省科技计划(2024-SF-125);基于贝叶斯时空模型的青海省健康差异及影响机制研究(2021-sk-1)。

摘　　要：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,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,

关 键 词：阿尔茨海默病 痴呆 疾病负担 老年人 中国 预测 

分 类 号：R745.7[医药卫生—神经病学与精神病学]