基于全球视角的中国痴呆症疾病负担现状及趋势分析

卢添欢; 宇传华

doi:10.16462/j.cnki.zhjbkz.2022.06.012

基于全球视角的中国痴呆症疾病负担现状及趋势分析

doi: 10.16462/j.cnki.zhjbkz.2022.06.012

卢添欢,
宇传华^,

430071 武汉，武汉大学公共卫生学院流行病与卫生统计学系

基金项目:

国家自然科学基金 82173626

国家自然科学基金 81773552

国家重点研发计划课题 2018YFC1315302

详细信息

通讯作者:
宇传华，E-mail: yuchua@whu.edu.cn

中图分类号: R181
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- 被引次数: 0
出版历程
- 收稿日期: 2021-10-08
- 修回日期: 2022-01-25
- 网络出版日期: 2022-06-16
- 刊出日期: 2022-06-10

Analysis on the status and trend of dementia burden in China based on the global perspective

LU Tian-huan,
YU Chuan-hua^,

Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan 430071, China

Funds:

National Natural Science Foundation of China 82173626

National Natural Science Foundation of China 81773552

National Key Research and Development Program of China 2018YFC1315302

More Information

Corresponding author: YU Chuan-hua, E-mail: yuchua@whu.edu.cn

摘要

摘要: 目的分析1990-2019年中国痴呆症的疾病负担现状、变化趋势及危险因素，为痴呆症的防控提供科学依据。方法基于2019年全球疾病负担(Global Burden of Disease, GBD)数据，获取1990-2019年中国、美国、日本、印度、马来西亚和全球痴呆症发病率、死亡率、伤残调整寿命年(disability adjusted life year, DALY)率及相应标化指标，利用Joinpoint软件计算痴呆症标化发病率、死亡率的年度变化百分比(annual percent change, APC)和平均年度变化百分比(average annual percent change, AAPC)，分析痴呆症发病和死亡随年份变化的趋势。结果 2019年中国痴呆症的疾病负担均表现为女性高于男性，高年龄组高于低年龄组。中国痴呆症的发病率、死亡率和DALY率分别从1990年的43.32/10万、7.88/10万、155.95/10万上升至2019年的126.57/10万、22.55/10万、420.22/10万。2019年中国痴呆症标化发病率、标化死亡率及标化DALY率均高于全球，但低于日本。中国痴呆症标化发病率平均每年上升0.47%、标化死亡率无明显变化。2019年造成男性和女性痴呆症疾病负担的主要危险因素分别为吸烟、高BMI和高FPG。结论 1990年以来，中国的痴呆症疾病负担总体呈上升趋势，应继续加强痴呆症防控的宣传教育，尤其关注老年人群的预防控制，制定合理政策，控制危险因素，进一步减轻中国痴呆症疾病负担。
- 痴呆症 /
- 发病率 /
- 死亡率 /
- 伤残调整寿命年 /
- 危险因素
Abstract: Objective Analyzing the disease burden and its changing trend of dementia in China from 1990 to 2019 to provide a scientific basis for the prevention and control of dementia. Methods Based on the Global Burden of Disease (GBD) 2019 data, to obtain the incidence, mortality and disability adjusted life year (DALY) rates and corresponding standardized indexes of dementia in China, USA, Japan, India, Malaysia, and the global in 1990-2019. Using Joinpoint to calculate annual percent change (APC) and average annual percent change (AAPC) of standardized incidence and mortality rate of dementia and compare the characteristics and trends of the burden of dementia with the development of years. Results In 2019, the incidence, mortality and DALY rate of dementia in China were higher in females than in males and higher in senior age groups than in lower age groups. From 1990 to 2019, the incidence, mortality and disability adjusted life year rate of dementia in China increased from 43.32/100 000, 7.88/100 000, 155.95/100 000 in 1990 to 126.57/100 000, 22.55/100 000, 420.22/100 000 in 2019, respectively. In 2019, the standardized incidence, standardized mortality and standardized DALY rate were higher than those in the global but lower than those in Japan. The standardized incidence rate of dementia in China has increased by 0.47% per year, and the standardized mortality rate has not changed significantly. The main risk factors of dementia in men and women were smoking, high BMI and high fasting plasma glucose in 2019. Conclusions Since 1990, the burden of dementia in China has been on the rise. Health education should be conducted to improve the public knowledge about the prevention of dementia, especially paying attention to the prevention and control of the elderly. People should formulate reasonable policies and control risk factors to further reduce the burden of dementia in China.
- Dementia /
- Incidence /
- Mortality /
- DALY /
- Risk factors

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图 1 1990-2019年全球、中国、美国、日本、印度和马来西亚痴呆症发病率(A)及标化发病率(B)

Figure 1. Incidence rates (A) and standardized incidence rates (B) of dementia in global, China, the US, Japan, India and Malaysia from 1990 to 2019

下载: 全尺寸图片幻灯片

图 2 1990-2019年全球、中国、美国、日本、印度和马来西亚痴呆症死亡率(A)及标化死亡率(B)

Figure 2. Mortality rates (A) and standardized mortality rates (B) of dementia in global, China, the US, Japan, India and Malaysia from 1990 to 2019

下载: 全尺寸图片幻灯片

图 3 1990-2019年全球、中国、美国、日本、印度和马来西亚痴呆症DALY率(A)及标化DALY率(B)

Figure 3. DALY rates (A) and standardized DALY rates (B) of dementia in global, China, the US, Japan, India and Malaysia from 1990 to 2019

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图 4 2019年全球、中国、美国、日本、印度和马来西亚痴呆症男(A)、女(B)危险因素

Figure 4. Risk factors of dementia in global, China, the US, Japan, India and Malaysia in 2019 by males (A) and females (B)

下载: 全尺寸图片幻灯片

表 1 1990-2019年全球、中国、美国、日本、印度和马来西亚痴呆症标化发病率(%)的Joinpoint分析

Table 1. Joinpoint analysis of standardized incidence rates of dementia in global, China, the US, Japan, India and Malaysia from 1990 to 2019

国家/地区	年度变化				AAPC(95% CI)值	t值	P值
国家/地区	年份(年)	APC(95% CI)值	t值	P值	AAPC(95% CI)值	t值	P值
中国	1990-1994	1.78(1.64~1.92)	26.79	< 0.001	0.47(0.44~0.51)	27.08	< 0.001
	1994-2010	0.03(0.01~0.04)	2.96	0.008
	2010-2016	1.06(0.97~1.16)	23.44	< 0.001
	2016-2019	-0.04(-0.26~0.17)	-0.41	0.683
美国	1990-1992	-1.90(-2.04~1.76)	-27.86	< 0.001	-0.16(-0.17~-0.14)	-17.29	< 0.001
	1992-1995	-1.02(-1.15~-0.88)	-15.23	< 0.001
	1995-2000	0.71(0.67~0.74)	38.15	< 0.001
	2000-2019	-0.06(-0.06~0.06)	-40.58	< 0.001
日本	1990-1995	0.01(-0.42~0.43)	0.03	0.980	0.57(0.44~0.70)	8.62	< 0.001
	1995-2002	0.83(0.52~1.14)	5.55	< 0.001
	2002-2009	0.26(-0.05~0.56)	1.78	0.090
	2009-2019	0.88(0.74~1.03)	12.96	< 0.001
印度	1990-1995	-0.45(-0.48~-0.41)	-25.99	< 0.001	0.04(0.03~0.05)	7.85	< 0.001
	1995-2005	-0.14(-0.16~-0.13)	-20.93	< 0.001
	2005-2015	0.22(0.20~0.23)	31.89	< 0.001
	2009-2019	0.69(0.64~0.74)	28.47	< 0.001
马来西亚	1990-2000	-0.02(-0.04~-0.01)	-2.83	0.011	0.03(0.01~0.05)	3.24	0.001
	2000-2006	-0.13(-0.18~-0.08)	-5.63	< 0.001
	2006-2010	0.07(-0.03~0.18)	1.46	0.161
	2010-2019	0.18(0.16~0.20)	18.28	< 0.001
全球	1990-2006	-0.03(-0.04~-0.02)	-6.18	< 0.001	0.06(0.03~0.08)	4.36	< 0.001
	2006-2011	0.10(0.02~0.18)	2.51	0.021
	2011-2018	0.30(0.24~0.36)	10.61	< 0.001
	2017-2019	-0.09(-0.36~0.18)	-0.72	0.479

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