Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019.
Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019.
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DOI：
10.1016/s2468-2667(21)00249-8
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发表时间：
2022-03
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通讯作者：
GBD 2019 Dementia Forecasting Collaborators
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作者：
GBD 2019 Dementia Forecasting Collaborators
鉴于人口老龄化和人口增长的预测趋势，痴呆症患者的人数预计将增加。此外，强有力的证据已经出现，支持潜在的可改变的风险因素对痴呆症的重要性。描述预期增长的分布和幅度对于公共卫生规划和资源优先顺序至关重要。这项研究旨在通过产生国家一级的估计和纳入有关选定风险因素的信息，改进以前对痴呆症患病率的预测。我们预测了2019年全球疾病负担、伤害和风险因素研究（GBD）中包含的三个痴呆风险因素导致的痴呆症患病率（高体重指数，高空腹血糖和吸烟）从2019年到2050年，使用相对风险和预测的风险因素患病率来预测2050年全球以及世界地区和国家的GBD风险归因患病率。使用线性回归模型，包括教育作为一个额外的预测因素，我们预测痴呆症的患病率不归因于GBD的风险。为了评估GBD风险因素、教育、人口增长和人口老龄化的未来趋势的相对贡献，我们进行了分解分析。我们估计，全球痴呆症患者的数量将从2019年的5740万（95%不确定性区间504 - 651）万例增加到2050年的15280万（1308 - 1759）万例。尽管预计痴呆症患者人数大幅增加，但年龄标准化的男女患病率在2019年至2050年期间保持稳定（全球百分比变化为0.1%[-7统计5至10.8]）。我们估计，2019年全球痴呆症女性患者多于男性患者（女性与男性的比例为1.69 [1.64 - 1.73]），我们预计这种模式将持续到2050年（女性与男性的比例为1.67 [1.52 - 1.85]）。各国和各地区的预计增长率存在地理异质性，亚太地区高收入地区的预计痴呆症病例数变化百分比最小（53% [41-67]）和西欧（74% [58-90]），北非和中东（367% [329-403]）以及撒哈拉以南非洲东部（357% [323-395]）最大。预计病例数的增加在很大程度上可归因于人口增长和人口老龄化，尽管其相对重要性因世界各区域而异，撒哈拉以南非洲的增加主要是人口增长造成的，东亚的增加主要是人口老龄化造成的。痴呆症患者人数的增长强调了公共卫生规划工作和政策的必要性，以满足这一群体的需求。国家一级的估计数可用于为国家规划工作和决定提供信息。多方面的方法，包括扩大干预措施以应对可改变的风险因素和投资于生物机制的研究，将是解决受痴呆症影响的人数预期增加的关键。比尔和梅琳达·盖茨基金会和盖茨风险投资公司。
Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. We estimated that the number of people with dementia would increase from 57·4 (95% uncertainty interval 50·4–65·1) million cases globally in 2019 to 152·8 (130·8–175·9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0·1% [–7·5 to 10·8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1·69 [1·64–1·73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1·67 [1·52–1·85]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41–67]) and western Europe (74% [58–90]), and the largest in north Africa and the Middle East (367% [329–403]) and eastern sub-Saharan Africa (357% [323–395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. Bill & Melinda Gates Foundation and Gates Ventures.