2018 Alzheimer's disease facts and figures
2018 Alzheimer's disease facts and figures
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DOI：
10.1016/j.jalz.2018.02.001
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发表时间：
2018-03-01
影响因子：
14
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中科院分区：
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本文介绍了阿尔茨海默病（AD）对公共卫生的影响，包括发病率和患病率，死亡率和发病率，护理成本，以及对护理人员和社会的总体影响。特别报告探讨了在疾病过程的早期诊断阿尔茨海默氏症的好处，在阿尔茨海默氏症导致的轻度认知障碍阶段。估计有570万美国人患有阿尔茨海默氏症。到本世纪中叶，美国阿尔茨海默氏症痴呆症患者的数量预计将增长到1380万，这在很大程度上是由于婴儿潮一代的老龄化。2015年，官方死亡证明记录了110，561例AD死亡，使AD成为美国第六大死亡原因和美国年龄≥ 65岁的第五大死亡原因。在2000年至2015年期间，中风、心脏病和前列腺癌导致的死亡人数下降，而AD导致的死亡人数增加了123%。2017年，超过1600万家庭成员和其他无偿护理人员为阿尔茨海默氏症或其他痴呆症患者提供了约184亿小时的护理。这种护理的价值超过2320亿美元，但其成本延伸到家庭护理人员情绪困扰和负面身心健康结果的风险增加。向年龄≥ 65岁的阿尔茨海默氏症或其他痴呆症受益人提供服务的平均每人医疗保险支付额是向没有这些条件的受益人支付的三倍多，医疗补助支付额是23倍多。2018年，为年龄≥ 65岁的痴呆症患者提供的医疗保健、长期护理和临终关怀服务的总支出估计为2770亿美元。随着近年来AD生物标志物的鉴定，我们对该疾病的理解已经从基于症状转变为基于大脑变化。因为这些变化早在临床症状出现之前开始，所以阿尔茨海默氏症有可能在痴呆阶段之前被诊断出来。AD的早期诊断可能具有重要的个人和经济利益。一个数学模型估计，早期和准确的诊断可以节省高达7.9万亿美元的医疗和护理费用。
This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, costs of care, and the overall impact on caregivers and society. The Special Report examines the benefits of diagnosing Alzheimer's earlier in the disease process, in the stage of mild cognitive impairment due to Alzheimer's disease. An estimated 5.7 million Americans have Alzheimer's dementia. By mid-century, the number of people living with Alzheimer's dementia in the United States is projected to grow to 13.8 million, fueled in large part by the aging baby boom generation. In 2015, official death certificates recorded 110,561 deaths from AD, making AD the sixth leading cause of death in the United States and the fifth leading cause of death in Americans age >= 65 years. Between 2000 and 2015, deaths resulting from stroke, heart disease, and prostate cancer decreased, whereas deaths from AD increased 123%. In 2017, more than 16 million family members and other unpaid caregivers provided an estimated 18.4 billion hours of care to people with Alzheimer's or other dementias. This care is valued at more than $232 billion, but its costs extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes. Average per-person Medicare payments for services to beneficiaries age >= 65 years with Alzheimer's or other dementias are more than three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 23 times as great. Total payments in 2018 for health care, long-term care and hospice services for people age >= 65 years with dementia are estimated to be $277 billion. With the identification of AD biomarkers in recent years, our understanding of the disease has moved from one based on symptoms to one based on brain changes. Because these changes begin well before clinical symptoms arise, Alzheimer's has the potential to be diagnosed before the dementia stage. Early diagnosis of AD could have important personal and financial benefits. A mathematical model estimates that early and accurate diagnosis could save up to $7.9 trillion in medical and care costs.