Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016

被引：1530

作者：

Nichols, Emma ^{[1
]}

Szoeke, Cassandra E. I. ^{[4
,6
]}

Vollset, Stein Emil ^{[1
]}

Abbasi, Nooshin ^{[12
,13
]}

Abd-Allah, Foad ^{[15
]}

Abdela, Jemal ^{[16
]}

Aichour, Miloud Taki Eddine ^{[17
]}

Akinyemi, Rufus O. ^{[18
]}

Alahdab, Fares ^{[19
,20
]}

Asgedom, Solomon W. ^{[25
]}

Awasthi, Ashish ^{[27
,28
]}

Barker-Collo, Suzanne L. ^{[29
]}

Baune, Bernhard T. ^{[30
]}

Bejot, Yannick ^{[31
,32
]}

Belachew, Abate B. ^{[26
]}

Bennett, Derrick A. ^{[33
]}

Bijani, Belete Biadgo Ali ^{[34
,39
]}

Bin Sayeed, Muhammad Shahdaat ^{[40
,41
]}

Brayne, Carol ^{[42
]}

Carpenter, David O. ^{[43
]}

Carvalho, Felix ^{[44
,46
]}

Catala-Lopez, Ferran ^{[49
]}

Cerin, Ester ^{[5
,50
]}

Choi, Jee-Young J. ^{[51
]}

Dang, Ahn K. ^{[52
]}

Degefa, Meaza G. ^{[24
]}

Djalalinia, Shirin ^{[53
]}

Dubey, Manisha ^{[54
]}

Duken, Eyasu Ejeta ^{[55
,56
]}

Edvardsson, David ^{[58
,59
]}

Endres, Matthias ^{[60
]}

Eskandarieh, Sharareh ^{[11
]}

Faro, Andre ^{[61
]}

Farzadfar, Farshad ^{[12
]}

Fereshtehnejad, Seyed-Mohammad ^{[14
,62
]}

Fernandes, Eduarda ^{[47
]}

Filip, Irina ^{[63
,64
]}

Fischer, Florian ^{[66
]}

Gebre, Abadi K. ^{[25
]}

Geremew, Demeke ^{[35
]}

Ghasemi-Kasman, Maryam ^{[37
]}

Gnedovskaya, Elena V. ^{[67
]}

Gupta, Rajeev ^{[68
,69
]}

Hachinski, Vladimir ^{[70
,71
]}

Hagos, Tekleberhan B. ^{[21
]}

Hamidi, Samer ^{[72
]}

Hankey, Graeme J. ^{[73
,74
]}

Haro, Josep M. ^{[75
,76
]}

Hay, Simon I. ^{[1
]}

Irvani, Seyed Sina N. ^{[12
,77
]}

机构：

[1] Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA

[2] Univ Washington, Dept Neurol, Seattle, WA 98121 USA

[3] Univ Melbourne, Dept Med, Melbourne, Vic, Australia

[4] Univ Melbourne, Sch Hlth Sci, Melbourne, Vic, Australia

[5] Australian Catholic Univ, Mary MacKillop Inst Hlth Res, Melbourne, Vic, Australia

[6] Australian Catholic Univ, Brain Inst, Melbourne, Vic, Australia

[7] Univ Tehran Med Sci, Dept Anat, Tehran, Iran

[8] Univ Tehran Med Sci, Digest Dis Res Inst, Tehran, Iran

[9] Univ Tehran Med Sci, Hematol Malignancies Res Ctr, Tehran, Iran

[10] Univ Tehran Med Sci, Hematol Oncol & Stem Cell Transplantat Res Ctr, Tehran, Iran

[11] Univ Tehran Med Sci, MS Res Ctr, Tehran, Iran

[12] Univ Tehran Med Sci, Noncommunicable Dis Res Ctr, Tehran, Iran

[13] McGill Univ, Montreal Neuroimaging Ctr, Montreal, PQ, Canada

[14] McGill Univ, Montreal Neurol Inst, Montreal, PQ, Canada

[15] Cairo Univ, Dept Neurol, Cairo, Egypt

[16] Haramaya Univ, Sch Pharm, Harar, Ethiopia

[17] Higher Natl Sch Vet Med, Algiers, Algeria

[18] Univ Ibadan, Inst Adv Med Res & Training, Ibadan, Nigeria

[19] Mayo Clin, Fdn Med Educ & Res, Evidence Based Practice Ctr, Rochester, MN USA

[20] Syrian Amer Med Soc, Washington, DC USA

[21] Mekelle Univ, Anat Unit, Mekelle, Ethiopia

[22] Mekelle Univ, Clin Pharm Unit, Mekelle, Ethiopia

[23] Mekelle Univ, Coll Hlth Sci, Mekelle, Ethiopia

[24] Mekelle Univ, Dept Nutr & Dietet, Mekelle, Ethiopia

[25] Mekelle Univ, Sch Pharm, Mekelle, Ethiopia

[26] Mekelle Univ, Sch Publ Hlth, Mekelle, Ethiopia

[27] Indian Inst Publ Hlth, Gandhinagar, India

[28] Publ Hlth Fdn India, Gurugram, India

[29] Univ Auckland, Sch Psychol, Auckland, New Zealand

[30] Melbourne Med Sch, Melbourne, Vic, Australia

[31] Univ Hosp Dijon, Dept Neurol, Dijon, France

[32] Univ Burgundy, UFR Sci Sante, Dijon, France

[33] Univ Oxford, Nuffield Dept Populat Hlth, Oxford, England

[34] Univ Gondar, Dept Clin Chem, Gondar, Ethiopia

[35] Univ Gondar, Dept Med Microbiol, Gondar, Ethiopia

[36] Babol Univ Med Sci, Dept Pharmacol, Babol Sar, Iran

[37] Babol Univ Med Sci, Hlth Res Inst, Babol Sar, Iran

[38] Babol Univ Med Sci, Infect Dis & Trop Med Res Ctr, Babol Sar, Iran

[39] Babol Univ Med Sci, Social Determinant Hlth Res Ctr, Babol Sar, Iran

[40] Australian Natl Univ, Natl Ctr Epidemiol & Populat Hlth, Canberra, ACT, Australia

[41] Univ Dhaka, Dept Clin Pharm & Pharmacol, Ramna, Bangladesh

[42] Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge, England

[43] SUNY Albany, Inst Hlth & Environm, Rensselaer, NY USA

[44] Univ Porto, Appl Mol Biosci Unit, Porto, Portugal

[45] Univ Porto, Dept Clin Neurosci & Mental Hlth, Fac Med, Porto, Portugal

[46] Univ Porto, Inst Publ Hlth, Porto, Portugal

[47] Univ Porto, REQUIMTE LAQV, Porto, Portugal

[48] Univ Porto, UCIBIO, Porto, Portugal

[49] Inst Hlth Carlos III, Dept Hlth Planning & Econ, Madrid, Spain

[50] Univ Hong Kong, Sch Publ Hlth, Hong Kong, Peoples R China

来源：

LANCET NEUROLOGY | 2019年 / 18卷 / 01期

基金：

比尔及梅琳达.盖茨基金会;

关键词：

RISK-FACTOR; COGNITIVE IMPAIRMENT; PREVALENCE; METAANALYSIS; DECLINE; TRENDS; LIFE;

D O I：

10.1016/S1474-4422(18)30403-4

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

100204 [神经病学];

摘要：

Background The number of individuals living with dementia is increasing, negatively affecting families, communities, and health-care systems around the world. A successful response to these challenges requires an accurate understanding of the dementia disease burden. We aimed to present the first detailed analysis of the global prevalence, mortality, and overall burden of dementia as captured by the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016, and highlight the most important messages for clinicians and neurologists. Methods GBD 2016 obtained data on dementia from vital registration systems, published scientific literature and surveys, and data from health-service encounters on deaths, excess mortality, prevalence, and incidence from 195 countries and territories from 1990 to 2016, through systematic review and additional data-seeking efforts. To correct for differences in cause of death coding across time and locations, we modelled mortality due to dementia using prevalence data and estimates of excess mortality derived from countries that were most likely to code deaths to dementia relative to prevalence. Data were analysed by standardised methods to estimate deaths, prevalence, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs; computed as the sum of YLLs and YLDs), and the fractions of these metrics that were attributable to four risk factors that met GBD criteria for assessment (high body-mass index [BMI], high fasting plasma glucose, smoking, and a diet high in sugarsweetened beverages). Findings In 2016, the global number of individuals who lived with dementia was 43.8 million (95% uncertainty interval [UI] 3 7. 8-51.0), increased from 20.2 million (17. 4-23 5) in 1990. This increase of 117% (95% UI 114-121) contrasted with a minor increase in age-standardised prevalence of 1.7% (1.0-2.4), from 701 cases (95% UI 602-815) per 100 000 population in 1990 to 712 cases (614-828) per 100 000 population in 2016. More women than men had dementia in 2016 (27.0 million, 95% UI 23 .3-31. 4, vs 16.8 million, 14.4-19.6), and dementia was the fifth leading cause of death globally, accounting for 2.4 million (95% UI 2.1-2.8) deaths. Overall, 28.8 million (95% UI 24. 5-34. 0) DALYs were attributed to dementia; 6.4 million (95% UI 3 .4-10. 5) of these could be attributed to the modifiable GBD risk factors of high BMI, high fasting plasma glucose, smoking, and a high intake of sugar-sweetened beverages. Interpretation The global number of people living with dementia more than doubled from 1990 to 2016, mainly due to increases in population ageing and growth. Although differences in coding for causes of death and the heterogeneity in case-ascertainment methods constitute major challenges to the estimation of the burden of dementia, future analyses should improve on the methods for the correction of these biases. Until breakthroughs are made in prevention or curative treatment, dementia will constitute an increasing challenge to health-care systems worldwide. (C) 2018 The Author(s). Published by Elsevier Ltd.

引用

页码：88 / 106

页数：19

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