Abstract
OBJECTIVES: The China Alzheimer's Disease Report 2024 reveals that the number of deaths in China due to Alzheimer's disease (AD) and other types of dementia reached 320 715, accounting for 19.8% of global dementia-related deaths. The socioeconomic burden is increasingly prominent and poses a serious threat to the health of Chinese residents. This study aims to analyze the changes in the disease burden of dementias among Chinese residents from 1992 to 2021 and to predict future trends, so as to provide a reference for dementia prevention and control. METHODS: Based on data from the Global Burden of Disease (GBD) Study 2021, Joinpoint regression models were used to analyze the incidence and age-standardized incidence rate, deaths and age-standardized mortality rate, disability-adjusted life year (DALY) and age-standardized DALY rate of senile dementia among Chinese residents aged 60 years and above from 1992 to 2021. Age-period-cohort models were used to analyze incidence and mortality under different effects. Bayesian age-period-cohort models were applied to predict the age-standardized incidence rate of dementias among Chinese residents from 2022 to 2031. RESULTS: From 1992 to 2021, the disease burden of senile dementia among Chinese residents increased year by year. The age-standardized incidence rate and age-standardized DALY rate showed fluctuating upward trends, while the age-standardized mortality rate declined. The average annual percent change (AAPC) of the age-standardized incidence rate, age-standardized mortality rate, and age-standardized DALY rate were 0.57%, -0.07%, and 0.09%, respectively (all P<0.05). From 2019 to 2021, the numbers of incident cases, deaths, and DALY of dementia among Chinese residents aged 60 years and above increased significantly, with higher values in females than in males. The age-period-cohort model indicated that incidence and mortality risks increased with age, with a marked increase after 70 years of age; incidence risk showed a "wave-like" pattern of increase-decrease-increase over periods, while mortality risk showed a trend of decrease followed by increase; incidence risk fluctuated upward across birth cohorts, whereas mortality risk fluctuated downward. Predictions from the Bayesian age-period-cohort model indicate that from 2022 to 2031, the age-standardized incidence rate of dementia in China may continue to increase, reaching 1 616.87 per 100 000 in the total population, 1 304.71 per 100 000 in males, and 1 809.09 per 100 000 in females by 2031. CONCLUSIONS: From 1992 to 2021, the disease burden of senile dementia in China has increased year by year, with a particularly heavy burden among older women. Senile dementia remains a major public health problem, and its disease burden may continue to increase in the future. It is recommended to promote early screening to promote early screening among high-risk populations and to enhance public awareness through extensive health education to reduce incidence risk and comprehensively improve the effectiveness of senile dementia prevention and control.