Abstract
This study analyzes the burden of Alzheimer disease and other dementias (ADOD) in China using Global Burden of Disease 2021 data. The data on ADOD in China from 1990 to 2021 was collected from the Global Burden of Disease 2021. The incidence rate, mortality and the number of disability adjusted life years (DALYs), and age-standardized rates of ADOD were analyzed. Use Joinpoint analysis to evaluate trends. Analyze the attribution ratio of risk factors such as smoking, high body mass index, and high fasting blood glucose (FPG) to the burden of ADOD disease. Evaluate the relative contributions of epidemiological changes, population growth, and population aging through decomposition analysis. Autoregressive Integrated Moving Average model is used to evaluate future trends. Age-standardized incidence rose from 121.11 (95% confidence interval: 105.5-137.99) to 151.47 (131.22-173.34) per 100,000, with an estimated annual percentage change (APC) of 0.41% (0.34-0.49%). Age-standardized mortality declined from 31.39 (7.6-83.63) to 30.82 (7.88-82.43) per 100,000, yet deaths increased by 3.92% annually (estimated APC: 3.79-4.04%). disability adjusted life years (DALYs) surged to 10.07 (4.95-22.22) million, with age-standardized DALY rate reaching 562.39 (271.16-1238.81) per 100,000. Joinpoint regression confirmed upward trends for age-standardized incidence (average APC = 0.60%, 0.46-0.74%) and age-standardized DALY rate (average APC = 0.10%, -0.01 to 0.22%). The incidence rate, mortality, and DALYs of ADOD in men and women mostly occur in the age group over 75 years old. FPG was the leading risk factor, attributing to 10.5% of DALYs, followed by smoking (8.0%) and high body mass index (0.2%). Decomposition analysis identified epidemiological changes as the primary driver of mortality increases (679,000 deaths, 45.6% contribution), exceeding aging (595,000 deaths) and population growth (214,000 deaths). Projections to 2036 indicate dramatic growth: cases rising to 7.46 (5.73-9.20) million, deaths to 1.12 (0.93-1.31) million, and DALYs to 23.76 (19.10-28.43) million. The ADOD burden in China has significantly increased, especially among women and the elderly population. It is worth noting that FPG is the primary risk factor for ADOD. The disease ADOD burden will continue to rise. Attention should be paid to the issue of population aging, and interventions targeting ADOD risk factors should be emphasized.