Disease Burden and Attributable Risk Factors of Alzheimer's Disease and Dementia in China from 1990 to 2019

Background Updated information on the burden of Alzheimer's disease and other forms of dementia are of great importance for evidence-based health care planning. However, such an estimate has been lacking in Chinese populations at both national and provincial levels. Objective To estimate the temporal trends and the attributable burdens of selected risk factors of Alzheimer's disease and other forms of dementia in China. Design, Setting, and Participants This is an observational description of the Global Burden of Diseases Study 2019 (GBD 2019). Data on incidence, mortality, prevalence, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) of Alzheimer's disease and other forms of dementia were derived from the GBD 2019 study at both national and provincial levels in China. Measurements Six indicators were used: incidence, mortality, prevalence, DALYs, YLLs, and YLDs. Absolute numbers in detail by age, sex, region, and age-standardized rates (with 95% uncertainty intervals) were calculated. Results There were notable increasing trends in the number of deaths (247.9%), incidence (264.8%), prevalence (296.5%), DALYs (228.1%), YLDs (308.7%) and YLLs (201.7%) from 1990 to 2019, respectively. The corresponding age-standardized rates increased by 6.2%, 19.3%, 33.6%, 10.7%, 33.4% and 3.1%. Smoking, high body mass index, high fasting plasma glucose levels, and metabolic risks were the four leading risk factors. Higher burden was observed among females versus males and in the more developed regions. Conclusions The disease burden in China were increasing substantially. Regional differences of the disease burden are accompanied by discrepancies of economic level and geographical location, as well as different levels of exposure to risk factors. Targeted prevention and control strategies are urgently needed to reduce the disease burden.