To analyze the disease burden of Alzheimer's disease (AD) in China from 1990 to 2021 and its trend of change, providing evidence for targeted interventions to reduce the burden of AD. A descriptive analysis of AD and its main risk factors among males and females of different ages in China from 1990 to 2021 was conducted using the Global Burden of Disease (GBD) 2021 database. The evaluation indicators were incidence rate, prevalence rate, mortality rate, and disability-adjusted life years (DALYs). The risk factors included high body mass index (BMI), high fasting plasma glucose, and smoking. The results showed that in 2021, the number of AD incidence among the Chinese population was 2 914 112 (204.8/100 000), the number of prevalence was 16 990 827 (1 194.2/100 000), the number of DALYs was 10 072 477 (708.0/100 000), and the number of deaths was 491 773 (34.6/100 000), which increased by 242.7%, 249.1%, 208.2%, and 239.4% respectively compared with 1990. In 2021, the AD incidence rate (264.4/100 000), prevalence rate (1 558.9/100 000), DALYs rate (935.8/100 000), and mortality rate (47.3/100 000) were all higher in women than in men. All rates showed a clear age-dependent trend. In 2021, the DALYs attributable to smoking, high BMI, and high fasting plasma glucose in the AD population in China were 602 501.1 (42.3/100 000), 466 728.7 (32.8/100 000), and 1 204 039.4 (84.6/100 000), respectively, with death tolls of 24 897.3 (1.7/100 000), 20 856.3 (1.5/100 000), and 58 838.2 (4.1/100 000). The proportion of DALYs attributable to high BMI showed an upward trend during 1990-2021, while the proportion of DALYs attributable to smoking showed a gradual decrease. The difference in the attributable risk factors between the genders was significant. In 2021, the highest risk among men was attributed to smoking, with DALYs rate and mortality rate of 68.3/100 000 and 2.7/100 000, respectively. In contrast, the highest risk among women was attributed to high fasting blood sugar, with DALYs rate and mortality rate of 111.1/100 000 and 5.6/100 000, respectively. In conclusion,the disease burden of AD is still increasing, and targeted interventions should be taken for both males and females to reduce the burden of AD by reducing unhealthy lifestyles.
分析1990—2021年中国阿尔茨海默病（Alzheimer′s disease，AD）的疾病负担状况及变化趋势，为有针对性地降低AD疾病负担提供依据。利用2021年全球疾病负担（GBD 2021）数据库，对1990—2021年中国不同性别、年龄的AD及其主要危险因素进行描述分析。评价指标主要为发病率、患病率、死亡率和伤残调整寿命年（disability-adjusted life years，DALYs）。危险因素包括高体重指数（body mass index，BMI）、高空腹血糖和吸烟。结果显示，2021年中国人群AD发病人数为2 914 112例（204.8/100 000），患病数为16 990 827例（1 194.2/100 000），DALYs数为10 072 477（708.0/100 000），死亡人数为491 773例（34.6/100 000），与1990年相比分别增长了242.7%、249.1%、208.2%和239.4%。2021年女性的AD发病率（264.4/100 000）、患病率（1 558.9/100 000）、DALYs率（935.8/100 000）和死亡率（47.3/100 000）均高于男性。发病率、患病率、DALYs率和死亡率均呈明显的随年龄上升趋势。2021年中国AD人群归因于吸烟、高BMI和高空腹血糖的DALYs数分别为602 501.1（42.3/100 000）、466 728.7（32.8/100 000）和1 204 039.4（84.6/100 000），死亡数分别为24 897.3（1.7/100 000）、20 856.3（1.5/100 000）和58 838.2（4.1/100 000）。1990—2021年间，高BMI所致的DALYs比例呈上升趋势，而归因于吸烟的DALYs比例则逐渐降低。不同性别的归因危险因素差别较大。2021年男性归因于吸烟的疾病风险最高，DALYs率和死亡率分别为68.3/100 000和2.7/100 000。而女性则主要归因于高空腹血糖，DALYs率和死亡率分别为111.1/100 000和5.6/100 000。综上，1990—2021年中国AD的疾病负担仍在持续增加，男性和女性应分别采取有针对性的干预措施，减少不良生活方式以降低AD疾病负担。.