摘要
目的阿尔茨海默病和其他痴呆症(Alzheimer's disease and other dementias,ADOD)疾病负担沉重,吸烟是影响其疾病负担的前三位危险因素之一。本研究旨在了解1990—2019年全球归因于吸烟的ADOD疾病负担现状及变化,并预测2020—2030年吸烟所致ADOD的疾病负担发展趋势,为制定有针对性的吸烟相关干预策略提供理论依据。方法利用全球疾病负担(global burden of diseases,GBD)数据,使用死亡率、伤残调整寿命年(disability adjusted life years,DALYs)率指标描述全球吸烟所致ADOD疾病负担状况。采用Joinpoint回归模型和年龄-时期-队列模型分析30年间归因于吸烟的ADOD死亡率变化趋势。最后运用贝叶斯年龄-时期-队列分析(Bayesian age-period-cohort analysis,BAPC)对2020—2030年间全球归因于吸烟的ADOD的死亡率进行预测。结果归因于吸烟的ADOD死亡率和DALYs率均随年龄增加而增加,尤其在70岁以后增长迅速。归因于吸烟的ADOD疾病负担主要在男性,且男性吸烟所致ADOD死亡率的增长速度远高于女性。1990—2019年,全球归因于吸烟的ADOD死亡人数和DALYs数均有所上升,而标化死亡率和标化DALYs率却有所下降。Joinpoint回归分析结果显示全球总体归因于吸烟的ADOD标化死亡率的平均年度变化百分比(average annual percentage of change,AAPC)为-0.598%(95%CI:-0.622%~-0.573%),呈下降趋势。年龄-时期-队列分析结果表明因吸烟所致ADOD的总体死亡风险随时间推移在逐渐降低。预计在2020—2030年,全球归因于吸烟的ADOD的死亡人数将持续上升,而标化死亡率仍将继续呈现下降趋势。结论老年人群和男性是归因于吸烟的ADOD疾病负担的主要承担者,应对这部分群体给予足够的重视,采取有效干预措施。预计未来10年吸烟所致的ADOD死亡人数仍然上升,提示全球各国可以采取更加严格的控烟措施来进一步降低ADOD的疾病负担。
Objective Alzheimer's disease and other dementia(ADOD)have a heavy disease burden,and smoking is one of the top three risk factors.The study aims to understand the current status of the global burden of ADOD attributed to smoking and the changes from 1990 to 2019,and predict the trend from 2020 to 2030,thereby providing a theoretical basis for the development of targeted smoking-related intervention strategies.Methods We used the latest data from the global burden of diseases(GBD),where indicators including death rate and disability adjusted life years(DALYs)rate were used to describe the global burden of ADOD attributed to smoking.Joinpoint regression models and age-period-cohort models were performed to analyze the trend of global ADOD death rates attributed to smoking over the past 30 years.Finally,Bayesian age-period-cohort analysis(BAPC)was used to predict the global death rate of ADOD attributed to smoking from 2020 to 2030.Results The death rate and DALYs rate of ADOD attributed to smoking both increased with age,especially rapidly after the age of 70.The disease burden of ADOD attributable to smoking was mainly in males,and the death rate was increasing at a much higher rate in males than in females.From 1990 to 2019,the number of ADOD deaths and DALYs attributable to smoking worldwide both increased,while the age standardized death rate and the age-standardized DALYs rate decreased.The results of Joinpoint regression analysis showed that the global average annual percentage of change(AAPC)in ADOD age-standardized death rate attributable to smoking was-0.598%(95%CI:-0.622%to-0.573%),showing a decreasing trend.Age-period-cohort analysis results suggested that the overall risk of death from ADOD attributable to smoking was gradually decreasing over time.It is expected that the number of deaths from ADOD attributed to smoking worldwide will continue to rise,while the age-standardized death rate will continue to show a downward trend from 2020 to 2030.Conclusion The elderly population and males are the main bearers of ADOD disease burden attributed to smoking,and sufficient attention should be paid on them and effective intervention measures should be taken.The number of deaths caused by smoking in ADOD will continue to rise in the next 10 years,suggesting that countries around the world can adopt stricter smoking control measures to further reduce the disease burden of ADOD.
作者
金丽芬
袁满琼
方亚
Jin Lifen;Yuan Manqiong;Fang Ya(School of Public Health,Xiamen University/Key Laboratory of Health Technology Evaluation of Fujian Province,Xiamen 361102)
出处
《中国卫生统计》
北大核心
2025年第6期849-855,共7页
Chinese Journal of Health Statistics
基金
国家重点研发计划(2022YFC3603000)
厦门市自然科学基金(3502Z20227014)。
关键词
吸烟
阿尔茨海默病和其他痴呆症
疾病负担
预测
Smoking
Alzheimer's disease and other dementias
Burden of diseases
Joinpoint regression model
BAPC Prediction
