Supplementary Material for: Trends of Alzheimer's Disease and Other Dementias with Socioeconomic Insights: An Age-period-cohort Analysis and Forecasts for 2046

Introduction
The disease burden of dementia varies in different economic development regions. This study provides a comprehensive overview of Alzheimer’s Disease and Other Dementias(ADOD) trends across regions with varying socio-economic statuses and forecasts global incidence rates from 2022 to 2046.
Methods
Based on the Global Burden of Disease (GBD) study, we utilized an age-period-cohort (APC) model to analyze annual changes in incidence and the risk factors associated with age, period, and birth cohort across different Socio-Demographic Index (SDI) regions. Additionally, a log-linear APC model was employed to project global trends in ADOD incidence from 2022 to 2046.
Results
Between 1992 and 2021, We estimated that the net drift of the incidence of ADOD is 0.03(95% CI: 0.01 to 0.04). High-middle SDI regions demonstrated the highest net drift (0.22,95% CI: 0.18 to 0.26). At the country level, the net drift was highest in China, at 0.36 (95% CI: 0.322 to 0.400), and we found a global upward trend in the incidence of the disease in people aged 50-64 years, especially in regions with high SDI. By 2046, there will be 21.24 million cases of ADOD worldwide. The age-standardized incidence rate for all patients with ADOD will increase slowly and is projected to be 120.8 per 100,000 population by 2046.
Conclusion
We found a steady increase in incidence worldwide, with the greatest increase in High-medium SDI regions. The incidence is declining in areas with high SDI, and higher levels of socioeconomic development have a protective effect against ADOD. Incidence is increasing in younger age groups. Therefore, we believe that improving the level of social and economic development and formulating relevant targeted policies are helpful for the prevention of ADOD. Focusing on the trends in disease incidence across different economic development regions will enable more targeted strategies to address the burden of disease.

引言
不同经济发展水平地区的痴呆疾病负担存在差异。本研究全面概述了不同社会经济地位区域的阿尔茨海默病及其他痴呆（Alzheimer’s Disease and Other Dementias, ADOD）流行趋势，并对2022年至2046年的全球发病率进行了预测。

方法
本研究基于全球疾病负担（Global Burden of Disease, GBD）研究，采用年龄-时期-队列（age-period-cohort, APC）模型分析不同社会人口指数（Socio-Demographic Index, SDI）区域内发病率的年度变化，以及与年龄、时期和出生队列相关的危险因素。此外，本研究还采用对数线性年龄-时期-队列模型，对2022年至2046年全球阿尔茨海默病及其他痴呆的发病率趋势进行预测。

结果
1992年至2021年间，本研究估算得到阿尔茨海默病及其他痴呆发病率的净漂移值为0.03（95%置信区间：0.01~0.04）。其中，高中等社会人口指数区域的净漂移值最高，达0.22（95%置信区间：0.18~0.26）。在国家层面，中国的净漂移值最高，为0.36（95%置信区间：0.322~0.400）。研究发现，50~64岁人群的阿尔茨海默病及其他痴呆发病率呈全球上升趋势，在高社会人口指数区域尤为明显。至2046年，全球阿尔茨海默病及其他痴呆患病人数将达2124万。全人群阿尔茨海默病及其他痴呆的年龄标化发病率将缓慢上升，预计到2046年将达到每10万人120.8例。

结论
本研究发现，全球阿尔茨海默病及其他痴呆发病率呈稳步上升趋势，其中高中等社会人口指数区域的增长幅度最大；而高社会人口指数区域的发病率则呈下降趋势，提示更高水平的社会经济发展对阿尔茨海默病及其他痴呆具有保护作用。此外，年轻年龄组的发病率呈上升趋势。因此，本研究认为，提升社会经济发展水平并制定相关针对性政策，有助于阿尔茨海默病及其他痴呆的预防。关注不同经济发展区域的疾病发病率趋势，可助力制定更具针对性的策略以应对疾病负担。