Table 2_Temporal trends in dementias in older adults attributable to high fasting plasma glucose from 1990 to 2021 and forecasted disease burden in 2040 in China and globally.xlsx

IntroductionThe Global Burden of Diseases Study systematically updates the dementia burden attributable to high fasting plasma glucose (HFPG) to investigate the temporal trends of dementia burden and promote comparisons between countries, sexes, and age groups. In this study, we aimed to estimate the disease burden of dementia attributable to HFPG using an age-period-cohort model in adults aged >60 years from 1990 to 2021 and forecast the mortality and disability-adjusted life-years (DALYs) rates in China and globally in 2040.
MethodData on the mortality and DALYs rates of dementia attributable to HFPG in China and globally were extracted from the Global Burden of Disease Study 2021. An age-period-cohort model was used to estimate the net drift, local drift, fitted longitudinal age-specific rates, and period/cohort relative risks from 1990 to 2021. The Bayesian age-period-cohort model was used to predict future mortality and DALYs rates from 2022 to 2040.
ResultsThe net drifts showed an overall upward trend in the dementia burden attributable to HFPG in China and globally from 1990 to 2021, with a much slower trend in China. A constantly rising risk for age and birth cohort effects was observed, while period effects presented a globally constantly increasing risk and two inflection points in China, probably due to healthcare reform. The forecasted disease burden by 2040 demonstrated an increasing trend globally and a declining trend in China.
ConclusionThe burden of dementia attributable to HFPG has consistently increased globally over the past 30 years but has gradually declined in China in recent years. China’s strategies for preventing and managing diabetes and dementia may provide valuable insights for other regions. Further targeted policies are required to reduce the burden on females and older adults, particularly to improve their quality of life.

引言：《全球疾病负担研究》（Global Burden of Diseases Study）会系统性更新由空腹血糖升高（HFPG）导致的痴呆症疾病负担，以探究痴呆症负担的时间变化趋势，并推动不同国家、性别及年龄组之间的对比。本研究旨在利用年龄-时期-队列模型，估算1990年至2021年间60岁以上成年人中由HFPG所致的痴呆症疾病负担，并预测2040年中国及全球的死亡率与伤残调整寿命年（DALYs）率。
方法：本研究从《2021年全球疾病负担研究》中提取中国及全球范围内由HFPG导致的痴呆症死亡率与DALYs率数据。采用年龄-时期-队列模型估算1990年至2021年的净漂移、局部漂移、拟合的纵向年龄别率，以及时期/队列相对风险。使用贝叶斯年龄-时期-队列模型预测2022年至2040年的未来死亡率与DALYs率。
结果：1990年至2021年，中国及全球范围内由HFPG所致的痴呆症负担的净漂移整体呈上升趋势，其中中国的上升趋势更为平缓。研究观察到年龄与出生队列效应的风险持续升高，而时期效应方面，全球整体风险持续上升，中国则出现两个拐点，这可能与医疗改革有关。至2040年的预测疾病负担显示，全球负担将呈上升趋势，而中国负担将呈下降趋势。
结论：过去30年间，全球范围内由HFPG所致的痴呆症负担持续上升，但近年来中国的该负担已逐渐下降。中国在糖尿病与痴呆症防控及管理方面的策略，可为其他地区提供宝贵借鉴。此外，仍需制定针对性政策，以减轻女性与老年群体的疾病负担，尤其需改善其生活质量。