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Incidence and prevalence of Alzheimer’s disease in China: a systematic review and meta-analysis

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Abstract

As China faces demographic shifts and socioeconomic changes, the burden of Alzheimer’s disease (AD) and associated cognitive impairments is increasing dramatically, with significant implications for public health and the economy. This systematic review and meta-analysis aims to provide a comprehensive assessment of the prevalence and incidence of AD across China. Drawing from an extensive search of international and Chinese databases up to August 27, 2023, including PubMed, Embase, and the Cochrane Library, we synthesized data from 105 studies. Our analysis reveals a combined prevalence of AD of 3.48% within a sample of 626,276 elderly individuals and an incidence rate of 7.90 per 1000 person-years. Subgroup and meta-regression analyses highlight age and gender as pivotal factors influencing these epidemiological patterns. Notably, significant heterogeneity exists due to variations in diagnostic criteria and study quality, impacting the comparability of findings. This meta-analysis underscores the need for continued research into demographic and modifiable risk factors influencing AD, while emphasizing standardized reporting practices to address these limitations and improve the understanding of AD’s challenge in China.

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References

  1. Breijyeh Z, Karaman R. Comprehensive review on alzheimer’s disease: causes and treatment. Molecules (Basel, Switzerland). 2020;25(24):5789. https://doi.org/10.3390/molecules25245789.

    Article  CAS  PubMed  Google Scholar 

  2. Lambert MA, Bickel H, Prince M, Fratiglioni L, Von Strauss E, Frydecka D, et al. Estimating the burden of early onset dementia; systematic review of disease prevalence. Eur J Neurol. 2014;21(4):563–9. https://doi.org/10.1111/ene.12325.

    Article  CAS  PubMed  Google Scholar 

  3. Dubois B, Feldman HH, Jacova C, Hampel H, Molinuevo JL, Blennow K, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol. 2014;13(6):614–29. https://doi.org/10.1016/S1474-4422(14)70090-0.

    Article  PubMed  Google Scholar 

  4. Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, et al. Dementia prevention, intervention, and care. Lancet (London, England). 2017;390(10113):2673–734. https://doi.org/10.1016/S0140-6736(17)31363-6.

    Article  PubMed  Google Scholar 

  5. Wang Q-H, Wang X, Bu X-L, Lian Y, Xiang Y, Luo H-B, et al. Comorbidity burden of dementia: a hospital-based retrospective study from 2003 to 2012 in seven cities in China. Neurosci Bull. 2017;33(6):703–10. https://doi.org/10.1007/s12264-017-0193-3.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Li C, Götz J. Tau-based therapies in neurodegeneration: opportunities and challenges. Nat Rev Drug Discovery. 2017;16(12):863–83. https://doi.org/10.1038/nrd.2017.155.

    Article  CAS  PubMed  Google Scholar 

  7. Stevenson-Hoare J, Heslegrave A, Leonenko G, Fathalla D, Bellou E, Luckcuck L, et al. Plasma biomarkers and genetics in the diagnosis and prediction of Alzheimer’s disease. Brain A J Neurol. 2023;146(2):690–9. https://doi.org/10.1093/brain/awac128.

    Article  Google Scholar 

  8. Hox J, Moerbeek M, Van de Schoot R. Multilevel analysis: techniques and applications. London: Routledge; 2017.

    Book  Google Scholar 

  9. Viechtbauer W. Conducting meta-analyses in R with the metafor package. J Stat Softw. 2010;36:1–48. https://doi.org/10.18637/jss.v036.i03.

    Article  Google Scholar 

  10. Fowkes FGR, Rudan D, Rudan I, Aboyans V, Denenberg JO, McDermott MM, et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. The Lancet. 2013;382(9901):1329–40. https://doi.org/10.1016/S0140-6736(13)61249-0.

    Article  Google Scholar 

  11. Fanelli D, Costas R, Ioannidis JPA. Meta-assessment of bias in science. Proc Natl Acad Sci USA. 2017;114(14):3714–9. https://doi.org/10.1073/pnas.1618569114.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Hubble JP, Busenbark KL, Pahwa R, Lyons K, Koller WC. Clinical expression of essential tremor: effects of gender and age. Mov Disord. 1997;12(6):969–72. https://doi.org/10.1002/mds.870120620.

    Article  CAS  PubMed  Google Scholar 

  13. Baranyi G, Scholl C, Fazel S, Patel V, Priebe S, Mundt AP. Severe mental illness and substance use disorders in prisoners in low-income and middle-income countries: a systematic review and meta-analysis of prevalence studies. Lancet Glob Health. 2019;7(4):e461–71. https://doi.org/10.1016/S2214-109X(18)30539-4.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Jia J, Zuo X, Jia X-F, et al. Diagnosis and treatment of dementia in neurology outpatient departments of general hospitals in China. Alzheimer’s Dement. 2016;12(4):446–53. https://doi.org/10.1016/j.jalz.2015.06.1892].

    Article  Google Scholar 

  15. Sun F. Caregiving stress and coping: a thematic analysis of Chinese family caregivers of persons with dementia. Dementia (London, England). 2014;13(6):803–18. https://doi.org/10.1177/1471301213485593.

    Article  PubMed  Google Scholar 

  16. Wu C, Gao L, Chen S, Dong H. Care services for elderly people with dementia in rural China: a case study. Bull World Health Organ. 2016;94(3):167–73. https://doi.org/10.2471/BLT.15.160929.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Yuan J, Zhang Z, Wen H, et al. Incidence of dementia and subtypes: a cohort study in four regions in China. Alzheimers Dement. 2016;12(3):262–71.

    Article  PubMed  Google Scholar 

  18. Meng H, Li Y, Zhang W, Zhao Y, Niu X, Guo J. The relationship between cognitive impairment and homocysteine in a B12 and folate deficient population in China: a cross-sectional study. Medicine. 2019;98(47):e17970. https://doi.org/10.1097/md.0000000000017970.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Yingquan W, Jinghong L, Ruixia J, Yong X. Prediction of the prevalence of Alzheimer’s disease in China from 2020 to 2050. Alzheimer’s Dis Relat Dis. 2019;2(1):289–98. https://doi.org/10.3969/j.issn.2096-5516.2019.01.012.

    Article  Google Scholar 

  20. Prince M, Wimo A, Guerchet M, Ali G-C, Wu Y-T, Prina M. World Alzheimer report 2015. The global impact of dementia: an analysis of prevalence, incidence, cost and trends.Alzheimer’s disease international. 2015.World Alzheimer Report 2015 | Alzheimer’s Disease International (ADI) (alzint.org).Accessed August 2015.

  21. Jansen WJ, Ossenkoppele R, Knol DL, Tijms BM, Scheltens P, Verhey FRJ, et al. Prevalence of cerebral amyloid pathology in persons without dementia: a meta-analysis. JAMA. 2015;313(19):1924–38. https://doi.org/10.1001/jama.2015.4668.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Parnetti L, Chipi E, Salvadori N, D’Andrea K, Eusebi P. Prevalence and risk of progression of preclinical Alzheimer’s disease stages: a systematic review and meta-analysis. Alzheimer’s Res Ther. 2019;11(1):7. https://doi.org/10.1186/s13195-018-0459-7.

    Article  Google Scholar 

  23. Hendriks S, Peetoom K, Bakker C, van der Flier WM, Papma JM, Koopmans R, et al. Global prevalence of young-onset dementia: a systematic review and meta-analysis. JAMA Neurol. 2021;78(9):1080–90. https://doi.org/10.1001/jamaneurol.2021.2161.

    Article  PubMed  Google Scholar 

  24. Cao Q, Tan C-C, Xu W, Hu H, Cao X-P, Dong Q, et al. The prevalence of dementia: a systematic review and meta-analysis. J Alzheimer’s Dis. 2020;73(3):1157–66. https://doi.org/10.3233/JAD-191092.

    Article  Google Scholar 

  25. Bacigalupo I, Mayer F, Lacorte E, Di Pucchio A, Marzolini F, Canevelli M, et al. A systematic review and meta-analysis on the prevalence of dementia in Europe: estimates from the highest-quality studies adopting the DSM IV diagnostic criteria. J Alzheimer’s Dis. 2018;66(4):1471–81. https://doi.org/10.3233/JAD-180416.

    Article  Google Scholar 

  26. Ossenkoppele R, Jansen WJ, Rabinovici GD, Knol DL, van der Flier WM, van Berckel BNM, et al. Prevalence of amyloid PET positivity in dementia syndromes: a meta-analysis. JAMA. 2015;313(19):1939–49. https://doi.org/10.1001/jama.2015.4669.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Petersen RC, Lopez O, Armstrong MJ, Getchius TSD, Ganguli M, Gloss D, et al. Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2018;90(3):126–35. https://doi.org/10.1212/WNL.0000000000004826.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Gustavsson A, Norton N, Fast T, Frölich L, Georges J, Holzapfel D, et al. Global estimates on the number of persons across the Alzheimer’s disease continuum. Alzheimers Dement. 2023;19(2):658–70. https://doi.org/10.1002/alz.12694.

    Article  PubMed  Google Scholar 

  29. Chêne G, Beiser A, Au R, et al. Gender and incidence of dementia in the Framingham Heart Study from mid-adult life. Alzheimer’s Dement. 2015;11(3):310. https://doi.org/10.1016/j.jalz.2013.10.005.

    Article  Google Scholar 

  30. Scourfield P. Unaging. the four factors that impact how you age Robert P. Friedland, Cambridge University Press, Cambridge, UK, 2022, 344 pp., pbk £14.99, ISBN 13: 978-1-00-908774-2. Ageing Soc. 2023;43(10):2472–3. https://doi.org/10.1017/S0144686X23000375.

    Article  Google Scholar 

  31. Ren R, Qi J, Lin S, et al. The China Alzheimer Report 2022. General Psychiatry. 2022;35(1):e100751. https://doi.org/10.1136/gpsych-2022-100751.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Yang JJ, Yu D, Wen W, et al. Tobacco smoking and mortality in Asia: a pooled meta-analysis. JAMA Netw Open. 2019;2(3):e191474. https://doi.org/10.1001/jamanetworkopen.2019.1474.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet (London, England). 2020;396(10248):413–46. https://doi.org/10.1016/S0140-6736(20)30367-6.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, 66 Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, China

    Qianqian Ji & Yiqiang Zhan

  2. School of Medicine, Sun Yat-Sen University, 66 Gongchang Road, Guangming District, Shenzhen, 518107, Guangdong, China

    Jingqi Chen & Yafei Li

  3. Department of Neurology, The Eighth Affiliated Hospital, Sun Yat-Sen University, 3025 Shennan Zhong Road, Futian District, Shenzhen, 518033, Guangdong, China

    Enxiang Tao

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Ji, Q., Chen, J., Li, Y. et al. Incidence and prevalence of Alzheimer’s disease in China: a systematic review and meta-analysis. Eur J Epidemiol 39, 701–714 (2024). https://doi.org/10.1007/s10654-024-01144-2

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