PDF(Pubmed)
Abstract：
UNASSIGNED: In China, dementia poses a significant public health challenge, exacerbated by an ageing population and lifestyle changes. This study assesses the temporal trends and disparities in the population-attributable fractions (PAFs) of modifiable risk factors (MRFs) for new-onset dementia from 2011 to 2018.
UNASSIGNED: We used data from the China Health and Retirement Longitudinal Study (CHARLS), covering 75,214 person-waves. We calculated PAFs for 12 MRFs identified by the Lancet Commission (including six early-to mid-life factors and six late-life factors). We also determined the individual weighted PAFs (IW-PAFs) for each risk factor. Subgroup analyses were conducted by sex, socio-economic status (SES), and geographic location.
UNASSIGNED: The overall PAF for dementia MRFs had a slight increase from 45.36% in 2011 to 52.46% in 2018, yet this change wasn\'t statistically significant. During 2011-2018, the most contributing modifiable risk was low education (average IW-PAF 11.3%), followed by depression, hypertension, smoking, and physical inactivity. Over the eight-year period, IW-PAFs for risk factors like low education, hypertension, hearing loss, smoking, and air pollution showed decreasing trends, while others increased, but none of these changes were statistically significant. Sex-specific analysis revealed higher IW-PAFs for traumatic brain injury (TBI), social isolation, and depression in women, and for alcohol and smoking in men. The decline in IW-PAF for men\'s hearing loss were significant. Lower-income individuals had higher overall MRF PAFs, largely due to later-life factors like depression. Early-life factors, such as TBI and low education, also contributed to SES disparities. Rural areas reported higher overall MRF PAFs, driven by factors like depression, low education, and hearing loss. The study also found that the gap in MRF PAFs across different SES groups or regions either remained constant or increased over the study period.
UNASSIGNED: The study reveals a slight but non-significant increase in dementia\'s MRF PAF in China, underscoring the persistent relevance of these risk factors. The findings highlight the need for targeted public health strategies, considering the demographic and regional differences, to effectively tackle and reduce dementia risk in China\'s diverse population.
UNASSIGNED: This work was supported by the PKU Young Scholarship in Global Health and Development.
UNASSIGNED: We used data from the China Health and Retirement Longitudinal Study (CHARLS), covering 75,214 person-waves. We calculated PAFs for 12 MRFs identified by the Lancet Commission (including six early-to mid-life factors and six late-life factors). We also determined the individual weighted PAFs (IW-PAFs) for each risk factor. Subgroup analyses were conducted by sex, socio-economic status (SES), and geographic location.
UNASSIGNED: The overall PAF for dementia MRFs had a slight increase from 45.36% in 2011 to 52.46% in 2018, yet this change wasn\'t statistically significant. During 2011-2018, the most contributing modifiable risk was low education (average IW-PAF 11.3%), followed by depression, hypertension, smoking, and physical inactivity. Over the eight-year period, IW-PAFs for risk factors like low education, hypertension, hearing loss, smoking, and air pollution showed decreasing trends, while others increased, but none of these changes were statistically significant. Sex-specific analysis revealed higher IW-PAFs for traumatic brain injury (TBI), social isolation, and depression in women, and for alcohol and smoking in men. The decline in IW-PAF for men\'s hearing loss were significant. Lower-income individuals had higher overall MRF PAFs, largely due to later-life factors like depression. Early-life factors, such as TBI and low education, also contributed to SES disparities. Rural areas reported higher overall MRF PAFs, driven by factors like depression, low education, and hearing loss. The study also found that the gap in MRF PAFs across different SES groups or regions either remained constant or increased over the study period.
UNASSIGNED: The study reveals a slight but non-significant increase in dementia\'s MRF PAF in China, underscoring the persistent relevance of these risk factors. The findings highlight the need for targeted public health strategies, considering the demographic and regional differences, to effectively tackle and reduce dementia risk in China\'s diverse population.
UNASSIGNED: This work was supported by the PKU Young Scholarship in Global Health and Development.
摘要：
■在中国，痴呆症构成了重大的公共卫生挑战，人口老龄化和生活方式的改变加剧了。这项研究评估了2011年至2018年新发痴呆症的可改变危险因素（MRF）的人群归因分数（PAF）的时间趋势和差异。
■我们使用了中国健康与退休纵向研究(CHARLS)的数据，涵盖75,214个人波。我们计算了柳叶刀委员会确定的12个MRF的PAF（包括6个早至中年因素和6个晚年因素）。我们还确定了每个风险因素的单个加权PAF(IW-PAF)。亚组分析按性别进行，社会经济地位(SES)，和地理位置。
■痴呆症MRF的总体PAF从2011年的45.36%略有增加到2018年的52.46%，但这种变化没有统计学意义。在2011-2018年期间，贡献最大的可改变风险是低教育(平均IW-PAF11.3%)，其次是抑郁症，高血压,吸烟,缺乏体力活动。在八年期间，低教育等风险因素的IW-PAF，高血压,听力损失,吸烟,空气污染呈下降趋势，虽然其他人增加了，但这些变化均无统计学意义.性别特异性分析显示，创伤性脑损伤（TBI）的IW-PAF较高，社会孤立,和女性的抑郁症，以及男性饮酒和吸烟。男性听力损失的IW-PAF下降显著。低收入个人的总体MRFPAF较高，主要是由于晚年的因素，如抑郁症。早期生活因素，比如TBI和低教育，也导致了SES差异。农村地区报告的总体MRFPAF较高，受抑郁等因素的驱动，低教育,和听力损失。研究还发现，在研究期间，不同SES组或地区的MRFPAF之间的差距保持不变或增加。
■该研究表明，中国痴呆症的MRFPAF略有增加，但没有显着增加，强调这些风险因素的持续相关性。调查结果强调了有针对性的公共卫生战略的必要性，考虑到人口和地区差异，有效解决和降低中国多样化人群痴呆症风险。
■这项工作得到了北京大学全球健康与发展青年奖学金的支持。
■我们使用了中国健康与退休纵向研究(CHARLS)的数据，涵盖75,214个人波。我们计算了柳叶刀委员会确定的12个MRF的PAF（包括6个早至中年因素和6个晚年因素）。我们还确定了每个风险因素的单个加权PAF(IW-PAF)。亚组分析按性别进行，社会经济地位(SES)，和地理位置。
■痴呆症MRF的总体PAF从2011年的45.36%略有增加到2018年的52.46%，但这种变化没有统计学意义。在2011-2018年期间，贡献最大的可改变风险是低教育(平均IW-PAF11.3%)，其次是抑郁症，高血压,吸烟,缺乏体力活动。在八年期间，低教育等风险因素的IW-PAF，高血压,听力损失,吸烟,空气污染呈下降趋势，虽然其他人增加了，但这些变化均无统计学意义.性别特异性分析显示，创伤性脑损伤（TBI）的IW-PAF较高，社会孤立,和女性的抑郁症，以及男性饮酒和吸烟。男性听力损失的IW-PAF下降显著。低收入个人的总体MRFPAF较高，主要是由于晚年的因素，如抑郁症。早期生活因素，比如TBI和低教育，也导致了SES差异。农村地区报告的总体MRFPAF较高，受抑郁等因素的驱动，低教育,和听力损失。研究还发现，在研究期间，不同SES组或地区的MRFPAF之间的差距保持不变或增加。
■该研究表明，中国痴呆症的MRFPAF略有增加，但没有显着增加，强调这些风险因素的持续相关性。调查结果强调了有针对性的公共卫生战略的必要性，考虑到人口和地区差异，有效解决和降低中国多样化人群痴呆症风险。
■这项工作得到了北京大学全球健康与发展青年奖学金的支持。
