The Prevalence of Alzheimer’s Disease in China: A Systematic Review and Meta-analysis
-
Kanglan LI
,
Shouchao WEI
,
Zhou LIU
,
Li HU
,
Jiajing LIN
,
Shiting TAN
,
Yingren MAI
,
Wanjuan PENG
,
Hui MAI
,
Qi HOU
,
Guifeng TU
Abstract
Background: Several studies have investigated the prevalence of Alzheimer’s disease (AD) among the general population in several parts of China. However, the results have been inconsistent. This meta-analysis was conducted to estimate the overall prevalence of AD between 2007 and 2017 in China.
Methods: English and Chinese electronic databases were searched with a date range from Nov 2007 to Nov 2017 and the reference lists of the included studies were screened as well. Cross-sectional studies addressing the prevalence of AD among the general Chinese population were retrieved irrespective of the age, location or sex of the participants. Study quality was assessed using the recommended checklist of STROBE.
Results: Overall, 184058 subjects and 7445 patients with AD were included from 17 studies in this meta-analysis. The overall prevalence of AD in China was calculated to be 0.04(95% CI:0.04-0.05). The prevalence was higher in older age groups, among females, and in the rural areas of the country, with an increasing trend in recent years.
Conclusion: AD is a common problem among those in the Chinese population older than 65 yr. Furthermore, an increasing trend of the disease over the past 10 years is indicative of a critical public health problem in China in the near future. Further evidence based on a national survey is needed to estimate the exact prevalence of the disease in the country.
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14. Yang L, Jin X, Yan J, et al (2016). Prevalence of dementia, cognitive status and associ-ated risk factors among elderly of Zhejiang province, China in 2014. Age Ageing, 45(5):708 -12
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20. Fan Qinghua, ZhengJianzhong (2011). In-vestigation of prevalence Alzheimer’s dis-ease and its risk factors. Modern Preventive Medicine, 38: 3029–3033.
21. Chen Jie, Wang Zhongheng et al (2013). Epidemiological investigation of Alzhei-mer's disease in Nanchang area. Jiang Xi Yi Yao, 48(9):837-838.
22. Ji Min, Yao Xinwei, Lv Jun et al (2010). A Cross-Section Study of Senile Dementia in Shanghai. Chin J Rehabil Theory Pract, 16:513-515.
23. Sun Hong Xian, Wu Yiwen, Ye Fulin (2012). Prevalence of dementia among elderly people in Sheshantown, Songjiang dis-trict, Shanghai. Journal of Internal Medicine Concepts & Practice, 7:91-95
24. Ma Yong,JiangZhongping, Wang Jiwei (2013). The prevalence of the main sub-types of dementia in 65 years or above population of Xujiahui, Shanghai. ZhongGuo Lao NianXue, 33(6):1365-1366.
25. Ye Guoying, Chen Jianer, Chen Furong (2011). Dementia in Ningbo over 60 years and related risk factors. ZhongGuo-NongCun Wei Sheng Shi Ye Guan Li, 31(2):152-155.
26. Li Chonghui, Yanglishun, Zhao Lan (2015).The prevalence of dementia in Tianjin. Shi Yong Yu Fang Yi Xue, 22(3):305-308.
27. Kang MY, Gao YM Huo HQ, et al (2011). Epidemiological fearures of chronic and Azheimer’s disease in the community-based elderly living in cities in Hebei province. Zhonghua Liu Xing Bing Xue Za Zhi, 32(7):672-675.
28. Kalaria RN, Maestre GE, Arizaga R et al (2008). Alzheimer's disease and vascular dementia in developing countries: preva-lence, management, and risk factors. Lan-cet Neurol, 7(9):812-826.
29. Prince M, Ali G C, Guerchet M, et al (2016). Recent global trends in the prevalence and incidence of dementia, and survival with dementia. Alzheimers Res Ther, 8(1):23.
30. Plassman B L, Langa K M, Fisher G G, et al (2007). Prevalence of Dementia in the United States: The Aging, Demographics, and Memory Study. Neuroepidemiology, 29(1-2):125-132.
31. O’Brien JT, Burns A (2011). Clinical practice with anti-dementia drugs: a revised (sec-ond) consensus statement from the Brit-ish Association for Psychopharmacology. J Psychopharmacol, 25(8):997-1019.
32. Cho MJ, Lee JY, Kim B-S et al (2011). Prev-alence of the major mental disorders among the Korean elderly. J Korean Med Sci, 26(1): 1–10.
33. Kim YJ, Han JW, So YS, et al (2014). Preva-lence and trends of dementia in Korea: a systematic review and meta-analysis. J Ko-rean Med Sci, 29(7):903-912.
34. Yang X, Yang Y, Liu J, et al (2012). In-creased phosphorylation of tau and syn-aptic protein loss in the aged transgenic mice expressing familiar Alzheimer's dis-ease-linked presenilin 1 mutation. Neuro-chem Res,37(1):15-22.
35. Ferri CP, Prince M, Brayne C, et al (2005). Global prevalence of dementia: a Delphi consensus study. Lancet, 366(9503):2112-7.
36. Shaji S, Bose S, Verghese A (2005). Preva-lence of dementia in an urban population in Kerala, India. Br J Psychiatry, 186:136-140.
37. Wu Y T, Brayne C, Matthews F E (2015). Prevalence of dementia in East Asia: a synthetic review of time trends. Int J Geri-atr Psychiatry, 30(8):793-801.
38. Castellani RJ, Rolston RK, Smith MA (2010). Alzheimer disease. Dis Mon, 56(9):484-546.
39. Lee JY, Kim JH, Choi DW, et al (2012). The association of heavy metal of blood and serum in the Alzheimer's diseases. Toxicol Res, 28(2):93-98.
40. Durazzo T C, Korecka M, Trojanowski J Q, et al (2016). Active Cigarette Smoking in Cognitively-Normal Elders and Probable Alzheimer's Disease is Associated with Elevated Cerebrospinal Fluid Oxidative Stress Biomarkers. J Alzheimers Dis, 54(1):99-107.
41. Saetre P, Jazin E, Emilsson L (2011). Age-related changes in gene expression are accelerated in Alzheimer's disease. Synapse, 65(9):971-974.
42. Dunckley T, Beach TG, Ramsey KE, et al (2006). Gene expression correlates of neurofibrillary tangles in Alzheimer's dis-ease. Neurobiol Aging, 27(10):1359-1371.
43. Guerreiro R J, Baquero M, Blesa R, et al (2010). Genetic screening of Alzheimer's disease genes in Iberian and African samples yields novel mutations in prese-nilins and APP. Neurobiol Aging, 31(5):725-31.
44. Cova I, Markova A, Campini I, et al (2017). Worldwide trends in the prevalence of dementia. J Neurol Sci, 379:259-260.
45. Gao S, Hendrie H C, Hall K S, et al (1998). The relationships between age, sex, and the incidence of dementia and Alzheimer disease: a meta-analysis. Arch Gen Psychia-try, 55(9):809-15.
46. Fratiglioni L, Grut M, Forsell Y, et al (1991). Prevalence of Alzheimer's disease and other dementias in an elderly urban population Relationship with age, sex, and education. Neurology, 41(12):1886-92.
47. Moffat SD, Zonderman AB, Metter EJ, et al (2004). Free testosterone and risk for Alzheimer disease in older men. Neurology, 62(2):188-193.
48. Henderson VW, Hogervorst E (2004). Tes-tosterone and Alzheimer disease: is it men's turn now? Neurology, 62(2):170-171.
49. Pennanen C, Laakso MP, Kivipelto M et al (2004). Serum testosterone levels in males with Alzheimer's disease. J Neuroendocrinol, 16(2): 95-98.
50. Paoletti AM, Congia S, Lello S et al (2004). Low androgenization index in elderly women and elderly men with Alzheimer's disease. Neurology, 62(2): 301-303.
2. Yin P, Feng X, Astellburt T, et al (2016).Temporal Trends and Geographic Variations in Dementia Mortality in Chi-na Between 2006 and 2012: Multilevel Evidence from a Nationally Representa-tive Sample. Alzheimer Dis Assoc Disord, 30(4):348-353.
3. Chow N (2006). The practice of filial piety and its impact on long-term care policies for elderly people in Asian Chinese communities. Asian J Gerontol Geriatr, 1:31-35.
4. Wang J, Xiao L D, Li X, et al (2015). Care-giver distress and associated factors in dementia care in the community setting in China. Geriatr Nurs, 36(5):348-54.
5. Chan KY, Wang W, Wu JJ, et al (2013). Ep-idemiology of Alzheimer’s disease and other forms of dementia in China, 1990–2010: a systematic review and analysis. Lancet, 381(9882): 2016–2023.
6. Jia J, Wang F, Wei C, et al (2014). The preva-lence of dementia in urban and rural are-as of China. Alzheimers Dement, 10(1):1-9.
7. Prince M, Bryce R, Albanese E, et al (2013). The global prevalence of dementia: a sys-tematic review and meta-analysis. Alz-heimers Dement, 9(1):63-75.e2.
8. Prince M, Comas-Herrera A, Knapp M et al (2016). World Alzheimer Report 2016: improving healthcare for people living with dementia. Coverage, quality and costs now and in the future. Alzheimer's Disease International. https://www.alz.co.uk/research/WorldAlzheimerReport2016.pdf
9. Vandenbroucke JP, von Elm E, Altman DG et al (2007). STROBE Initiative. Strength-ening the reporting of observational studies in epidemiology (STROBE): Ex-planation and elaboration. PLoS Med, 4:e297.
10. Higgins JP, Thompson SG, Deeks JJ, et al (2003). Measuring inconsistency in meta-analyses. BMJ, 327(7414):557-560.
11. Mantel N, Haenszel W (1959). Statistical as-pects of the analysis of data from retro-spective studies of disease. J Natl Cancer Inst, 22(4):719-48.
12. DerSimonian R, Laird N (1986). Meta-analysis in clinical trials. Control Clin Trials, 7(3):177-188.
13. Huriletemuer, Wen S, Zhang C, et al (2011). An epidemiological study of Alzheimer’s disease in elderly Mongolian and Han populations living in rural areas of Inner Mongolia. Aging Clin Exp Res, 23(5-6):470-475.
14. Yang L, Jin X, Yan J, et al (2016). Prevalence of dementia, cognitive status and associ-ated risk factors among elderly of Zhejiang province, China in 2014. Age Ageing, 45(5):708 -12
15. Ji Y, Shi Z, Zhang Y, et al (2015). Prevalence of dementia and main subtypes in rural northern China. Dement Geriatr Cogn Dis-ord, 39(5-6): 294–302.
16. Li Hong, Zhang HH, Huang H, et al (2009). Prevalence of dementia among rural el-derly in Gushantownship,Fuzhou. Zhong-hua Liu Xing Bing Xue Za Zhi, 30(8):772-775.
17. Lao Meili, Zhang Haiying, Yi Xinan et al (2009). The epidemiological survey of Alzheimer's disease in Hainan Island. ZhongGuo Lao NianXue, 31(20):4016-4018.
18. ZouZhanpin, Chen Lusong, Zou Li, et al (2014). Survey on prevalence of Alz-heimer’s disease in Haining. Zhonghua QuanKe Yi Xue, 12(10):1639-1641.
19. Zhang Qingyu, Wan Xiaohui, Zhang Min et al (2017). The epidemiology investigation and related influence factors analysis of Alzheimer's disease in Lanzhou city. Ying Xiang Yan Jiu Yu Lin Chuang Ying Yong, 1(10):222-224.
20. Fan Qinghua, ZhengJianzhong (2011). In-vestigation of prevalence Alzheimer’s dis-ease and its risk factors. Modern Preventive Medicine, 38: 3029–3033.
21. Chen Jie, Wang Zhongheng et al (2013). Epidemiological investigation of Alzhei-mer's disease in Nanchang area. Jiang Xi Yi Yao, 48(9):837-838.
22. Ji Min, Yao Xinwei, Lv Jun et al (2010). A Cross-Section Study of Senile Dementia in Shanghai. Chin J Rehabil Theory Pract, 16:513-515.
23. Sun Hong Xian, Wu Yiwen, Ye Fulin (2012). Prevalence of dementia among elderly people in Sheshantown, Songjiang dis-trict, Shanghai. Journal of Internal Medicine Concepts & Practice, 7:91-95
24. Ma Yong,JiangZhongping, Wang Jiwei (2013). The prevalence of the main sub-types of dementia in 65 years or above population of Xujiahui, Shanghai. ZhongGuo Lao NianXue, 33(6):1365-1366.
25. Ye Guoying, Chen Jianer, Chen Furong (2011). Dementia in Ningbo over 60 years and related risk factors. ZhongGuo-NongCun Wei Sheng Shi Ye Guan Li, 31(2):152-155.
26. Li Chonghui, Yanglishun, Zhao Lan (2015).The prevalence of dementia in Tianjin. Shi Yong Yu Fang Yi Xue, 22(3):305-308.
27. Kang MY, Gao YM Huo HQ, et al (2011). Epidemiological fearures of chronic and Azheimer’s disease in the community-based elderly living in cities in Hebei province. Zhonghua Liu Xing Bing Xue Za Zhi, 32(7):672-675.
28. Kalaria RN, Maestre GE, Arizaga R et al (2008). Alzheimer's disease and vascular dementia in developing countries: preva-lence, management, and risk factors. Lan-cet Neurol, 7(9):812-826.
29. Prince M, Ali G C, Guerchet M, et al (2016). Recent global trends in the prevalence and incidence of dementia, and survival with dementia. Alzheimers Res Ther, 8(1):23.
30. Plassman B L, Langa K M, Fisher G G, et al (2007). Prevalence of Dementia in the United States: The Aging, Demographics, and Memory Study. Neuroepidemiology, 29(1-2):125-132.
31. O’Brien JT, Burns A (2011). Clinical practice with anti-dementia drugs: a revised (sec-ond) consensus statement from the Brit-ish Association for Psychopharmacology. J Psychopharmacol, 25(8):997-1019.
32. Cho MJ, Lee JY, Kim B-S et al (2011). Prev-alence of the major mental disorders among the Korean elderly. J Korean Med Sci, 26(1): 1–10.
33. Kim YJ, Han JW, So YS, et al (2014). Preva-lence and trends of dementia in Korea: a systematic review and meta-analysis. J Ko-rean Med Sci, 29(7):903-912.
34. Yang X, Yang Y, Liu J, et al (2012). In-creased phosphorylation of tau and syn-aptic protein loss in the aged transgenic mice expressing familiar Alzheimer's dis-ease-linked presenilin 1 mutation. Neuro-chem Res,37(1):15-22.
35. Ferri CP, Prince M, Brayne C, et al (2005). Global prevalence of dementia: a Delphi consensus study. Lancet, 366(9503):2112-7.
36. Shaji S, Bose S, Verghese A (2005). Preva-lence of dementia in an urban population in Kerala, India. Br J Psychiatry, 186:136-140.
37. Wu Y T, Brayne C, Matthews F E (2015). Prevalence of dementia in East Asia: a synthetic review of time trends. Int J Geri-atr Psychiatry, 30(8):793-801.
38. Castellani RJ, Rolston RK, Smith MA (2010). Alzheimer disease. Dis Mon, 56(9):484-546.
39. Lee JY, Kim JH, Choi DW, et al (2012). The association of heavy metal of blood and serum in the Alzheimer's diseases. Toxicol Res, 28(2):93-98.
40. Durazzo T C, Korecka M, Trojanowski J Q, et al (2016). Active Cigarette Smoking in Cognitively-Normal Elders and Probable Alzheimer's Disease is Associated with Elevated Cerebrospinal Fluid Oxidative Stress Biomarkers. J Alzheimers Dis, 54(1):99-107.
41. Saetre P, Jazin E, Emilsson L (2011). Age-related changes in gene expression are accelerated in Alzheimer's disease. Synapse, 65(9):971-974.
42. Dunckley T, Beach TG, Ramsey KE, et al (2006). Gene expression correlates of neurofibrillary tangles in Alzheimer's dis-ease. Neurobiol Aging, 27(10):1359-1371.
43. Guerreiro R J, Baquero M, Blesa R, et al (2010). Genetic screening of Alzheimer's disease genes in Iberian and African samples yields novel mutations in prese-nilins and APP. Neurobiol Aging, 31(5):725-31.
44. Cova I, Markova A, Campini I, et al (2017). Worldwide trends in the prevalence of dementia. J Neurol Sci, 379:259-260.
45. Gao S, Hendrie H C, Hall K S, et al (1998). The relationships between age, sex, and the incidence of dementia and Alzheimer disease: a meta-analysis. Arch Gen Psychia-try, 55(9):809-15.
46. Fratiglioni L, Grut M, Forsell Y, et al (1991). Prevalence of Alzheimer's disease and other dementias in an elderly urban population Relationship with age, sex, and education. Neurology, 41(12):1886-92.
47. Moffat SD, Zonderman AB, Metter EJ, et al (2004). Free testosterone and risk for Alzheimer disease in older men. Neurology, 62(2):188-193.
48. Henderson VW, Hogervorst E (2004). Tes-tosterone and Alzheimer disease: is it men's turn now? Neurology, 62(2):170-171.
49. Pennanen C, Laakso MP, Kivipelto M et al (2004). Serum testosterone levels in males with Alzheimer's disease. J Neuroendocrinol, 16(2): 95-98.
50. Paoletti AM, Congia S, Lello S et al (2004). Low androgenization index in elderly women and elderly men with Alzheimer's disease. Neurology, 62(2): 301-303.
| Files | ||
| Issue | Vol 47 No 11 (2018) | |
| Section | Review Article(s) | |
| Keywords | ||
| China Meta-analysis Alzheimer’s disease Dementia Prevalence Systematic review | ||
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How to Cite
1.
LI K, WEI S, LIU Z, HU L, LIN J, TAN S, MAI Y, PENG W, MAI H, HOU Q, TU G. The Prevalence of Alzheimer’s Disease in China: A Systematic Review and Meta-analysis. Iran J Public Health. 2018;47(11):1615-1626.
