澳大利亚可改变的痴呆危险因素15年患病率趋势的性别和社会经济差异：横断面时间序列分析

IF 13.4 Q1 GERIATRICS & GERONTOLOGY

Lancet Healthy Longevity Pub Date : 2025-05-01 DOI:10.1016/j.lanhl.2025.100711

Heidi J Welberry PhD , Prof Louisa R Jorm PhD , Kim M Kiely PhD , Hamidul Huque PhD , Prof Ruth Peters PhD , Prof Kaarin J Anstey PhD

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引用次数: 0

摘要

背景：潜在可改变的风险因素可能占全球痴呆症病例的约45%。对于有针对性的预防，了解特定人群的风险模式至关重要。我们的目的是跟踪澳大利亚各地痴呆症患病率的变化，并计算12个风险因素（即低教育程度、高血压、肥胖、高胆固醇、吸烟、高酒精摄入量、不良饮食、缺乏体育锻炼、听力损失、抑郁、糖尿病和社会孤立）对痴呆症的人口归因比例。方法：在这个横断面时间序列分析中，我们使用2007-08年至2022年澳大利亚五项全国健康调查计算了痴呆症的患病率。对校正患病率和综合人群归因分数进行估计。人口亚组按性别和社会经济劣势来定义（最低40%家庭收入vs最高60%家庭收入）。结果按生命阶段（45-64岁的中年和65-84岁的晚年）进行分类。研究发现：在中年，样本量从2022年的4100人到2017-18年的5589人不等；在老年，样本量从2011-12年的2799人到2017-18年的3762人不等。吸烟、高酒精摄入、缺乏运动、听力损失和低教育的中年减少，肥胖、抑郁和不良饮食增加；导致人口归因分数没有变化（2007-08年为47.2% [95% CI 46.5 - 48.0]， 2022年为46.9%[45.9 - 47.7]）。高酒精摄入、缺乏身体活动和低教育水平在晚年减少；抑郁和不良饮食增加；人口归因分数无变化（2007-08年为51.5%[50.9 - 52.5]，2022年为51.4%[50.7 - 52.4]）。在中年阶段，低收入群体和男性的可变风险更高，2022年抑郁症是主要的可变风险因素，对低收入家庭和女性的影响尤为严重。解释：在过去的15年里，澳大利亚痴呆症的可调整人口归因比例保持稳定，但风险概况发生了变化。低收入群体（与高收入群体相比）具有高得多的可改变风险，有针对性的多领域干预可以帮助缩小差距。资助：国家卫生和医学研究。

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Sex and socioeconomic differences in 15-year prevalence trends for modifiable dementia risk factors in Australia: a cross-sectional, time series analysis

Background

Potentially modifiable risk factors could account for approximately 45% of dementia cases globally. For targeted prevention, understanding population-specific patterns of risk is essential. We aimed to track changes in dementia prevalence across Australia, and calculate population attributable fractions of dementia, for 12 risk factors (ie, low education, hypertension, obesity, high cholesterol, smoking, high alcohol intake, poor diet, physical inactivity, hearing loss, depression, diabetes, and social isolation).

Methods

In this cross-sectional, time series analysis we calculated the prevalence of dementia using five national Australian health surveys from 2007–08 to 2022. Adjusted prevalence ratios and combined population attributable fractions were estimated. Population subgroups were defined by sex and socioeconomic disadvantage (lowest 40% household income vs highest 60%). Results were disaggregated by life-stage (mid-life aged 45–64 years and late life aged 65–84 years).

Findings

In mid-life, the sample sizes ranged from 4100 in 2022 to 5589 in 2017–18 and in late-life from 2799 in 2011–12 to 3762 in 2017–18. Smoking, high alcohol intake, physical inactivity, hearing loss, and low education in mid-life decreased and obesity, depression, and poor diet increased; resulting in no change in population attributable fraction (47·2% [95% CI 46·5–48·0] in 2007–08 and 46·9% [45·9–47·7] in 2022). High alcohol intake, physical inactivity, and low education in late-life decreased; depression and poor diet increased; and there was no change in population attributable fraction (51·5% [50·9–52·5] in 2007–08 and 51·4% [50·7–52·4] in 2022). In mid-life, modifiable risk was higher among low-income groups and males and depression was the leading modifiable risk factor in 2022, disproportionately affecting low-income households and females.

Interpretation

The modifiable population attributable fraction of dementia in Australia in the past 15 years remained stable, but the profile of risk has changed. Low-income groups (compared with high-income groups) have substantially higher modifiable risk and targeted multidomain interventions could help reduce disparities.

Funding

National Health and Medical Research.

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来源期刊

Lancet Healthy Longevity GERIATRICS & GERONTOLOGY-

CiteScore

16.30

自引率

2.30%

发文量

192

审稿时长

12 weeks

期刊介绍： The Lancet Healthy Longevity, a gold open-access journal, focuses on clinically-relevant longevity and healthy aging research. It covers early-stage clinical research on aging mechanisms, epidemiological studies, and societal research on changing populations. The journal includes clinical trials across disciplines, particularly in gerontology and age-specific clinical guidelines. In line with the Lancet family tradition, it advocates for the rights of all to healthy lives, emphasizing original research likely to impact clinical practice or thinking. Clinical and policy reviews also contribute to shaping the discourse in this rapidly growing discipline.