延迟老年痴呆症发病的人群干预策略

分析2016—2020年上海市静安区老年痴呆死亡病例的流行病学特征以及死亡率、标化死亡率、早死所致寿命损失年（YLL）、伤残所致寿命损失年（YLD）和伤残调整寿命年（DALY）的变化规律和趋势，为老年痴呆的防控提供科学依据。

通过分析2016—2020年上海市静安区老年痴呆死亡病例资料，了解老年痴呆在性别、年龄别、婚姻状况和文化程度等方面的分布。利用全球疾病负担（GBD）2019研究方法和结果计算静安区居民2016—2020年老年痴呆的YLL、YLD和DALY。结合人口资料，进而计算得到相应的YLL率、YLD率和DALY率。

相比不伴发老年痴呆的死亡病例，伴发痴呆的死亡病例以女性、≥80岁、丧偶、初中及以下文化程度居多。伴发痴呆的死亡病例中，根本死因为痴呆的仅占27.70%，其他主要为脑血管病、冠心病和糖尿病，分别占25.54%、17.81%和7.28%。静安区老年痴呆疾病负担存在明显的性别差异，在死亡率、标化死亡率、YLL率、YLD率和DALY率等方面，女性高于男性；老年痴呆疾病负担随着年龄增加而增加。2016—2020年静安区老年痴呆死亡率和YLL率变化趋势差异无统计学意义（P>0.05）；YLD率和DALY率呈上升趋势，差异有统计学意义（P<0.05）。

随着上海市静安区居民寿命增加和人口老龄化的加深，老年痴呆的疾病负担依然沉重，需要积极探索老年痴呆的防控策略和措施，改善患者生活质量，减少疾病负担。

Population intervention strategies towards delaying the onset of dementia

To analyze the epidemiological characteristics of senile dementia death in Jing’an District from 2016 to 2020， as well as the trends of mortality， standardized mortality， years of life lost （YLL） due to early death， years lived with disability （YLD）， and disability-adjusted life year （DALY）， and to provide scientific basis for the prevention and control of senile dementia.The distribution of senile dementia in terms of gender， age， marital status and education level was investigated in the senile dementia death cases from 2016 to 2020 in Jing’an District. The YLL， YLD， DALY and their rates of the residents of Jing’an District from 2016 to 2020 were calculated by using Global Burden of Disease （GBD 2019） research method and results in combination with the corresponding population data.Compared to those without dementia， deaths with dementia were more likely to be female， more likely to be over 80 years old， less likely to be married， and more likely to have education level under middle school. Among the deaths with dementia， only 27.70% of the primary cause of death was dementia， and the other main causes were cerebrovascular disease， coronary heart disease and diabetes mellitus， which accounted for 25.54%， 17.81% and 7.28%， respectively. There was a significant gender difference in the burden of disease on senile dementia in Jing’an District. Mortality， standardized mortality， YLL， YLD and DALY rates of females were higher than those of males. The burden of disease on senile dementia increased with age. The change trend of mortality and YLL rate from 2016 to 2020 was not statistically significant， while the YLD rate and DALY rate showed an upward trend， which was statistically significant.As the life span of residents in Jing’an District increases and the population aging deepens， the burden of disease on senile dementia is still heavy. This requires extensive attention of the whole society， and active exploration of prevention and control strategies and measures for senile dementia， so as to improve the life quality of patients and reduce the burden of disease.