Trend analysis of Alzheimer's disease deaths in residents aged ≥40 years in China, 2013−2021

Objective To understand the mortality rate of Alzheimer's disease and its trends in residents aged ≥40 years in China from 2013 to 2021, and provide evidence for the further improvement of Alzheimer's disease prevention and control.

Methods The mortality data of Alzheimer's disease and demographic information of death cases in different age, gender, urban/rural status groups and regions in China were collected from the Death Cause Surveillance Dataset of National Disease Surveillance System （2013−2021）, the crude mortality rate was calculated and standardized with 2010 census data to descriptive the Alzheimer's disease mortality, the mortality trend was analyzed by using Joinpoint regression model, and the comparison of the mortality rates among groups was performed with χ² test.

Results A total of 130,517 Alzheimer's disease deaths in residents aged ≥40 years were reported in China from 2013 to 2021. The crude mortality rate showed an increasing trend year by year（AAPC=4.36, P<0.001）, and the crude mortality rates in both men and women showed increasing trends year by year（AAPC=4.07, P<0.001 ; AAPC=4.53, P<0.001）, and the crude and standardized mortality rates of Alzheimer's disease were higher in women than in men （χ²=2029.97, P<0.001; χ²=9017.00, P<0.001）. The standardized mortality rate of Alzheimer's disease in residents aged ≥40 years tended to increase with age（AAPC=149.59%, P<0.001）. The crude mortality rate in age group ≥80 years showed an increasing trend year by year（AAPC=2.12%, P= 0.021）, and there was no significant change in trend of Alzheimer's disease mortality among age groups 40～49 years, 50～59 years, 60～69 years and 70～79 years（P>0.05）. The crude mortality rates of Alzheimer's disease showed increasing trends in both urban and rural residents（AAPC=3.43, P<0.001; AAPC=4.73, P<0.001）, and the crude mortality rate and standardized mortality rate were higher in rural residents than in urban residents（χ²=640.36, P<0.001; χ²=621.44, P<0.001）. The crude mortality rates of Alzheimer's disease showed increasing trends in the eastern, central and western regions of China（AAPC=2.59, P<0.001; AAPC=6.11, P=0.001; AAPC=6.66, P<0.001）, and the crude mortality rate and standardized mortality rate were higher in the eastern region than in the western region and in the western region than in the central region（χ²=10,766.46, P<0.001; χ²=34720.92, P<0.001）.

Conclusion The mortality rate of Alzheimer's disease in residents aged ≥40 years showed an increasing trend year by year in China from 2013 to 2021. There were gender, age, urban-rural status and region specific differences in Alzheimer's disease mortality. Women, the elderly, and residents in rural area and eastern region are high-risk groups, to whom priority attention should be paid.