基于Markov模型的中国阿尔茨海默病患病趋势预测

Trend Prediction of Prevalence of Alzheimer' s Disease in China Based on Markov Model

目的估计2010年中国阿尔茨海默病(Alzheimer's disease,AD)的患病情况,预测之后20年中国AD患病数的发展趋势,并评价不同干预方案对AD患病数的影响。方法基础模型是一个离散时间多状态Markov模型。人口估计等从国家统计局获得。预测方案包括方案D(人口方案)、方案P(从2015年开始发病率减少25%)、方案T(从2015年开始疾病进程减少25%)、方案C(两种干预的综合,即从2015年开始发病率和疾病进程都减少25%)。结果模型估计2010年大约有662万人患有AD,男性患者292万(44.1%),女性患者370万(55.9%);疾病的早期阶段373万(56.3%),晚期阶段289万(43.7%);患病率会随着年龄的增长而增长。预测2030年的AD患病数:方案D可能增长为原来的2.42倍,方案P增长为1.85倍,方案T增长为2.54倍,方案C增长为1.94倍。结论 2030年我国将有1603万人患AD,开展积极的预防控制措施将有效降低AD患病数。

Objective To estimate prevalence of Alzheimer＇s disease（ AD） in China in 2010 and 20 years later,and to evaluate the impact of different intervention programs for prevalence of AD. Methods The basic model is a multi-state timediscrete M arkov model. Population estimate w as obtained from the National Bureau of Statistics of the People＇s Republic of China. Prediction scenarios include scenario D（ The demographic scenario）,scenario P（ the relative risk of disease incidence falls by one-quarter starting in 2015）,scenario T（ the relative risk of disease progression falls by one-quarter starting in 2015）,scenario C（ integrated scenario P and scenario T,namely from 2015 incidence and disease processes are all reduced by one-quarter）. Results 6. 62 million people w ill suffer from AD in 2010,2. 92 million male patients（ 44. 1%）,3. 70 million（ 55. 9%） female patients; the early stage of the disease 3. 73 million（ 56. 3%）,late stage of the disease 2. 89 million（ 43. 7%）; prevalence w ill increase w ith age. The number of AD prevalence in 2030 may increase to 2. 42 times due to demographic factors,only 1. 85 times under scenario P,2. 54 times under scenario T and 1. 94 times under scenario C. Conclusion There w ill be 16. 03 million people w ith AD in 2030 in China. Prevention and control measures w ill effectively reduce the AD prevalence.