【摘要】 目的 分析1990—2023年归因于吸烟的阿尔茨海默病及相关痴呆症(ADRD)疾病负担变化趋势，为开展痴呆症防治工作提供建议。方法 基于全球疾病负担(GBD)1990—2023年数据，采用Joinpoint回归分析趋势，运用年龄-时期-队列模型分解效应。结果 1990—2023年间，中国归因于吸烟行为的ADRD死亡数和DALYs分别增长269.002%和223.932%;同期ASMR和ASDR整体呈轻微下降趋势，年均变化率分别为-0.135%和-0.040%。年龄效应：疾病负担随年龄显著上升，60岁后增幅趋缓但始终维持在高水平；时期效应：疾病负担风险随时间持续上升，在2020—2023年达到峰值；队列效应：呈显著代际下降趋势，在女性中下降更为显著。结论 我国归因于吸烟的阿尔茨海默病及其他痴呆的年龄标准化疾病负担虽持续下降，但绝对数上升，男性负担明显高于女性。60岁前长期吸烟累积效应已显著增加疾病负担，为老年阶段高峰奠定基础，提示早中年干预的重要性。应重点针对中老年男性吸烟者，通过政策、社区支持及个体行为干预多层面联合措施，降低长期疾病负担。更多还原

【Abstract】 Objective To analyze the trends in disease burden of Alzheimer’s disease and related dementias(ADRD) attributable to smoking in China from 1990 to 2023, and to provide evidence to inform prevention and control strategies for dementia. Methods Based on Global Burden of Disease(GBD) data from 1990-2023, trends were analyzed using Joinpoint regression, and age-period-cohort(APC) models were applied to decompose age, period, and cohort effects. Results Between 1990 and 2023, the number of deaths and DALYs of ADRD attributable to smoking in China increased by 269.002% and 223.932%, respectively. During the same period, the age-standardized mortality rate(ASMR) and age-standardized DALY rate(ASDR) showed a slight overall decline, with average annual changes of-0.135% and-0.040%, respectively. Age effect: Disease burden increased significantly with age, rising more slowly after 60 years but remaining at high levels. Period effect: Risk of disease burden continued to increase over time, peaking between 2020 and 2023. Cohort effect: A significant intergenerational decline was observed, more pronounced among females. Conclusion Although the age-standardized burden of ADRD attributable to smoking in China has gradually decreased, the absolute burden has increased, with males bearing a significantly higher burden than females. The cumulative effect of long-term smoking before age 60 has markedly increased disease burden, laying the foundation for a peak in older age, highlighting the importance of early-and mid-life interventions. Multi-level strategies, including policy measures, community support, and individual behavior interventions, should focus on middle-aged and older male smokers to reduce long-term disease burden.更多还原