Abstract
BackgroundMany studies have considered the prevalence of dementia in mainland China, Hong Kong and Taiwan. However, area level estimates have not been produced. This study examines area differences across mainland China, Hong Kong and Taiwan adjusting for the effect of methodological factors with the aim of producing estimates of the numbers of people with dementia in these areas.Method and FindingsA search of Chinese and English databases identified 76 dementia prevalence studies based on samples drawn from mainland China, Hong Kong and Taiwan between 1980 and 2012. A pattern of significantly decreasing prevalence was observed from northern, central, southern areas of mainland China, Hong Kong and Taiwan. Area variations in dementia prevalence were not explained by differences in methodological factors (diagnostic criteria, age range, study sample size and sampling method), socioeconomic level or life expectancy between areas. The results of meta-analysis were applied to current population data to provide best estimate. Based on the DSM-IV diagnostic criteria, the total number of people aged 60 and over with dementia in mainland China, Hong Kong and Taiwan is 8.4 million (4.6%, 95% CI: 3.4, 5.8) and in northern, central and southern areas are 3.8 (5.1%, 95% CI: 4.1, 6.1), 3.2 (4.4%, 95% CI: 3.2, 5.6) and 1.2 (3.9%, 95% CI: 2.3, 5.4) million respectively. These estimates were mainly based on the studies existing in highly developed areas and potentially affected by incomplete and insufficient data.ConclusionsThe findings of this review provide a robust estimate of area differences in dementia prevalence. Application of the estimated prevalence to population data reveals the number of people with dementia is expected to double every 20 years, areas in mainland China will be facing the greatest dementia challenge.
Highlights
As the country with the largest population in the world, China will face considerable challenges in adapting to its ageing population and including rising numbers of people with dementia [1,2]
The findings of this review provide a robust estimate of area differences in dementia prevalence
Application of the estimated prevalence to population data reveals the number of people with dementia is expected to double every 20 years, areas in mainland China will be facing the greatest dementia challenge
Summary
As the country with the largest population in the world, China will face considerable challenges in adapting to its ageing population and including rising numbers of people with dementia [1,2]. A more recent meta-analysis carried out for the World Health Organisation global study of dementia produced a crude estimate of 3.2% in the population aged 60 and over and 4.98% after age and sex standardisation to the population structure of Western Europe [2] Both these international reviews produced similar estimates of dementia prevalence for China. A recent review which included 48 studies in mainland China, Hong Kong and Taiwan from 1980 to 2010 provided a pooled estimate for the population aged 60 and over as 3.0% (95% CI: 2.4–3.9), ranging from 0.6–9.0% across age-bands, and reported higher prevalence in northern China (3.9%, 95% CI: 2.8–5.5) than in southern China (2.9%, 95% CI: 1.9–3.6) [5]. This study examines area differences across mainland China, Hong Kong and Taiwan adjusting for the effect of methodological factors with the aim of producing estimates of the numbers of people with dementia in these areas
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