Tobacco-attributable burden of alzheimer’s disease and other dementias in China and ASEAN

This study aimed to systematically analyze the disease burden of Alzheimer’s disease and other dementias (ADOD) attributed to tobacco in China and ASEAN countries from 1990 to 2021, and predict the disease burden in the next ten years to characterize the disparities in disease burden between the 2 sides, and to conduct a preliminary exploration of factors that may be associated with these disparities. Data on ADOD deaths, mortality, DALYs and DALY rates attributed to tobacco in China and ASEAN countries were extracted from GBD 2021, and the trend of disease burden was analyzed using Joinpoint regression model. R software was used for data analysis and visualization, and Joinpoint regression model was used to calculate the APC of each indicator; the disease burden attributable to tobacco in China and ASEAN countries was analyzed through the SDI; and the ARIMA was used to predict ADOD from 2022 to 2035. In China, the number of ADOD deaths (1990: 8126.47, 95% CI: 1822.19–22,577.84), mortality rate, DALYs, and DALY rate attributable to tobacco all exhibited significant and sustained upward trends from 1990 to 2021, and consistently exceeded the corresponding levels in the other ten ASEAN countries. The APC for mortality and DALY rates showed a significant increase in China and most ASEAN countries, with particularly rapid increases in mortality in China, Thailand, Cambodia, and Indonesia. Correspondingly, the DALY rate rose in most countries, indicating a growing overall disease burden. An exception was Myanmar, where the burden decreased. The burden of tobacco-attributable ADOD was consistently higher among males than females in all countries. Analysis based on SDI revealed a lower and more stable disease burden in high-SDI areas, whereas medium- and low-SDI countries demonstrated an upward trend. ARIMA model projections for 2022–2035 suggest that while mortality trends are diverse, an increasing trend is anticipated in most countries. The disease burden of ADOD attributable to tobacco use has continued to rise in China and ASEAN countries. This trend suggests a potential role for tobacco control in the prevention of ADOD, and also points to the value of strengthening tobacco regulation and paying early attention to cognitive interventions.