Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK.
Southern Health, Southampton, UK.
Acta Neurol Scand. 2017 Dec;136(6):698-707. doi: 10.1111/ane.12789. Epub 2017 Jun 18.
A population-based controlled study to determine whether adult (55-74 years) neurological disease deaths are continuing to rise and are there significant differences between America and the twenty developed countries 1989-91 and 2012-14.
Total Neurological Deaths (TND) rates contrasted against control Cancer and Circulatory Disease Deaths (CDD) extrapolated from WHO data. Confidence intervals compare USA and the other countries over the period. The Over-75's TND and population increases are examined as a context for the 55-74 outcomes.
Male neurological deaths rose >10% in eleven countries, the other countries average rose 20% the USA 43% over the period. Female neurological deaths rose >10% in ten counties, averaging 14%, the USA up 68%. USA male and female neurological deaths increased significantly more than twelve and seventeen countries, respectively. USA over-75s population increased by 49%, other countries 56%. Other countries TND up 187% the USA rose fourfold. Male and female cancer and CDD fell in every country averaging 26% and 21%, respectively, and 64% and 67% for CDD. Male neurological rates rose significantly more than Cancer and CCD in every country; Female neurological deaths rose significantly more than cancer in 17 countries and every country for CDD. There was no significant correlation between increases in neurological deaths and decreases in control mortalities.
There are substantial increases in neurological deaths in most countries, significantly so in America. Rises in the 55-74 and over-75's rates are not primarily due to demographic changes and are a matter of concern warranting further investigation.
一项基于人群的对照研究，旨在确定成年人（55-74 岁）的神经疾病死亡是否持续上升，以及美国与 1989-1991 年和 2012-2014 年的 20 个发达国家之间是否存在显著差异。
总神经死亡（TND）率与从世界卫生组织数据中推断出的对照癌症和循环系统疾病死亡（CDD）进行对比。置信区间比较了美国和其他国家在该时期的情况。作为 55-74 岁人群结果的背景，检查了 75 岁以上人群的 TND 和人口增长情况。
11 个国家男性神经死亡人数上升超过 10%，其他国家平均上升 20%，美国上升 43%。10 个国家女性神经死亡人数上升超过 10%，平均上升 14%，美国上升 68%。美国男性和女性神经死亡人数的增长明显高于其他 12 个和 17 个国家。美国 75 岁以上人口增加了 49%，其他国家增加了 56%。其他国家 TND 增加了 187%，美国增加了 4 倍。男性和女性癌症和 CDD 死亡率在每个国家都下降了，平均下降 26%和 21%，CDD 下降了 64%和 67%。在每个国家，男性神经疾病死亡率的上升都明显高于癌症和 CCD；在 17 个国家和每个国家，女性神经疾病死亡率的上升都明显高于癌症死亡率。神经疾病死亡人数的增加与对照死亡率的降低之间没有显著相关性。
大多数国家的神经疾病死亡人数都有大幅增加，美国的情况尤为显著。55-74 岁和 75 岁以上人群的死亡率上升并非主要归因于人口变化，值得进一步调查，引起关注。
