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204 个国家、1990-2019 年全球、区域和国家阿尔茨海默病和帕金森病的健康不平等。

Global, regional, and national health inequalities of Alzheimer's disease and Parkinson's disease in 204 countries, 1990-2019.

机构信息

Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital Tongji University School of Medicine, Tongji University, Shanghai, 201619, China.

Department of Epidemiology, School of Public Health, Tongji University School of Medicine, Tongji University, 2209 Xingguang Road, Songjiang, Shanghai, 201619, China.

出版信息

Int J Equity Health. 2024 Jun 19;23(1):125. doi: 10.1186/s12939-024-02212-5.

Abstract

BACKGROUND

Alzheimer's disease and related dementias (ADRD) and Parkinson's disease (PD), pose growing global health challenges. Socio-demographic and economic development acts paradoxically, complicating the process that determines how governments worldwide designate policies and allocate resources for healthcare.

METHODS

We extracted data on ADRD and PD in 204 countries from the Global Burden of Disease 2019 database. Health disparities were estimated using the slope index of inequality (SII), and concentration index (CIX) based on the socio-demographic index. Estimated annual percentage changes (EAPCs) were employed to evaluate temporal trends.

RESULTS

Globally, the SII increased from 255.4 [95% confidence interval (CI), 215.2 to 295.5)] in 1990 to 559.3 (95% CI, 497.2 to 621.3) in 2019 for ADRD, and grew from 66.0 (95% CI, 54.9 to 77.2) in 1990 to 132.5 (95% CI, 118.1 to 147.0) in 2019 for PD; CIX rose from 33.7 (95% CI, 25.8 to 41.6) in 1990 to 36.9 (95% CI, 27.8 to 46.1) in 2019 for ADRD, and expanded from 22.2 (95% CI, 21.3 to 23.0) in 1990 to 29.0 (95% CI, 27.8 to 30.3) in 2019 for PD. Age-standardized disability-adjusted life years displayed considerable upward trends for ADRD [EAPC = 0.43 (95% CI, 0.27 to 0.59)] and PD [0.34 (95% CI, 0.29 to 0.38)].

CONCLUSIONS

Globally, the burden of ADRD and PD continues to increase with growing health disparities. Variations in health inequalities and the impact of socioeconomic development on disease trends underscored the need for targeted policies and strategies, with heightened awareness, preventive measures, and active management of risk factors.

摘要

背景

阿尔茨海默病和相关痴呆症(ADRD)和帕金森病(PD)是全球日益严峻的健康挑战。社会人口和经济发展带来了矛盾,使全球各国政府在制定医疗政策和分配资源方面的过程变得复杂。

方法

我们从 2019 年全球疾病负担数据库中提取了 204 个国家的 ADRD 和 PD 数据。使用不平等斜率指数(SII)和基于社会人口指数的集中指数(CIX)来估计健康差距。采用估计的年平均变化百分比(EAPC)来评估时间趋势。

结果

在全球范围内,ADRD 的 SII 从 1990 年的 255.4(95%置信区间(CI),215.2 至 295.5)增加到 2019 年的 559.3(95%CI,497.2 至 621.3),PD 的 SII 从 1990 年的 66.0(95%CI,54.9 至 77.2)增加到 2019 年的 132.5(95%CI,118.1 至 147.0);1990 年,ADRD 的 CIX 从 33.7(95%CI,25.8 至 41.6)上升至 36.9(95%CI,27.8 至 46.1),PD 的 CIX 从 22.2(95%CI,21.3 至 23.0)上升至 29.0(95%CI,27.8 至 30.3)。ADRD(EAPC=0.43(95%CI,0.27 至 0.59))和 PD(EAPC=0.34(95%CI,0.29 至 0.38))的年龄标准化残疾调整生命年呈明显上升趋势。

结论

在全球范围内,ADRD 和 PD 的负担继续增加,健康差距不断扩大。健康不平等的变化以及社会经济发展对疾病趋势的影响突显了需要制定有针对性的政策和战略,提高认识,采取预防措施,并积极管理风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd50/11188225/5d0fbc4c0013/12939_2024_2212_Fig1_HTML.jpg

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