Zhang Jian, Fan Yue, Liang Hao, Zhang Yong
Department of Neurosurgery, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, 510317, China.
Department of Obstetrics and Gynecology, Fuyang Hospital of Anhui Medical University, Fuyang, 236000, China.
Neurol Sci. 2025 Apr;46(4):1647-1660. doi: 10.1007/s10072-024-07941-7. Epub 2024 Dec 14.
BACKGROUND: Parkinson's disease (PD) ranks as the second most prevalent neurodegenerative disorder; however, its epidemiological characteristics among middle-aged and older adults at global, regional, and national levels remain inadequately documented. METHODS: This study assessed temporal trends in PD among middle-aged and older adults by extracting incidence rates, disability-adjusted life year (DALY) rates, and corresponding age-specific rates (ASRs) from the Global Burden of Disease (GBD) database spanning 1990 to 2021. Estimated annual percentage change (EAPC) was employed to analyze trends over the past 30 years. The slope index of inequality (SII) and concentration index (CI) were utilized to evaluate disparities in the burden of PD across various countries. Additionally, Bayesian age-period-cohort (BAPC) modeling was applied to project DALY figures for the next 15 years. RESULTS: In 2021, the global incidence and DALY rates for middle-aged and older adults with PD stood at 79.68 and 477.50 cases per 100,000 population, respectively. Both incidence and DALY rates have exhibited an upward trajectory over the past 32 years, with EAPCs of 1.2 (95% UI: 1.1-1.3) and 0.6 (95% UI: 0.5-0.7), respectively. Among the five sociodemographic index (SDI) regions, the high-middle SDI region reported the highest incidence and DALY rates for PD in 2021, at 93.93 and 512.29 cases per 100,000 population, respectively. A positive correlation was observed between the SDI and age-specific incidence rate (ASIR) as well as age-specific DALY rate (ASDR). Disparities in the burden of PD among middle-aged and older adults, associated with SDI, are on the rise and are primarily concentrated in high SDI countries. It is projected that the global incidence and DALY rates for middle-aged and older adults with PD will experience significant increases over the next 15 years. CONCLUSIONS: The global burden of PD among middle-aged and older adults has markedly escalated over the past 32 years, particularly in high-middle SDI regions. These findings underscore the necessity for the development of effective interventions and public health policies, contributing to the attainment of the sustainable development goals established by the World Health Organization (WHO).
背景:帕金森病(PD)是第二常见的神经退行性疾病;然而,在全球、区域和国家层面,其中老年人的流行病学特征仍记录不足。 方法:本研究通过从1990年至2021年的全球疾病负担(GBD)数据库中提取发病率、伤残调整生命年(DALY)率以及相应的年龄别率(ASR),评估了中老年人帕金森病的时间趋势。采用估计年度百分比变化(EAPC)分析过去30年的趋势。利用不平等斜率指数(SII)和集中指数(CI)评估各国帕金森病负担的差异。此外,应用贝叶斯年龄-时期-队列(BAPC)模型预测未来15年的DALY数据。 结果:2021年,全球中老年帕金森病患者的发病率和DALY率分别为每10万人79.68例和477.50例。在过去32年中,发病率和DALY率均呈上升趋势,EAPC分别为1.2(95% UI:1.1 - 1.3)和0.6(95% UI:0.5 - 0.7)。在五个社会人口指数(SDI)区域中,高中等SDI区域在2021年报告的帕金森病发病率和DALY率最高,分别为每10万人93.93例和512.29例。观察到SDI与年龄别发病率(ASIR)以及年龄别DALY率(ASDR)之间存在正相关。中老年人帕金森病负担与SDI相关的差异正在增加,且主要集中在高SDI国家。预计未来15年全球中老年帕金森病患者的发病率和DALY率将显著上升。 结论:在过去32年中,全球中老年帕金森病负担显著增加,特别是在高中等SDI区域。这些发现强调了制定有效干预措施和公共卫生政策的必要性,有助于实现世界卫生组织(WHO)制定的可持续发展目标。
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