老年人群中类风湿关节炎的全球、区域和国家负担及趋势：基于2021年全球疾病负担研究的分析

Global, regional, and national burden and trends of rheumatoid arthritis among the elderly population: an analysis based on the 2021 Global Burden of Disease study.

作者信息

Wei Lu, Chen Xiang, Liu Mengmeng

机构信息

Department of Trauma Center, Liuzhou Worker's Hospital, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China.

Guangxi Key Laboratory for the Research and Clinical Translation of Orthopedic Biomaterials, Liuzhou, China.

出版信息

Front Immunol. 2025 Apr 15;16:1547763. doi: 10.3389/fimmu.2025.1547763. eCollection 2025.

DOI:10.3389/fimmu.2025.1547763

PMID:40303393

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12037513/

Abstract

BACKGROUND

Rheumatoid arthritis (RA) is an autoimmune and inflammatory disease. In elderly patients, the disease progresses more rapidly, involves more complications, and places a greater burden on health. Currently, there is a lack of studies investigating the disease burden of RA in the elderly population.

METHODS

We analyzed data on elderly rheumatoid arthritis from the Global Burden of Disease (GBD) database for 1990-2021, focusing on three main indicators: prevalence, incidence, and Disability-Adjusted Life Years (DALYs). Percentage change and the estimated annual percentage change (EAPC) were used to evaluate the trends in the disease burden.

RESULTS

In 2021, the global prevalence cases, incidence cases, and DALYs of elderly RA were 7,919,136, 334,291, and 1,549,877, representing increases of 157.59%, 169.71%, and 116.53% compared to 1990. Both the prevalence rate and incidence rate increased, with EAPCs of 0.54 (95% CI: 0.5, 0.58) and 0.75 (95% CI: 0.7, 0.79), respectively. Notably, the prevalence rate in females was 2.2 times higher than that in males. The DALY rate showed a slight decline. Among the five Socio-demographic Index (SDI) regions, the High SDI region had the highest prevalence cases, incidence cases, and DALYs in 2021, with 2,821,305, 114,994, and 483,579, respectively, accounting for 36%, 34%, and 32% of the global totals. This region also recorded the highest prevalence and incidence rates. In contrast, the Low SDI and Low-middle SDI regions exhibited the fastest growth in both prevalence and incidence cases as well as rates. The highest prevalence cases and incidence rate were observed in the 65-69 age group. Decomposition analysis revealed that the rising disease burden was primarily attributable to the growth of the global elderly population.

CONCLUSIONS

Between 1990 and 2021, the global burden of rheumatoid arthritis in the elderly population increased. The High SDI region experienced the highest disease burden. In contrast, the Low and Low-middle SDI regions showed the most rapid growth in disease burden. Females exhibited a higher burden compared to males, with the highest burden observed in the 65-69 age group. Early diagnosis and treatment in elderly patients are essential to mitigating adverse outcomes and reducing the burden.

摘要

背景

类风湿关节炎（RA）是一种自身免疫性炎症性疾病。在老年患者中，该疾病进展更快，涉及更多并发症，对健康造成更大负担。目前，缺乏针对老年人群中类风湿关节炎疾病负担的研究。

方法

我们分析了1990 - 2021年全球疾病负担（GBD）数据库中关于老年类风湿关节炎的数据，重点关注三个主要指标：患病率、发病率和伤残调整生命年（DALYs）。采用百分比变化和估计年百分比变化（EAPC）来评估疾病负担的趋势。

结果

2021年，全球老年类风湿关节炎的患病率病例、发病率病例和DALYs分别为7919136例、334291例和1549877例，与1990年相比分别增长了157.59%、169.71%和116.53%。患病率和发病率均有所上升，EAPC分别为0.54（95%CI：0.5，0.58）和0.75（95%CI：0.7，0.79）。值得注意的是，女性的患病率是男性的2.2倍。DALY率略有下降。在五个社会人口指数（SDI）区域中，高SDI区域在2021年的患病率病例、发病率病例和DALYs最高，分别为2821305例、114994例和483579例，分别占全球总数的36%、34%和32%。该区域的患病率和发病率也最高。相比之下，低SDI和低中SDI区域的患病率和发病率病例及比率增长最快。65 - 69岁年龄组的患病率病例和发病率最高。分解分析表明，疾病负担的上升主要归因于全球老年人口的增长。