Zhang Chen, Yang Xuan, Wan Dongshan, Ma Qingfeng, Yin Peng, Zhou Maigeng, Hao Junwei
Department of Neurology, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing 100053, China.
National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Med. 2025 Aug 8;6(8):100692. doi: 10.1016/j.medj.2025.100692. Epub 2025 May 2.
The burden of neurological disorders in China has not been systematically analyzed. We aim to provide a comprehensive estimation of the national and subnational neurological burden across China from the Global Burden of Disease Study (GBD) 2021.
We assessed burden estimates for 16 neurological disorders by age, sex, and province from 1990 to 2021, with prevalence, death, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs). We performed decomposition analysis to determine contributing factors for DALYs and used the socio-demographic index (SDI) to assess relations with development level.
In 2021, there were 468.29 million prevalent cases of neurological disorders in China, corresponding to 78.10 million DALYs. Intracerebral hemorrhage was the leading cause of DALYs, followed by ischemic stroke, dementias, and migraine. DALYs of neurological disorders were higher in males than females, peaking at 70-74 years. From 1990 to 2021, the number and age-standardized rate of DALYs significantly decreased for idiopathic epilepsy and subarachnoid hemorrhage, primarily attributed to the reduction in YLLs, while the number of DALYs disproportionately increased for dementias, Parkinson's disease, and ischemic stroke contributed by population aging. The age-standardized DALY rates of seven neurological disorders had more than 5-fold variation between western and eastern provinces, despite reduced burdens with rising SDI.
Neurological disorders pose a large and growing burden on public health, primarily driven by population aging. Our findings could inform priority setting and targeted strategies to optimize neurological service delivery.
The funding information is presented in the acknowledgments.
中国神经系统疾病的负担尚未得到系统分析。我们旨在根据《2021年全球疾病负担研究》（GBD 2021）对中国全国及各地区的神经系统负担进行全面评估。
我们评估了1990年至2021年期间16种神经系统疾病按年龄、性别和省份划分的负担估计值，包括患病率、死亡率、伤残调整生命年（DALYs）、寿命损失年数（YLLs）和伤残生存年数（YLDs）。我们进行了分解分析以确定DALYs的影响因素，并使用社会人口指数（SDI）来评估与发展水平的关系。
2021年，中国神经系统疾病的患病率为4.6829亿例，对应的DALYs为7810万。脑出血是导致DALYs的主要原因，其次是缺血性中风、痴呆症和偏头痛。神经系统疾病的DALYs男性高于女性，在70 - 74岁达到峰值。1990年至2021年期间，特发性癫痫和蛛网膜下腔出血的DALYs数量和年龄标准化率显著下降，主要归因于YLLs的减少，而痴呆症、帕金森病和缺血性中风的DALYs数量因人口老龄化而不成比例地增加。尽管随着SDI的上升负担有所减轻，但西部和东部省份七种神经系统疾病的年龄标准化DALY率仍存在超过5倍的差异。
神经系统疾病给公共卫生带来了巨大且不断增长的负担，主要由人口老龄化驱动。我们的研究结果可为确定优先事项和制定针对性策略提供信息，以优化神经系统疾病的服务提供。
资金信息在致谢中列出。
