Chen Xiang, Wang Wenqiang, Dong Shunan, Wei Lu, Zhen Puxiang, Mo Yongjun, Nie Xinyu, Hua Qikai
Department of Bone and Joint Surgery (Guangxi Diabetic Foot Salvage Engineering Research Center/Research Centre for Regenerative Medicine), the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China.
Department of Trauma Center, Liuzhou Worker's Hospital, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, 545005, China.
BMC Geriatr. 2025 Aug 4;25(1):589. doi: 10.1186/s12877-025-06228-6.
Elderly individuals have a higher burden of peripheral arterial disease (PAD), but currently, there are no global reports on the disease burden of PAD in patients aged 60 and above.
This study analyzed data on elderly patients with PAD from 1990 to 2021 using the Global Burden of Disease (GBD) database, focusing on prevalence, mortality, and Disability-Adjusted Life Years (DALYs). We summarized the trends in disease burden across 21 GBD regions and 204 countries and projected the global burden for the next 20 years.
Between 1990 and 2021, the prevalence cases of elderly PAD individuals worldwide increased by 105%, from 42,618,313 to 87,523,486. However, the Age-standardized prevalence rate (ASPR) decreased to 8,220.2 cases per 100,000 population (95% UI: 6,717.3-9,995.7), with an Estimated Annual Percentage Change (EAPC) of -0.52 (95% CI: -0.56 to -0.48). Similar trends were observed in mortality and DALYs. In 2021, elderly individuals represented 77% of PAD prevalence cases and 94% of related mortality cases. The ASPR for women was 1.7 times higher than for men, yet women experienced a lower mortality rate and DALY rate, suggesting a heavier overall disease burden. The disease burden increased with the Socio-Demographic Index (SDI), with the fastest growth observed in Low and Low-middle SDI regions. Among the GBD regions, High-Income North America and Western Europe had the highest burden, with the United States bearing the heaviest burden of all 204 countries. High fasting blood glucose was the leading risk factor, contributing 36% of the PAD burden, with population growth being the primary driver of the rising burden. The disease burden is projected to intensify over the next two decades.
From 1990 to 2021, the burden of PAD in the elderly has steadily increased, with projections for continued growth over the next two decades. Addressing diabetes and global population trends is essential for guiding effective public health strategies.
老年人外周动脉疾病（PAD）负担较重，但目前尚无关于60岁及以上患者PAD疾病负担的全球报告。
本研究使用全球疾病负担（GBD）数据库分析了1990年至2021年老年PAD患者的数据，重点关注患病率、死亡率和伤残调整生命年（DALY）。我们总结了21个GBD地区和204个国家的疾病负担趋势，并预测了未来20年的全球负担。
1990年至2021年期间，全球老年PAD患者的患病例数增加了105%，从42618313例增至87523486例。然而，年龄标准化患病率（ASPR）降至每10万人口8220.2例（95% UI：6717.3 - 9995.7），估计年变化百分比（EAPC）为 -0.52（95% CI：-0.56至 -0.48）。在死亡率和DALY方面也观察到类似趋势。2021年，老年人占PAD患病例数的77%，占相关死亡病例的94%。女性的ASPR比男性高1.7倍，但女性的死亡率和DALY率较低，这表明总体疾病负担更重。疾病负担随着社会人口指数（SDI）的增加而增加，在低SDI和低中SDI地区增长最快。在GBD地区中，高收入的北美和西欧负担最重，美国在所有204个国家中负担最重。空腹血糖高是主要危险因素，占PAD负担的36%，人口增长是负担上升的主要驱动因素。预计未来二十年疾病负担将加剧。
1990年至2021年期间，老年人PAD负担稳步增加，预计未来二十年将持续增长。应对糖尿病和全球人口趋势对于指导有效的公共卫生策略至关重要。
