Chen Ying, Dong Xiao, Xu Wenxing, Long Yudan, Liu Kai
Medical Laboratory Center, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China.
Geriatric Center, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, China.
Front Public Health. 2025 Aug 26;13:1644610. doi: 10.3389/fpubh.2025.1644610. eCollection 2025.
This study aims to analyze global trends and health inequalities in mental disorders among older adults (≥60 years) using Global Burden of Disease (GBD) 2021 data, with a focus on informing equity-focused public health strategies to address disparities in burden and access to care.
Using GBD 2021 data, we examined mental disorders in adults ≥60 across 204 countries (1990-2021). We calculated age-standardized incidence (ASIR) and disability-adjusted life years (DALYs) rates and estimated annual percentage change (EAPC). Bayesian Age-Period-Cohort modeling and frontier analysis assessed trends and projections. Analyses used R (v4.4.2) and JD_GBDR software.
In 2021, there were 74.9 million (95%UI: 59.8-94.2) new mental disorder cases among older adults globally, with an ASIR of 6,867.6 per 100,000. ASIR remained stable since 1990 (EAPC: 0.01), but varied regionally from 13,024.1 (Central Sub-Saharan Africa) to 4,643.9 (Oceania). The age-standardized DALY rate (ASDR) was 2,095.4 per 100,000, highest in low-SDI regions (2,423.9) and lowest in high-SDI regions (1,934.2). Females had higher ASIR (7,483.7 vs. 5,181.6) and ASDR (2,198.3 vs. 1,760.2) than males, with male DALYs increasing (EAPC: 0.07). By 2035, ASDR is projected to rise to 2,494.5, with depressive and anxiety disorders predominant in high-SDI regions and schizophrenia more prevalent in low-SDI areas.
Significant disparities persist, with low-SDI regions and women disproportionately affected. Targeted strategies should strengthen mental healthcare access, implement sex-specific interventions, and address aging-related challenges.
本研究旨在利用《2021年全球疾病负担》（GBD 2021）数据，分析60岁及以上老年人精神障碍的全球趋势和健康不平等状况，重点是为以公平为重点的公共卫生战略提供信息，以解决负担和获得护理方面的差距。
我们使用GBD于2021年的数据，对204个国家（1990 - 2021年）60岁及以上成年人的精神障碍进行了研究。我们计算了年龄标准化发病率（ASIR）和伤残调整生命年（DALY）率，并估计了年度百分比变化（EAPC）。贝叶斯年龄-时期-队列模型和前沿分析评估了趋势和预测。分析使用了R（v4.4.2）和JD_GBDR软件。
2021年，全球老年人中有7490万（95%UI：5980 - 9420万）新发精神障碍病例，ASIR为每10万人6867.6例。自1990年以来，ASIR保持稳定（EAPC：0.01），但在各地区有所不同，从撒哈拉以南非洲中部的13024.1例到大洋洲的4643.9例。年龄标准化DALY率（ASDR）为每10万人2095.4例，在低社会人口指数（SDI）地区最高（2423.9例），在高SDI地区最低（1934.2例）。女性的ASIR（7483.7例对5181.6例）和ASDR（2198.3例对1760.2例）高于男性，男性的DALY有所增加（EAPC：0.07）。预计到2035年，ASDR将升至2494.5例，在高SDI地区以抑郁和焦虑障碍为主，在低SDI地区精神分裂症更为普遍。
显著的差距仍然存在，低SDI地区和女性受到的影响尤为严重。有针对性的战略应加强精神卫生保健的可及性，实施针对性别的干预措施，并应对与老龄化相关的挑战。
