The global, regional, and National burden of parkinson's disease in 204 countries and territories, 1990-2021: a systematic analysis for the global burden of disease study 2021.

BACKGROUND

Parkinson's disease (PD) represents a prevalent neurodegenerative condition that leads to significant disability and contributes to a growing public health challenge worldwide. However, a comprehensive report on progress from 1990 to 2021 is still lacking, especially regarding the risk factors associated with PD by gender and age. This study aims to examine the patterns of PD incidence, mortality rates, and disability-adjusted life years (DALYs) across all age groups, along with the risk factors linked to PD-related fatalities, spanning the years from 1990 to 2021.

METHODS

We retrieved data on PD from the Global Burden of Disease Study 2021. The burden of PD was assessed using incidence, deaths, and DALYs, with corresponding 95% uncertainty interval (UI). Analyses were conducted globally, regionally, and nationally for the period between 1990 and 2021, stratified by age, sex, and the Socio-demographic Index (SDI). Estimated annual percentage changes (EAPCs) were calculated to assess temporal trends. Only cases directly attributable to PD were included, and a comorbidity correction was applied to ensure accurate estimation of the burden.

RESULTS

In 2021, there were 13.35 million (95% UI: 12.67-14.08) incident cases and 388,194 (95% UI: 347,250-417,388) deaths cases globally. The global DALYs attributed to PD climbed from 53.51 to 94.68 per 100,000 population (95% UI: 49.54-57.56 to 85.37-103.11) from 1990 to 2021. During the same period, age-standardized incidence rates rose from 7.82 to 16.92 per 100,000 population (95% UI: 6.95-8.75 to 15.16-18.82), while mortality rates increased from 2.78 to 4.91 per 100,000 population (95% UI: 2.55-2.97 to 4.40-5.29). Among the five SDI regions, the high SDI region reported the highest PD mortality rate in 2021. The burden of PD was most pronounced in the 85-89 age group. Smoking was identified as a key risk factor for PD-associated mortality in 2021, with the proportion of deaths attributable to smoking ranging from - 9.09% in individuals aged 50-54 years to -2.69% in those aged 95 years and older.

CONCLUSIONS

PD represents a significant and escalating global health challenge, driven by increasing incidence rates and an aging population. This growing burden highlights the urgent need for effective strategies in prevention, early diagnosis, and tailored management, particularly for elderly males who are disproportionately affected. Addressing modifiable risk factors and advancing etiological research are crucial to mitigating the rising prevalence and optimizing resource allocation. Coordinated public health interventions and robust healthcare policies are essential to reduce the global impact of PD and improve outcomes for affected individuals.