Neuroepidemiology最新文献

{"title":"The Direct Medical Cost of Essential Tremor.","authors":"Elan D Louis, Kandice A Kapinos, Elan D Louis","doi":"10.1159/000541968","DOIUrl":"10.1159/000541968","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to determine the direct medical cost of illness from essential tremor (ET) from a patient perspective.</p><p><strong>Methods: </strong>Secondary data from the Optum's de-identified Clinformatics® Data Mart Database from 2018-2019 were used to assess medical resource utilization and costs. Propensity score matching was used to match patients aged 40+ to statistically similar controls. Generalized linear models were used to estimate average, adjusted total costs of care per year, by healthcare setting, and provider specialty.</p><p><strong>Results: </strong>The final sample included 41,200 patients with at least one ET claim and 36,871 matched patients. Overall, ET patients aged 40+ had about USD 28,217 in direct medical costs per year, which was about USD 1,601 more than matched comparisons (p < 0.001). This was driven by greater number of outpatient visits overall and with specialists. Extrapolating the estimates from our study and pairing them with published age-specific disease prevalence statistics for ET, we calculated an annual cost for direct medical care of ET patients aged 40+ to be about USD 9.4 billion.</p><p><strong>Conclusion: </strong>The estimated direct medical costs among adults aged 40+ with an ET diagnosis aggregated to the population level are nontrivial.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"498-504"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thiazolidinediones Decrease the Recurrence of Intracerebral Hemorrhage in Type 2 Diabetes Mellitus Patients: A Nested Case-Control Study.","authors":"Cheng-Di Chiu, You-Pen Chiu, Hei-Tung Yip, Hui-Ru Ji, Der-Yang Cho, Irene Han-Juo Cheng, Cho-Yi Chen","doi":"10.1159/000539001","DOIUrl":"10.1159/000539001","url":null,"abstract":"<p><strong>Introduction: </strong>Preclinical evidence demonstrated the therapeutic potential of thiazolidinediones (TZDs) for the treatment of intracerebral hemorrhage (ICH). The present study conducted an investigation of cerebrovascular and cardiovascular outcomes following ICH in patients with type 2 diabetes mellitus (T2DM) treated with or without TZDs.</p><p><strong>Methods: </strong>This retrospective nested case-control study used data from the Taiwan National Health Insurance Research Database. A total of 62,515 T2DM patients who were hospitalized with a diagnosis of ICH were enrolled, including 7,603 TZD users. Data for TZD non-users were extracted using propensity score matching. Primary outcomes included death and major adverse cardiovascular events (MACEs), which were defined as a composite of ischemic stroke, hemorrhagic stroke (HS), acute myocardial infarction, and congestive heart failure. Patients aged <20 years with a history of traumatic brain injury or any prior history of MACEs were excluded.</p><p><strong>Results: </strong>TZD users had significantly lower MACE risks compared with TZD non-users following ICH (adjusted hazard ratio [aHR]: 0.90, 95% confidence interval [CI]: 0.85-0.94, p < 0.001). The most significant MACE difference reported for TZD users was HS, which possessed lower incidence than in TZD non-users, especially for the events that happened within 3 months following ICH (aHR: 0.74, 95% CI: 0.62-0.89 within 1 month, p < 0.01; aHR: 0.68, 95% CI: 0.54-0.85 between 1 and 3 month).</p><p><strong>Conclusion: </strong>The use of TZD in patients with T2DM was associated with a lower risk of subsequent HS and mortality following ICH.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"43-56"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Much Does Dysphagia Cost? Understanding the Additional Costs of Dysphagia for New Zealand in Patients Hospitalised with Stroke.","authors":"Shnece Duncan, Andrea Menclova, Maggie-Lee Huckabee, Dominique A Cadilhac, Anna Ranta","doi":"10.1159/000539133","DOIUrl":"10.1159/000539133","url":null,"abstract":"<p><strong>Introduction: </strong>Dysphagia (i.e., disordered swallowing) is a consequence of stroke. Existing literature on the marginal cost of dysphagia after stroke is limited and ignores long-term impacts. Our aim was to determine the marginal 12-month cost attributable to dysphagia, including health-related quality of life (HRQoL) impacts, among patients hospitalised with stroke in New Zealand.</p><p><strong>Methods: </strong>Secondary analysis of observational data from the REGIONS Care study, a national study from New Zealand of consecutively hospitalised patients with acute stroke between May 1, 2018, and October 30, 2018, including an outcome survey at 12 months among those who provided consent. Patients were identified as dysphagic if they received a swallow screen in hospital resulting in a speech language therapist review. Patients that required a nasogastric feeding tube in hospital were classified as \"severe.\" Optimal linear propensity score matching was utilised to provide a group of patients to compare with stroke and dysphagia. All costs were converted to 2021NZD.</p><p><strong>Results: </strong>Overall, of the 2,379 patients in the REGIONS cohort (51% male, median age: 78), 40% (944/2,379) were dysphagic (52% male, median age: 78), and 5% (111/2,379) were classified as severely dysphagic. Within 12 months of hospital discharge, dysphagia reduced HRQoL overall by 0.06 index points (95% CI: 0.028-0.100), and severe dysphagia by 0.12 index points (95% CI: 0.03-0.20). The estimated marginal 12-month cost attributable to stroke-related dysphagia was NZD 24,200 on average per patient. This estimate includes the additional hospitalisation costs (NZD 16,100), community rehabilitation services (NZD 570), hospital level aged residential care (NZD 4,030), and reduced HRQoL (NZD 3,470) over a 12-month period post-hospital discharge. The overall total marginal cost for those with severe dysphagia was NZD 34,000 per patient.</p><p><strong>Conclusion: </strong>We report cost estimates to 12 months from a national perspective on the additional costs and HRQoL outcomes of dysphagia for people hospitalised with stroke in New Zealand. Findings provide a novel contribution internationally since few prior studies have extended beyond the acute hospital phase of care. By quantifying the economic burden, we provide information to decision makers to improve dysphagia management strategies and ultimately enhance the overall HRQoL for people with stroke and dysphagia.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"57-67"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Risk Factors of Cerebral Microbleeds among Egyptian Patients with Acute Ischemic Stroke.","authors":"Ahmed Nasreldein, Ashkan Shoamnesh, Nageh Foli, Marwa Makboul, Sabreen Salah, Klaus Faßbender, Silke Walter","doi":"10.1159/000540296","DOIUrl":"10.1159/000540296","url":null,"abstract":"<p><strong>Background: </strong>Cerebral microbleeds (CMBs) are markers of underlying hemorrhage-prone cerebral small vessel disease detected on MRI. They are associated with a heightened risk of stroke and cognitive decline. The prevalence of CMBs among Egyptian patients with ischemic stroke is not well studied. Our aim was to detect the prevalence of CMBs and associated risk factors among Egyptian patients with ischemic stroke.</p><p><strong>Methods: </strong>A prospective, cross-sectional, single-center study of consecutive patients with ischemic stroke. Patients were recruited between January 2021 and January 2022 at the Assiut University Hospital in the south of Egypt. Patients with known bleeding diathesis were excluded. All participants underwent full neurological assessment, urgent laboratory investigations, and MRI with T2* sequence.</p><p><strong>Results: </strong>The study included 404 patients, 191 (47.3%) of them were females. The mean age of the study population was 61 ± 1 years, and the mean NIHSS on admission was 12 ± 5. The prevalence of CMB was 26.5%, of whom 6.5% were young adults (age ≤45 years). CMBs were detected in 34.6% of patients with stroke caused by large artery atherosclerosis, 28.0% with small vessel disease stroke subtype, 25.2% with stroke of undetermined cause, and in 12.1% with cardioembolic stroke. History of AF, hypertension, dyslipidemia, Fazekas score >2, dual antiplatelet use, combined antiplatelet with anticoagulant treatment, and thrombolytic therapy remained independently associated with CMBs following multivariable regression analyses.</p><p><strong>Conclusion: </strong>The high number of identified CMBs needs to inform subsequent therapeutic management of these patients. We are unable to determine whether the association between CMBs and antithrombotic use is a causal relationship or rather confounded by indication for these treatments in our observational study. To understand more about the underlying cause of this finding, more studies are needed.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"227-235"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phosphodiesterase-5 Inhibitors and Dementia Risk: A Real-World Study.","authors":"Naomi Gronich, Nili Stein, Walid Saliba","doi":"10.1159/000540057","DOIUrl":"10.1159/000540057","url":null,"abstract":"<p><strong>Introduction: </strong>Biological and scarce epidemiological evidence suggested that phosphodiesterase-5 inhibitors (PDE5i) might reduce dementia risk. We aimed to examine the association between PDE5i and dementia using real-world data.</p><p><strong>Methods: </strong>Two retrospective cohorts within the database of Clalit, the largest healthcare provider in Israel (2005-2023), were studied. The first cohort included new daily users, older than 50 years of age, of low-dose tadalafil, prescribed for benign prostatic hypertrophy (BPH), propensity-score matched to new-users of alpha-1 blockers, and analyzed using 2-year lag time. The second cohort included patients with erectile dysfunction, with/without any PDE5i treatment, using time-dependent analysis. Individuals in the cohorts were followed through May 2023 for the occurrence of dementia.</p><p><strong>Results: </strong>The first cohort included 5,204 tadalafil initiators propensity-score matched to 18,565 alpha-1 blockers initiators. There was no association between tadalafil use and dementia risk, HR = 0.99 (95% CI: 0.88-1.12), p = 0.927. Similar results were obtained in a competing risk analysis, and in a sensitivity analysis in which we restricted the cohort to patients older than 60 years at cohort entry. The second cohort of 133,336 patients with erectile dysfunction included new users and nonusers of any PDE5i. In a mean follow-up of 7.9 years, 8,631 patients were newly diagnosed with dementia. In a time-dependent multivariable analysis, PDE5i use was not associated with reduced dementia risk, HR = 0.95 (95% CI: 0.86-1.04). Results were not changed in sensitivity analyses (patients older than 60 years or stratification by PDE5i type).</p><p><strong>Conclusion: </strong>This study suggests that the use of PDE5 inhibitors is not associated with decreased risk of dementia.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"193-202"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality of Epilepsy in Chinese Populations: A Comprehensive Review.","authors":"Xiaowen Zhou, Ding Ding, Wenzhi Wang, Dong Zhou, Josemir W Sander","doi":"10.1159/000540426","DOIUrl":"10.1159/000540426","url":null,"abstract":"<p><strong>Background: </strong>Premature mortality is a significant part of the epilepsy burden and may vary across populations, especially between high-income and lower- and middle-income countries. People with epilepsy in China are approximately a fifth of the global population with epilepsy. Previous studies were unlikely to represent the situation in China due to limitations in design, methods, sample size, follow-up time, and other inherent population heterogeneity.</p><p><strong>Summary: </strong>By summarising the evidence on the mortality characteristics in Chinese populations with epilepsy in the last 6 decades, we found a median mortality rate of 14.7 (6.8-74.4)/1,000 person-years and a median standardised mortality ratio (SMR) of 4.4 (2.6-12.9) in population-based studies, and a median mortality rate of 12.3 (9.5-101.5)/1,000 person-years and a median SMR of 3.0 (1.5-5.1) in hospital-based studies. Vascular diseases, complications of diabetes, and accidental injuries were the leading causes of death. Risk factors for mortality were reported as older age, male, longer duration, and higher frequency of seizures. Case fatality ratios of status epilepticus in adults were higher than in children, and both increased with follow-up time. Mortality in people with symptomatic epilepsy was high and varied across different primary diseases.</p><p><strong>Key messages: </strong>The highest mortality rate and sudden unexpected death in epilepsy (SUDEP) incidence were reported from the least developed areas in China. Accidental injuries were the most common causes of epilepsy-related deaths, while the incidence of SUDEP may be underestimated in Chinese populations. Further research is warranted to improve the understanding of premature mortality risk so that preventative measures can be introduced to improve the situation.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"391-404"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between Adipose Tissue-Specific Insulin Resistance and Atherosclerotic Plaques and Burden in Community-Based Population.","authors":"Qi Zhou, Xueli Cai, Aoming Jin, Jing Jing, Mengxing Wang, Suying Wang, Lerong Mei, Xia Meng, Shan Li, Tiemin Wei, Yongjun Wang, Liping Liu, Yuesong Pan","doi":"10.1159/000540321","DOIUrl":"10.1159/000540321","url":null,"abstract":"<p><strong>Background: </strong>We aimed to examine the association between adipose tissue-specific insulin resistance and atherosclerotic burden and plaques in intracranial, extracranial, and coronary arteries in community residents without diabetes.</p><p><strong>Methods: </strong>Adipose tissue-specific insulin resistance index (Adipo-IR) was calculated by fasting serum insulin and free fatty acids and categorized into 4 groups according to the quartiles. The 3.0 T magnetic resonance imaging scanner was used to assess intracranial and extracranial atherosclerotic plaques, while computed tomography angiography was used to assess coronary atherosclerotic plaques. Intracranial, extracranial, and coronary atherosclerotic burden was assessed by segmental stenosis segment scores of the corresponding arterial segments, respectively. Binary and ordinal logistic regression models were utilized to investigate the relationship of Adipo-IR with the presence of atherosclerotic plaques and atherosclerotic burden.</p><p><strong>Results: </strong>Of 2,719 participants (mean [standard deviation] age, 60.9 [6.6] years; 1,441 [53.0%] women), the prevalence of intracranial atherosclerotic plaques, extracranial atherosclerotic plaques, and coronary plaques were 432 (15.9%), 975 (35.9%), and 1,160 (42.7%), respectively. Compared with individuals with the lowest quartile, participants with the fourth quartile of the Adipo-IR were associated with intracranial atherosclerotic burden (common odds ratio [cOR]: 1.35; 95% confidence interval [CI]: 0.99-1.82), coronary plaque (odds ratio [OR]: 1.45; 95% CI: 1.15-1.83), and segment stenosis score (cOR: 1.44; 95% CI: 1.15-1.81) after adjustment for age, sex, and current smoking.</p><p><strong>Conclusion: </strong>Adipose tissue-specific insulin resistance is associated with atherosclerotic burden and plaques in intracranial and coronary arteries in Chinese community nondiabetic residents.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"302-312"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forecasting the Worldwide Impact of Stroke for Individuals Aged 45 and Above.","authors":"Weinv Fan, Qinghua Ma, Qiongfeng Guan, Feng Wang, Hui Li","doi":"10.1159/000542366","DOIUrl":"10.1159/000542366","url":null,"abstract":"<p><strong>Background: </strong>We aimed to assess the global impact of stroke in people aged 45 years and older between 1990 and 2030, focusing on morbidity, mortality, and disability-adjusted life years (DALYs).</p><p><strong>Methods: </strong>Generalized additive models were used to project disease burden from 2020 to 2030. Additionally, the association between sociodemographic index (SDI) and stroke burden was investigated, and regional differences were assessed by Mann-Whitney U test.</p><p><strong>Results: </strong>The overall age-standardized stroke incidence rate (ASIR) among adults aged 45 years and older is projected to increase from 2020 to 2030, with an estimated annual percentage change (EAPC) of 1.29. Conversely, the age-standardized death rate (ASDR) in EAPC is expected to decrease by -1.48, and the age-standardized DALY in EAPC is expected to decrease by -1.66. By 2030, men are expected to have higher ASIR (181.81) and ASDR (87.31) than women (ASIR: 151.85, ASDR: 65.20). Regional differences are large. East Asia is expected to have the highest ASIR in 2030 (265.55). Age estimates show that older age groups, particularly those aged 75-79, are at higher risk of stroke. In addition, there is a significant inverse relationship between SDI and stroke severity, with areas with higher SDI tending to have lower morbidity, mortality, and DALYs.</p><p><strong>Conclusion: </strong>From 1990 to 2030, ASIR is expected to upgrade, especially in East Asia and regions with lower SDI. Men will bear a greater burden than women.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"355-367"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Survival in Contemporary Parkinson's Disease: A 47-Year Autopsy Study.","authors":"Eric Noyes, Eric Noyes, Ali H Rajput, Minyoung Kim, Alex Rajput","doi":"10.1159/000541420","DOIUrl":"10.1159/000541420","url":null,"abstract":"<p><strong>Introduction: </strong>Parkinson's disease (PD) is the second most common neurodegenerative disorder. The main clinical features are bradykinesia, rigidity, and resting tremor. Other neurodegenerative disorders such as progressive supranuclear palsy and multiple system atrophy share some of these clinical manifestations. All those disorders are collectively known as parkinsonism or Parkinson syndrome (PS). Definite diagnosis of PD requires brain autopsy. There is no known cure for PD. Since its discovery in the 1960s, levodopa (LD) has remained the best and most widely used medication in PD. The impact of that is important to understanding the neuroepidemiology of PD. The incidence of PD rises with advancing age. In the last six decades, life expectancy in the general population has increased resulting in a larger pool of at-risk persons. Onset age of PD is the most reliable indicator of PD survival as older onset cases have shorter survival. We report on survival in autopsy-confirmed PD cases with onset age <70 years treated with LD and compare that with similar onset-age cases of PD before the discovery of LD.</p><p><strong>Material and methods: </strong>The Saskatchewan Movement Disorders Program (SMDP) has operated uninterrupted since 1968. Long follow-up and autopsy studies are a special interest of the SMDP. All PS cases followed by the SMPD during 47 years (1968-2015) that came to autopsy were considered. Those with autopsy-confirmed PD and onset <70 years were included and were compared with pre-LD cases of similar age of onset.</p><p><strong>Results: </strong>Overall, 392 PS cases were seen in our clinic between 1968 and 2015 and had brain pathology studies. A total of 314 (80%) of those had PD. Overall, 128 (41%) of the PD cases had onset <70 years and were included in this study. Their median survival was 18 years.</p><p><strong>Conclusion: </strong>Prior to widespread use of LD, nearly all PD cases had onset <70 years and mean survival was 9.4 years. Longer survival in our study is attributed primarily to modern treatment. Increased survival has resulted in a larger number of older, chronically treated, higher comorbidity, and complicated PD patients. These changes present new challenges. It requires a larger and increasingly diverse workforce for patient care and research.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"517-524"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease Burden of Parkinson's Disease in Asia and Its 34 Countries and Territories from 1990 to 2021: Findings from the Global Burden of Disease Study 2021.","authors":"Xuehui Chang, Qifan Yang, Xuehui Chang, Shijin Li, Xiao Li, Changyuan Kang, Weiwei Yuan, Guiying Lv","doi":"10.1159/000542606","DOIUrl":"10.1159/000542606","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing global population and aging have made Parkinson's disease (PD) a significant public health concern. Comprehensive evaluations of PD burden trends in Asian subregions and countries are lacking. This study investigated PD burden in Asia from 1990 to 2021, categorized by age, sex, and region.</p><p><strong>Methods: </strong>Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 were analyzed to assess the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) across five Asian subregions and 34 countries/territories, using joinpoint regression, decomposition analysis, frontier analysis, and Bayesian models to examine changes, influencing factors, and predict future trends.</p><p><strong>Results: </strong>In 2021, the age-standardized PD incidence and prevalence in Asia were higher than the global average, particularly in East Asia (24.16 and 243.46/100,000, respectively). From 1990 to 2021, the incidence of PD in Asia rose by 198.01%, its prevalence rose by 284.35%, mortality rose by 111.27%, and DALY rose by 144.45%. Males consistently presented a greater PD burden than females did, with a growing sex gap over time. PD burden increased with age, especially among those aged 65 years and older. Population aging was the primary driver of new PD cases, and increasing etiological factors led to more patients. Inequalities in the PD burden have increased between high- and low-income areas, with low-income regions being more affected. By 2036, PD incidence is projected to increase in all subregions except the high-income Asia-Pacific region, with males experiencing a higher rate of increase.</p><p><strong>Conclusion: </strong>The PD burden in Asia has significantly increased over the past three decades, particularly in middle-aged and elderly males, middle- and low-SDI countries, and individuals already suffering from PD. The increasing incidence and aging population necessitate the reallocation of medical resources, improved chronic disease management systems, stronger public health interventions, and sustainable development efforts. Research into etiological factors, pathogenesis, early diagnosis, preventive interventions, and regional management is critical.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"525-557"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}