Neuroepidemiology最新文献

{"title":"Incidence and Associated Factors of Prehospital Care-Seeking Delay in People with Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.","authors":"Yanjie Zhao, Yuezhen Xu, Shuyan Fang, Shengze Zhi, Dongfei Ma, DongPo Song, Shizheng Gao, Yifan Wu, Qiqing Zhong, Changxu Jin, Rui Wang, Jiao Sun","doi":"10.1159/000542765","DOIUrl":"10.1159/000542765","url":null,"abstract":"<p><strong>Background: </strong>Despite decades of educational efforts, patients with acute ischemic stroke (AIS) remain delayed in seeking medical care, which becomes the greatest obstacle to the successful management of the condition.</p><p><strong>Objective: </strong>The objective of this study was to systematically explore the incidence and influencing factors of prehospital care-seeking delay in AIS patients.</p><p><strong>Methods: </strong>We systematically searched the PubMed, Embase, Cochrane Library, Web of Science, and Cumulative Index to Nursing and Allied Health Literature from database inception to September 30, 2023. Meta-analysis was conducted using the Stata 15.0 software package. The pooled incidence was calculated using a random-effects model. The quality of studies reporting incidence data was assessed using Joanna Briggs Institute's Critical Appraisal Checklist and Newcastle-Ottawa Scale. Subgroup analyses were performed according to study location, country income, recruitment date, and age.</p><p><strong>Results: </strong>Finally, 30 related articles were included, involving a total of 287,102 people. The estimated incidence of prehospital care-seeking delay was 68%, and there were differences in this incidence in different countries (p = 0.035). Meta-analysis results showed that the delay rate was highest in low-income countries (85%) and lowest in high-income countries (62%). Patients who live farther from hospitals, have a lower level of education, diabetes, hyperlipidemia, or a history of stroke are more likely to experience delays (all p < 0.05). Conversely, those who can recognize stroke symptom, perceive the severity of early symptom, understand thrombolysis treatment, atrial fibrillation, consciousness disturbance, visual disturbance, and symptom score at admission, emergency medical service use, and immediate help-seeking have a lower risk of delay (all p < 0.05).</p><p><strong>Conclusion: </strong>Prehospital care-seeking delays are common among patients with AIS, especially in low-income countries. To reduce delays, it is crucial to increase public awareness of stroke symptoms, improve education levels, and optimize healthcare accessibility.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-16"},"PeriodicalIF":3.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866473","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":"Preeclampsia and the Long-Term Risk of Developing Neurological Disorders Requiring Hospital Admission.","authors":"Nathalie Auger, Gilles Paradis, Mark Keezer, Valérie Leduc, Jessica Healy-Profitós, Antoine Lewin, Amanda Maniraho, Brian J Potter","doi":"10.1159/000543087","DOIUrl":"10.1159/000543087","url":null,"abstract":"<p><strong>Introduction: </strong>Preeclampsia is associated with acute neurological complications during pregnancy, but the subsequent risk of developing a neurological disorder is unclear. We determined if preeclampsia was associated with the long-term risk of neurological morbidity.</p><p><strong>Methods: </strong>We conducted a longitudinal cohort study of 1,460,098 pregnant women with and without preeclampsia in QC, Canada, between 1989 and 2023. The main exposure measure was preeclampsia diagnosed in any pregnancy. Outcomes included hospitalization for cerebrovascular disease, epilepsy, and other neurological disorders up to 3 decades after pregnancy. Using Cox regression models adjusted for confounders, we estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association between preeclampsia and neurological disorders during 27,659,555 person-years of follow-up.</p><p><strong>Results: </strong>There were 1,460,098 women in the cohort, including 73,890 (5.1%) with preeclampsia. Women with preeclampsia had a higher incidence of neurological disorders than women without preeclampsia (113.2 vs. 79.3 per 100,000 person-years). Compared with no preeclampsia, preeclampsia was associated with 1.49 times the risk of later neurological hospitalization (95% CI 1.41-1.57). Preeclampsia was primarily associated with cerebrovascular disease (HR 1.89, 95% CI, 1.76-2.03) and epilepsy (HR 1.39, 95% CI, 1.24-1.57). A link with other neuropathology was less apparent, although severe preeclampsia was associated with neurodegenerative disorders. Severe hypertension, including early onset (HR 2.35, 95% CI, 2.06-2.68), recurrent (HR 2.47, 95% CI, 2.13-2.86), and superimposed preeclampsia (HR 2.60, 95% CI, 2.17-3.12), was more strongly associated with neurological hospitalization overall.</p><p><strong>Conclusion: </strong>Preeclampsia is associated with the long-term risk of developing cerebrovascular disease and epilepsy, but associations with other neurological disorders are less prominent.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-9"},"PeriodicalIF":3.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820324","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":"Multiple Aneurysms: Insight through the Mirrors.","authors":"Pacôme Constant Dit Beaufils, Matilde Karakachoff, Pierre Thouant, Pierre-Antoine Gourraud, François Zhu, Antti Lindgren, Romain Bourcier","doi":"10.1159/000543053","DOIUrl":"10.1159/000543053","url":null,"abstract":"<p><strong>Introduction: </strong>Mirror intracranial aneurysms (MIAs) are intracranial aneurysms (IAs) located bilaterally and symmetrically on either side of the circle of Willis. This study explored the characteristics of MIAs and examined their prevalence at various intracranial locations in a large international population with multiple IAs, aimed at shedding light on the concept of MIA.</p><p><strong>Method: </strong>Data were collected from cohorts of patients in France and Finland with ≥2 definite saccular arterial dilatations at intracranial vessel bifurcations. Patients were classified as \"MIA patients\" if they had bilateral, symmetrically located IAs and further classified as having a pure phenotype (i.e., no other IAs present) or a mixed phenotype if non-mirror additional IAs were present. Statistical analysis used logistic regression models to assess the association of IA location with MIA status and conditional probabilities were calculated for paired locations.</p><p><strong>Results: </strong>In a population of 2,124 patients with 5,459 IAs, 754 patients (33.5%) with a mean age 55.5 (SD 11.3) years had 798 MIAs. MIA patients were predominantly female (541; 72%). We found no relevant differences in clinical characteristics between MIA and non-MIA patients. Middle cerebral artery (MCA) location was the only variable independently associated with MIA status (OR 1.36 [95% CI 1.07%-1.71%], p = 0.0101).</p><p><strong>Conclusion: </strong>MIAs on MCA is a distinct condition among patients with multiple IAs, indicating a potential focal vulnerability related to a predisposing anatomical factor. Particular care is therefore needed during IA screening and follow-up to identify and manage MIAs.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":3.2,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815054","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":"Status of Inpatients with Pediatric Epilepsy in Children's Hospitals in China (2016-2021).","authors":"Jiaqi Wang, Tinghong Liu, Hui Xu, Guoshuang Feng, Yangshuo Wang, Dezhi Cao, Zhirong Wei, Suhui Kuang, Haihua Wei, Feng Chen, Jinshan Xu, Feng Zhai, Shuli Liang","doi":"10.1159/000542887","DOIUrl":"10.1159/000542887","url":null,"abstract":"<p><strong>Background: </strong>Pediatric epilepsy is the most common disease of pediatric neurological diseases in China. Current demographic characteristics and economic burdens are needed to guide public health policy. In this study, we provide the demographic characteristics and economic burden of pediatric epilepsy patients in China from 2016 to 2021 and describe the change trend and correlation of demographic characteristics and economic burden by province.</p><p><strong>Methods: </strong>Using data from the Futang Research Center of Pediatric Development, we conducted a demographic-based cross-sectional study of pediatric epilepsy patients in 29 children's hospitals in China to assess changes in the distribution and economic burden over 6 years and related factors. We obtained per capita disposable income information from the Economic Statistical Bulletin of the National Bureau of Statistics of China and the statistical bureaus of provincial administrative regions. Demographic, diagnostic classification proportion and distribution trends and economic burden from 2016 to 2021 were verified for pediatric patients with epilepsy.</p><p><strong>Results: </strong>From 2016 to 2021, there were 149,375 patients diagnosed with epilepsy. The proportion of patients younger than 3 years decreased significantly from 51.13% to 29.43% (p = 0.00853, R2 = 0.9803). The root mean square error between the Inter-Provincial Visits Indexes decreased from 1.70 to 0.90, decreasing significantly (R2 = 0.8306). The disease burden decreased from 17.26% to 12.11% with a significant upward trend (p = 0.02417, R2 = 0.8817). A negative correlation between disease burden and the Inter-Provincial Visits Index (p = 0.0383) was observed, along with a positive correlation with the proportion of patients younger than 3 years old (p < 0.0001).</p><p><strong>Conclusions: </strong>From 2016 to 2021, the proportion of young patients, population mobility, and economic burden on patients decreased, and healthcare level of pediatric epilepsy improved. In addition, based on the current observations, the healthcare level of pediatric epilepsy in Western and Central China is lower than in other regions, and the economic burden on patients is higher than in other regions. In the future, these areas require higher priority concerning policy and financial support.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-14"},"PeriodicalIF":3.2,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774762","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 Many People Have a Huntington's Disease Expansion: A Population-Based Prevalence Study in Northern Scotland.","authors":"Heather Cruickshank, Zosia Miedzybrodzka","doi":"10.1159/000542739","DOIUrl":"10.1159/000542739","url":null,"abstract":"<p><strong>Introduction: </strong>Previous work demonstrated a prevalence of 14.6 per 100,000 manifest Huntington's disease (HD) patients and 8.3 per 100,000 identified pre-symptomatic gene expansion carriers (IPGEC) in Northern Scotland. Many of those at high risk of having a huntingtin (HTT) gene expansion remain untested with the exact number being unknown.</p><p><strong>Objectives: </strong>The objective of this study was to estimate how many people in Northern Scotland are at 50% risk of having a HTT gene expansion to help with HD clinic service planning and to calculate how many people could access an effective treatment if available.</p><p><strong>Methods: </strong>Clinical and pedigree records from the North of Scotland Genetic Clinic were examined to estimate numbers of manifest HD patients, IPGEC, and individuals at 50% risk.</p><p><strong>Results: </strong>The prevalence of those at 50% risk living in Northern Scotland was 45.2 per 100,000 people. Every manifest HD patient in Northern Scotland has 4.4 relatives at 50% risk and every patient with a HTT gene expansion has 2.9 relatives at 50% risk. There are up to 415 (46.2 per 100,000) adults who could access an effective treatment if available, but this number is likely to be an underestimate as not all manifesting individuals seek diagnosis.</p><p><strong>Conclusions: </strong>Despite high predictive testing rates, at least 2.2 adults are living with the HTT gene expansion for every one of the 14.5 per 100,000 manifest HD patients in Northern Scotland. Regional variation in rates and ascertainment need to be factored into future service planning, including genetic counselling and testing, management, and treatment delivery.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":3.2,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774787","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":"Rising Prevalence of Multiple Sclerosis in Switzerland: Results from the Swiss Multiple Sclerosis Registry.","authors":"Stefania Iaquinto, Andrew Chan, Zina-Mary Manjaly, Mina Stanikić, Benjamin Victor Ineichen, Jens Kuhle, Christina Haag, Jannis Müller, Özgür Yaldizli, Christian Philipp Kamm, Pasquale Calabrese, Chiara Zecca, Tomas Magnusson, Sabin Ammann, Jürg Kesselring, Claudia Baum, Miriam Kaminski, Milo Alan Puhan, Viktor von Wyl","doi":"10.1159/000542632","DOIUrl":"10.1159/000542632","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding the prevalence of multiple sclerosis (MS) provides information for healthcare planning and helps identify trends and patterns of disease occurrence. For Switzerland, the number of persons with MS (pwMS) was last estimated at approximately 15,000 in 2016. The study's objectives were to update estimates of MS prevalence and characterise the change in MS prevalence in Switzerland between 2016 and 2021, the last year with complete administrative data.</p><p><strong>Methods: </strong>The Swiss MS Registry (SMSR) is an ongoing, longitudinal study in Switzerland. It has previously established a methodology to assess the epidemiology of MS in Switzerland by integrating SMSR data with administrative data on reimbursement approvals for disease-modifying therapies (DMTs). Subsequently, the benchmark-multiplier method is applied to the combined data. Using the same methodology, we calculated overall and sex- and age-specific prevalence rates for 2021. Furthermore, we descriptively analysed changes since 2016 by comparing the prevalence figures and demographic and clinical characteristics of pwMS in both years.</p><p><strong>Results: </strong>We estimated the population of pwMS in Switzerland at 18,140 (95% simulation interval: 17,550-18,750), corresponding to a period prevalence of 200.8-214.5/100,000 inhabitants. Peak prevalence was observed in the 50- to 55-year age group. Compared to 2016, the 2021 estimate corresponds to a 20% increase (n = 3,000). Extrapolating from Swiss population growth, we estimated that one-fifth of the observed prevalence increase may be attributed to a rising population. The proportion of pwMS in the age range from 50 to 64 (32.5% vs. 35.9%) and above 65 (8.0% vs. 11.1%) years increased. Consequently, the median (interquartile range) age increased from 47 (37-55) to 49 (38-57) years. The median age at diagnosis (36 [28-45] years) and the female-to-male ratio (2.7:1) remained stable since 2016. The proportion of pwMS treated with DMTs increased from 62.1% to 69.0%, with the largest change observed in infusion therapies (15.7% vs. 23.3%).</p><p><strong>Conclusion: </strong>The estimated MS prevalence in Switzerland has increased since the previous estimate in 2016, with a shift in peak prevalence towards older ages. Population growth explained around one-fifth of this increase, thus leaving room for contributions by additional factors, which require further investigation. The rising MS prevalence has several implications for healthcare, research, and society.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-10"},"PeriodicalIF":3.2,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669935","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, 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":"1-8"},"PeriodicalIF":3.2,"publicationDate":"2024-11-14","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":"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":"1-33"},"PeriodicalIF":3.2,"publicationDate":"2024-11-14","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}

{"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":"1-13"},"PeriodicalIF":3.2,"publicationDate":"2024-11-12","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":"Analysis of Stroke Burden in China from 1990 to 2021 and Projections for the Next Decade.","authors":"Xingzhu Li, Tianyu Jin, Chen Bai, Xianna Wang, Haojie Zhang, Tong Zhang","doi":"10.1159/000542487","DOIUrl":"10.1159/000542487","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to describe the temporal trends of stroke burden in different age and sex groups in China from 1990 to 2021, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs), and to compare these data with global figures.</p><p><strong>Methods: </strong>Using data from the Global Burden of Disease database from 1990 to 2021, we analyzed changes in stroke burden in China and globally. The average annual percentage change (AAPC) was calculated using Joinpoint software to reflect trends. Stroke burden differences across various age groups and sexes were compared, and the ARIMA model was utilized for future projections.</p><p><strong>Results: </strong>Between 1990 and 2021, the age-standardized incidence rate (ASIR) of stroke in China decreased from 226.938 to 204.753 per 100,000, while the global ASIR decreased from 180.973 to 141.553 per 100,000. The age-standardized prevalence rate (ASPR) in China increased from 1,167.425 to 1,301.42 per 100,000, whereas the global ASPR decreased from 1,201.111 to 1,099.31 per 100,000. The age-standardized mortality rate (ASMR) in China fell from 242.18 to 138.029 per 100,000, while the global ASMR decreased from 144.313 to 87.454 per 100,000. China's age-standardized DALY rate (ASDR) declined from 4,834.791 to 2,648.025 per 100,000, whereas the global ASDR decreased from 3,078.952 to 1,886.196 per 100,000. The AAPCs for ASIR, ASPR, ASMR, and ASDR in China were -0.370%, 0.326%, -1.793%, and -1.933%, respectively, compared to -0.291%, -0.807%, -1.601%, and -1.570% globally from 1990 to 2021. Age and sex significantly influenced the stroke burden, with higher incidence and mortality rates in males than in females. Projections for the next decade indicate that stroke incidence in China will remain stable, with an expected rise in ASPR, and declines in ASMR and ASDR. Globally, ASIR is expected to decline, while ASPR will rise, and ASMR and ASDR will continue to decrease.</p><p><strong>Conclusion: </strong>From 1990 to 2021, the incidence, mortality, and DALYs of stroke in China have decreased, while the prevalence has increased. Stroke burden is age-related, with higher prevalence in older adults and higher mortality in the elderly. Males are more susceptible to stroke and have a higher risk of death. Over the next decade, stroke prevalence in China is expected to rise, posing challenges due to population aging, even as mortality and disability rates decline. Sustained public health efforts will be necessary.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-12"},"PeriodicalIF":3.2,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606204","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}