Sex-specific global, regional and national burden of dysthymia and major depression disorder in older adults from 1990 to 2021: a systematic analysis of the global burden of disease 2021 study.

Global Disease Burden From Acute Glomerulonephritis 1990–2019

Analysis of global prevalence, DALY and trends of inflammatory bowel disease and their correlations with sociodemographic index: Data from 1990 to 2019

Objective: To assess the trends in the burden of periodontal disease among individuals aged 60 years and above in China from 1990 to 2021, thereby providing a scientific foundation for the development of targeted prevention and control strategies for periodontal disease in the elderly. Methods: Utilizing data from the Global Burden of Disease Study 2021 (GBD 2021), key indicators including incidence, prevalence, and disability-adjusted life years (DALY) rates were analyzed. Age-standardized rates were determined using the global standard population. Trends in the disease burden of periodontal disease among the elderly population in China from 1990 to 2021 were analyzed using Joinpoint regression analysis, and an autoregressive integrated moving average (ARIMA) model was applied to forecast the disease burden from 2022 to 2036. Results: The annual average percentage changes (AAPC) in the number of incident cases, prevalent cases, and DALYs due to periodontal disease among individuals aged 60 years and above in China from 1990 to 2021 were 3.215% (95%CI: 3.149%-3.281%, P<0.05), 3.161% (95%CI:3.037%-3.286%, P<0.05), and 3.091%(95%CI: 2.887%-3.296%, P<0.05), respectively. The results indicated that the average annual change trends of the number of incident cases, number of prevalent cases, and number of DALYs were real upward trends. Compared with other age groups, the number of incident cases, prevalent cases, and DALYs were the highest among the population aged 60-69 years. The AAPC for age-standardized incidence rate, prevalence, and DALY rates were -0.012% (95%CI:-0.031%-0.008%, P>0.05), 0.023% (95%CI:-0.070%-0.116%, P>0.05), and 0.013% (95%CI:-0.089%-0.115%, P>0.05), respectively. This indicated that the average annual change trends of the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized DALY rate might be caused by random fluctuations. Males exhibited higher prevalence and DALY rates than females across all age groups (P<0.05), whereas the incidence rates showed minimal differences between males and females across all age groups. The ARIMA forecast model indicated that the age-standardized incidence rate among males in the elderly population in China was relatively stable, while that among females showed a downward trend; the age-standardized prevalence and DALY rates followed a pattern of "decline-rise-decline". Conclusions: The disease burden of periodontal disease among Chinese adults aged 60 and above showed an overall upward trend from 1990 to 2021, with males and individuals aged 60-69 identified as high-risk groups. With the exacerbation of aging, the prevention and control situation remains severe, necessitating the implementation of gender-differentiated interventions to reduce the disease burden.

We recently read the article by Shin YH et al., utilizing the Global Burden of Disease Study (GBD) 2019 to analyze the trends in the global burden of asthma and atopic dermatitis (AD) from 1990 to 2021 [1]. This study found that while the total number of cases has been increasing, the age-standardized prevalence rates have been declining. Given that the GBD has been updated to the 2021 version [2], it is essential to uncover the latest burden of asthma and AD. Therefore, we analyzed the prevalence, incidence, mortality, and disability-adjusted life years (DALYs) for asthma and AD, focusing exclusively on the data from 2021. Specifically, we conducted a cross-sectional analysis of the age-, sex-, and socio-demographic index (SDI)-specific burden, which is crucial for understanding the burden and informing strategies for prevention, control, and treatment. It is important to note that the GBD does not provide mortality data for AD. Consequently, our analysis and the presented figures do not include mortality data for this condition. In 2021, the highest age-standardized prevalence (ASP) and age-standardized incidence rate (ASIR) for asthma were observed in the High-income North America region, whereas the highest age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years (DALY) rate (ASDR) were reported in the Oceania region. For AD, the highest ASP, ASIR, and ASDR were all recorded in the High-income Asia Pacific region (Figure 1; Figure S1). In terms of age distribution, the ASP and ASIR of asthma are primarily concentrated in children and adolescents, whereas the ASMR and ASDR are predominantly observed in the elderly population. In contrast, the disease burden of AD is mainly concentrated in children and adolescents (Figure 2). Regarding gender differences, no significant disparities are observed in the burden of asthma between males and females. However, the burden of AD is notably higher in females compared with males, which may be attributed to multifaceted etiology, encompassing culturally idealized expectations of appearance for females, hormonal influences such as the impact of sex hormones on immune responses and skin barrier function and genetic predispositions with a spotlight on filaggrin gene mutations (Figure 2) [3-5]. When stratified by SDI, the ASP and ASIR of asthma are significantly higher in high-SDI regions than in low-SDI regions, whereas the ASMR and ASDR of asthma are markedly higher in low-SDI regions than in high-SDI regions, which is due to limited access to and affordability of essential asthma treatment medications, leading to severe morbidity [6]. On the contrary, the disease burden of AD is predominantly concentrated in high-SDI regions (Figure S2). Overall, our study underscores the heterogeneity in the burden of asthma and AD across different age groups, genders, and socio-demographic regions. Addressing these disparities requires targeted strategies that consider the specific drivers of burden in each context. For asthma, this should include improving access to preventive care and treatment in lower-income regions, while for AD, interventions aimed at early childhood may be most effective. Additionally, to effectively manage AD, key interventions include regular moisturization to maintain skin hydration and the use of emollients to repair the skin barrier. It is also crucial to avoid irritants and allergens, modify bathing practices by using lukewarm water and gentle, fragrance-free cleansers, and consider environmental controls such as maintaining optimal indoor humidity levels to prevent skin dryness and irritation. Our findings highlight the importance of context-specific interventions and underscore the need for continued monitoring and research to effectively reduce the burden of these common allergic diseases. We appreciate the excellent works by the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 collaborators. The authors have nothing to report. The authors have nothing to report. The authors declare no conflicts of interest. Data sources and code used in the Global Burden of Disease Study 2021 are available on the internet (http://ghdx.healthdata.org/gbd-results-tool). The data presented is unpublished elsewhere and are not duplicated. Figure S1. Age-standardized rates of prevalence, incidence, mortality and DALYs of asthma and atopic dermatitis in 2021 in 21 GBD regions. Error bars indicate the 95% uncertainty interval for age-standardized rates. Abbreviations: Age-standardized prevalence (ASP); Age-standardized incidence rate (ASIR); Age-standardized mortality rate (ASMR); Age-standardized disability-adjusted life years (DALY) rate (ASDR). Figure S2. Age-standardized rates of prevalence, incidence, mortality and DALYs of asthma and atopic dermatitis in 2021 in five SDI regions. Error bars indicate the 95% uncertainty interval for age-standardized rates. Abbreviations: Age-standardized prevalence (ASP); Age-standardized incidence rate (ASIR); Age-standardized mortality rate (ASMR); Age-standardized disability-adjusted life years (DALY) rate (ASDR). Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

BackgroundVector-borne parasitic infectious diseases associated with poverty (referred to as vb-pIDP), such as malaria, leishmaniasis, lymphatic filariasis, African trypanosomiasis, Chagas disease, and onchocerciasis, are highly prevalent in many regions around the world. This study aims to characterize the recent burdens of and changes in these vb-pIDP globally and provide a comprehensive and up-to-date analysis of geographical and temporal trends.MethodsData on the prevalence and disability-adjusted life years (DALYs) of the vb-pIDP were retrieved from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021 for 21 geographical regions and 204 countries worldwide, from 1990–2021. The age-standardized prevalence rate and DALYs rate by age, sex, and sociodemographic index (SDI) were calculated to quantify temporal trends. Correlation analysis was performed to examine the relationship between the age-standardized rate and the SDI.ResultsOver the past 30 years, the age-standardized prevalence rate and DALYs rate of these vb-pIDP have generally decreased, with some fluctuations. The distribution of vb-pIDP globally is highly distinctive. Except for Chagas disease, the age-standardized prevalence rate and DALYs rate of other vb-pIDP were highest in low-SDI regions by 2021. Malaria had the highest age-standardized prevalence rate (2336.8 per 100,000 population, 95% UI: 2122.9, 2612.2 per 100,000 population) and age-standardized DALYs rate (806.0 per 100,000 population, 95% UI: 318.9, 1570.2 per 100,000 population) among these six vb-pIDP globally. Moreover, significant declines in the age-standardized prevalence rate and DALYs rate have been observed in association with an increase in the SDI . Globally, 0.14% of DALYs related to malaria are attributed to child underweight, and 0.08% of DALYs related to malaria are attributed to child stunting.ConclusionsThe age-standardized prevalence rate and DALY rates for the vb-pIDP showed pronounced decreasing trends from 1990–2021. However, the vb-pIDP burden remains a substantial challenge for vector-borne infectious disease control globally and requires effective control strategies and healthcare systems. The findings provide scientific evidence for designing targeted health interventions and contribute to improving the prevention and control of infectious diseases.Graphical

BackgroundMigraine is a common neurological disorder that has become an increasingly significant public health issue. This study aims to analyze the burden of migraine in China and globally from 1990 to 2021, exploring epidemiological trends and differences, thus providing scientific evidence for migraine prevention and control.MethodsBased on the 2021 Global Burden of Disease (GBD) study, we assessed migraine burden in China and globally from 1990 to 2021 using indicators including incidence, prevalence, disability-adjusted life years (DALYs), and age-standardized rates. The epidemiological trends were analyzed by calculating the estimated annual percentage change (EAPC). Health inequality analysis was conducted to explore the association between migraine burden and the sociodemographic index (SDI). Decomposition analysis quantified contributions of age structure, population growth, and epidemiological changes to migraine burden. Additionally, the Bayesian Age-Period-Cohort (BAPC) model was applied to predict migraine burden in China and globally over the next 10 years.ResultsCompared with 1990, the number of migraine cases, prevalence, and DALYs in both China and globally significantly increased by 2021, though the global growth rate was considerably higher. Between 1990 and 2021, China experienced greater increases in age-standardized incidence rates (ASIR), age-standardized prevalence rates (ASPR), and age-standardized DALYs rates (ASDR) than the global average. Migraine burden was predominantly concentrated among adolescents and young adults, and females consistently exhibited a higher burden than males. Health inequality analysis revealed increasing disparity across 204 countries and regions, with a concentrated migraine burden in high socio-demographic index (SDI) countries, positively correlated with SDI. Decomposition analysis indicated that population growth was the primary driver of migraine burden changes in both China and globally. BAPC modeling predicted that the age-standardized incidence, prevalence, and DALY rates for migraine will continue to rise in China, whereas these rates are expected to slightly decline globally.ConclusionsMigraine burden is rising in both China and globally, driven by multiple factors such as age, gender, population growth, and SDI. There is an urgent need for precise interventions to reduce migraine's public health impact.

Acne vulgaris is a common skin condition affecting adolescents and young adults worldwide, yet data on the burden and trends of this disease remain limited. We aimed to investigate trends in the burden of acne vulgaris among adolescents and young adults aged 10-24 years at global, regional and national levels. We retrieved data from the Global Burden of Disease Study 2021 for individuals aged 10-24 years in 204 countries and territories from 1990 to 2021. We analysed the numbers, age-standardized rates and average annual percentage changes (AAPCs) of the prevalence, incidence and disability-adjusted life years (DALYs) for acne vulgaris at the global, regional and national levels. Additionally, we examined these global trends by age, sex and Sociodemographic Index (SDI). Globally, the age-standardized prevalence rate of acne vulgaris among adolescents and young adults increased from 8563.4 per 100 000 population [95% uncertainty interval (UI) 7343.5-9920.1] in 1990 to 9790.5 (95% UI 8420.9-11 287.2) per 100 000 population in 2021, with an AAPC of 0.43 [95% confidence interval (CI) 0.41-0.46]. The age-standardized incidence rate and age-standardized DALY rate also showed a similar upward trend. Regionally, Western Europe had the highest age-standardized prevalence, incidence and DALY rates, while North Africa and the Middle East had the largest increase in these rates. By SDI quintile, the high SDI region had the highest age-standardized prevalence, incidence and DALY rates from 1990 to 2021, whereas the low-middle SDI region had the lowest burden of acne vulgaris but experienced the most significant increase in these rates. Globally, the age-standardized prevalence rate of acne vulgaris in 2021 was approximately 25% higher in young women than in young men (10 911.8 per 100 000 population vs. 8727.8 per 100 000 population). Among all age groups, adolescents aged 15-19 years had the highest age-specific prevalence rate, while adolescents aged 10-14 years experienced the largest increase from 1990 to 2021 (AAPC 0.50, 95% CI 0.48-0.52). The burden of acne vulgaris among adolescents and young adults has continued to increase in nearly all countries since the 1990s. Managing this condition remains a significant challenge, necessitating more effective and targeted interventions to control the acne burden.

Global, regional and national burden of rheumatoid arthritis 1990–2017: a systematic analysis of the Global Burden of Disease study 2017

Global burden of non-rheumatic valvular heart disease in older adults (60-89 years old), 1990-2019: systematic analysis of the Global Burden of Disease Study 2019

ObjectiveTo determine the patterns and trends in the global, regional, and national burden of oral disorders among adolescents and young adults (AYA) from 1990 to 2021.MethodsThis is an epidemiological observational study that analyzed annual prevalence and disability-adjusted life years (DALYs) for oral disorders—including dental caries, periodontal disease, edentulism, and other oral conditions—among adolescents and young adults (ages 10–24) from 1990 to 2021. Data were sourced from the Global Burden of Disease Study (GBD) 2021. To assess temporal trends, the estimated annual percentage changes (EAPC) in age-standardized prevalence and DALY rates were calculated at global, regional, and national levels. The GBD 2021 also provides sociodemographic index (SDI) data across 204 countries and territories. Pearson correlation analyses were conducted to explore the relationships between age-standardized prevalence and DALY rates with the SDI and their respective EAPCs.ResultsGlobally, the prevalent cases of oral disorders increased by 17.1%, from 549.2 million in 1990 to 643.3 million in 2021, and DALYs rose by 22.2%, from 1.4 million in 1990 to 1.7 million in 2021. The overall age-standardized prevalence rate (EAPC = − 0.07 [95% CI, − 0.12 to − 0.03]) decreased, while the age-standardized DALY rate (EAPC = 0.06 [0.02 to 0.11]) increased over the same period. While the burden of dental caries declined, the burden of periodontitis and edentulism significantly increased. A negative correlation was observed between age-standardized prevalence and DALY rates and SDI, while a positive correlation was found between the EAPC of age-standardized DALY rates and SDI.ConclusionsThe prevalence and DALYs of oral disorders among AYA have risen over the past three decades, particularly due to the growing burden of periodontitis and edentulism. Notably, the most significant increases have been observed in Southern Latin America and South Asia. While the global decline in dental caries has led to a reduction in ASPR, the escalating burden of periodontal disease and edentulism remains a critical concern. These trends emphasize the urgent need for innovative prevention and intervention strategies to improve oral health for this demographic worldwide.

To assess the burden of anxiety disorders in the elderly and temporal trends at global, regional, and national levels during 1990-2021. Data on incidence, prevalence, and disability-adjusted life years (DALYs) of anxiety disorders in the elderly over 60 years old were extracted from the Global Burden of Disease Study 2021. Average annual percentage changes were determined to analyze the trends in age-standardized rates between 1990 and 2021. Correlation between age-standardized rates and Socio-demographic Index (SDI) was assessed using Spearman's rank-correlation analysis. We used a meta-regression model to estimate the incidence, prevalence, and DALY rates before and during the COVID-19 pandemic. In 2021, 4.49 million incident cases, 53.07 million prevalent cases, and 5.83 million DALYs were estimated in the elderly worldwide. The age-standardized incidence rate of anxiety disorders in older adults increased slightly, while prevalence and DALY rates remained stable. Middle SDI regions had the highest number of incident cases, prevalent cases, and DALYs, with the highest age-standardized prevalence and DALY rates in high SDI regions. Age-standardized prevalence and DALY rates of anxiety disorders were higher among elderly women than men. During the COVID-19 pandemic, the incidence rate of anxiety disorders among older adults rose by 7.82%, while prevalence and DALY rates increased by approximately 6%. Over the past three decades, the increasing burden of anxiety disorders among older adults has significantly added to the global mental health challenges. This burden is intensified by socioeconomic factors, especially in middle SDI regions, and exacerbated by the COVID-19 pandemic.

Brain and central nervous system (CNS) cancers remain a significant contributor to mortality worldwide. This study aims to provide the latest assessment of the prevalence, incidence, mortality, and disability-adjusted life years (DALY) rates of brain and CNS cancers from 1990 to 2021 at the global, regional, and national levels, stratified by sex, age, and the Sociodemographic Index (SDI). Data from the Global Burden of Disease (GBD) database were used to analyze the age-standardized prevalence (ASPR), incidence (ASIR), mortality (ASDR), and DALY rates of brain and CNS cancers. Joinpoint regression was employed to calculate the annual percent change (APC), and a log-transformed linear regression model was used to estimate the average annual percent change (EAPC) for trend analysis. The data were stratified by sex, 20 age groups, 21 GBD regions, 204 countries/territories, and five SDI quintiles. In 2021, there were an estimated 975,279.16 (95% UI, 857,199.67-1,096,203.50) global cases of brain and CNS cancers. The ASPR was 12.01 (95% UI, 10.54-13.52) per 100,000 population; the ASIR was 4.28 (95% UI, 3.71-4.88) per 100,000; the ASDR was 3.06 (95% UI, 2.62-3.50) per 100,000; and the age-standardized DALY rate was 49.58 (95% UI, 28.22-69.92) per 100,000. By SDI regions, the High SDI region showed the highest ASPR and ASIR, the High-Middle SDI region had the highest ASDR and age-standardized DALY rates, and the Low SDI region reported the lowest rates. Geographically, the High-income Asia Pacific region recorded the highest ASPR, Western Europe the highest ASIR, and Central Europe the highest ASDR and age-standardized DALY rates. Overall, in most regions globally, ASIR, ASDR, and age-standardized DALY rates among males increased with age and exceeded those of females. In high-SDI regions, the burden of brain and CNS cancers was predominantly in older adults, whereas in low-SDI regions, the burden among children was pronounced. The global burden of brain and CNS cancers is highest in High and High-Middle SDI regions, with a particularly severe burden in children in Low SDI regions. A comprehensive understanding of the epidemiology of brain and CNS cancers is crucial for strengthening disease prevention and control efforts worldwide.

Global burden and risk factors of musculoskeletal disorders among adolescents and young adults in 204 countries and territories, 1990–2019

BackgroundTo evaluate global burden of refraction disorders by year, age, region, gender, socioeconomic status and other national characteristics in terms of disability adjusted life years (DALYs) and prevalence from Global Burden of Disease (GBD) study 2019 and World Bank Open Data 2019.MethodsGlobal, regional, and national DALY numbers, crude DALY rates, age-standardized DALY and prevalence rates of refraction disorders were acquired from the GBD study 2019. Mobile cellular subscriptions, urban population, GDP per capita, access to electricity and total fertility rate were obtained from the World Bank to explore the factors that influenced the health burden of refraction disorders. Kruskal-Wallis test, linear regression and multiple linear regression were performed to evaluate the associations between the health burden with socioeconomic levels and other national characteristics. Wilcoxon Signed-Rank Test was used to investigate the gender disparity.ResultsGlobally, age-standardized DALY rates of refraction disorders decreased from 88.9 (95% UI: 60.5–120.3) in 1990 to 81.5 (95% UI: 55.0–114.8) in 2019, and might fall to 73.16 (95% UI: 67.81–78.51) by 2050. Age-standardized prevalence rates would also reduce to 1830 (95% UI: 1700–1960) by 2050, from 2080 (95% UI: 1870–2310) in 1990 to 1960 (95% UI: 1750–2180) in 2019. In low SDI region, age-standardized DALY rates (equation: Y = 114.05*X + 27.88) and prevalence rates (equation: Y = 3171.1*X + 403.2) were positively correlated with SDI in linear regression respectively. East Asia had the highest blindness rate caused by refraction disorders in terms of age-standardized DALY rates (11.20, 95% UI: 7.38–16.36). Gender inequality was found among different age groups and SDI regions.ConclusionHealth burden of refraction disorders decreased in recent years, and may continue to alleviate in the next three decades. Older ages, females and lower socioeconomic status were associated with higher refraction disorders health burden.

This study aims to comprehensively evaluate the global, regional, and national burden, trends, and health inequalities of inguinal, femoral, and abdominal hernias among older adults from 1990 to 2021, conduct predictive analyses, and provide insights to inform future public health strategies. A secondary analysis was conducted using the Global Burden of Disease 2021, focusing on the temporal trends, health inequality, and predictive development of inguinal, femoral, and abdominal hernia burden among older adults. Globally, the number of incident cases of inguinal, femoral, and abdominal hernias among older adults continuously increased from 1990 to 2021, along with the decline in age-standardized rates, prevalence, and Disability-Adjusted Life Years (DALYs). Older males exhibited higher incidence rates, prevalence, and DALYs for hernias relative to females. In terms of the Socio-Demographic Index (SDI) from 1990 to 2021, the Age-Standardized Prevalence Rate (ASPR) and Age-Standardized Rate of Disability-Adjusted Life Years (ASDR) remained the highest in low-middle and low SDI regions, while the Age-Standardized Incidence Rate (ASIR) was the highest in high SDI regions. At the national level, 10 countries experienced a significant increase in ASDR and ASPR, and 15 countries in ASIR. Among these, the highest increase was observed for ASIR in China, ASPR in Georgia, and ASDR in American Samoa. The projections to the year 2035 indicate an increase in the incidence and prevalence of hernias, with older males remaining predominant. However, the DALY rate is expected a declining trend. In spite of the progress in reducing the burden of inguinal, femoral, and abdominal hernias in older adults, the overall burden tends to rise. In particular, countries such as India, China, and Georgia are experiencing an increasing burden. It is crucial to implement targeted medical interventions, especially for older males in these regions.