Age-standardized Years Lived With Disability Research Articles

The burden and trends of heart failure caused by ischemic heart disease at the global, regional, and national levels from 1990 to 2021.

Ischemic heart disease (IHD) is a major cause of heart failure (HF), a condition expected to increasingly affect global health and economics. This study evaluates the global burden, trends, and disparities of HF linked to IHD, aiming to inform health policy development. Data from the Global Burden of Disease Study 2021 (GBD2021) is analyzed using Joinpoint regression, decomposition analysis, and Bayesian age-period-cohort analysis (BAPC). Health disparities are assessed through the Socio-demographic Index (SDI) via the Slope Index of Inequality (SII) and the Concentration Index (CI), with future trends projected from 2022 to 2045. In 2021, global HF cases due to IHD were over 19.16 million, with an age-standardized prevalence rate (ASPR) of 228.31 per 100 000 [95% UI, 188.18 to 279.55] and age-standardized years lived with disability (ASYLDs) rate of 20.43 per 100 000 [95% UI, 13.55 to 28.7].In 2021, there was a 2.87% increase in ASPR and ASYLDs compared to 1990, primarily driven by population growth and aging.Significant reductions in global ASPR and ASYLDs disparities are observed, though the disease burden has intensified in countries with lower SDI levels. Projections indicate that by 2045, while the prevalence and YLDs for HF caused by IHD will increase, while the ASPR and ASYLDs are expected to decrease. The global burden of HF from IHD remains a significant concern. Urgent improvements in the allocation of medical resources and the implementation of effective prevention and management strategies are necessary to address this issue.

Transition and trend analysis of the burden of depression in China and different income countries: Based on GBD database and joinpoint regression model

BackgroundDepression is a leading cause of disability and poor health worldwide and is expected to rank first worldwide by 2030. The aim of this study is to analyze the transition and trend of depression burden in China and various income-level countries by utilizing the Global Burden of Disease (GBD) database and the Joinpoint regression model. This analysis seeks to comprehend the variations in the burden of depression across different income regions and evaluate their developmental patterns. MethodsBased on the GBD 2019 open dataset, this study extracted data on YLD (Years Lived with Disability), DALY (Disability-Adjusted Life Years), and incidence related to depression. The analysis focused on the period between 1990 and 2019, covering global data and distinguishing between high-income, upper-middle-income, lower-middle-income, low-income countries, and China. We utilized the Joinpoint regression model to fit the spatiotemporal trend changes among different income-level countries. Pairwise comparisons were conducted to examine the parallelism and to determine if the differences in trend changes among various regions were statistically significant. ResultsFrom 1990 to 2019, the age-standardized YLD and DALY for depression female were higher than that in male. The YLD total change rate of depression men was higher than that of women. China exhibited the largest disparity in total YLD change rates between genders, reaching 0.08. During 1990 to 2019, the incidence of depression in 2005–2019 increased among females in middle to high-income countries, low-income countries, and China as compare to that of 1990–2005. Notably, China shown the most increase the incidence rate of females (from −0.4 % to 0.84 %). China experienced the most significant change in the YLD of depression during this period (AAPC = 0.45, 95 % CI = 0.41, 0.48, P < 0.01). China's YLD/Incidence rate was higher compared to the global, HICs, UMCs, LMCs, and LICs. In China, the YLD/incidence rate of depression began to rise in 1994, peaking around 2010, and then gradually declining. Since 2010, the growth rate of depression DALYs in China has been higher than the global average, high-income countries, upper-middle-income countries, lower-middle-income countries, and low-income countries. The DALY's AAPC value for the HLCs was the highest (AAPC = 0.24, 95 % CI = 0.22, 0.25, P < 0.01). The UMCs, in comparison to other regions, incidence rate had the highest AAPC value (AAPC = 0.48, 95 % CI = 0.46, 0.50, P < 0.01). ConclusionsGiven the significant variations in the burden of depression across countries with different income levels, future strategies aimed at reducing the burden of depression should adopt tailored and differentiated approaches according to each country's specific needs and developmental stages.

Global burden of leukemia attributable to occupational exposure to formaldehyde from 1990 to 2019.

The objective of this study was to evaluate the worldwide burden of leukemia owing to occupational exposure to formaldehyde (OEF) from 1990 to 2019. Data on leukemia due to OEF were obtained from the Global Burden of Disease Study (GBD) 2019. By region, age, sex, and disease subtype, the numbers and age-standardized rates (ASRs) associated with deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) were analyzed. Annual average percentage change (AAPC) was used to estimate disease burden trends from 1990 to 2019. To measure the risk of leukemia due to OEF, the population attributable fraction (PAF) was introduced. From 1990 to 2019, the number of deaths, DALYs, YLLs, and YLDs for leukemia caused by OEF increased by 44%, 34%, 33%, and 124%, respectively. Regarding the change in ASRs, the age-standardized YLDs (ASYLDs) rate of leukemia due to OEF, which was 38.03% (AAPC = 1.17 [95% confidence interval [CI] 1.11, 1.23]), indicated an increased trend. But the age-standardized mortality rate (ASMR), age-standardized DALY (ASDALY) rate, and age-standardized YLL (ASYLL) rate showed decline trends, with - 11.90% (AAPC = - 0.41 [95% CI - 0.45, - 0.37]), - 14.19% (AAPC = - 0.5 [95% CI - 0.55, - 0.45]), and - 14.97% (AAPC = - 0.53 [95% CI - 0.58, - 0.48]), respectively. In terms of PAFs, there were increasing trends in PAFs of age-standardized deaths, ASDALYs, ASYLLs, and ASYLDs for leukemia caused by OEF, with 20.15% (95% uncertainty interval [UI] 11.76%, 30.25%), 36.28% (95% UI 21.46%, 53.42%), 51.91% (95% UI 35.05%, 72.07%), and 36.34% (95% UI 21.58%, 53.63%), respectively. Across the socio-demographic index (SDI) regions, the leukemia burden caused by OEF was concentrated in middle and high-middle SDI regions. Besides, OEF poses a more serious risk for acute leukemia among the leukemia subtype. Globally, leukemia caused by OEF remains a public health burden. Policies must be developed to avoid the burden of leukemia caused by OEF.

Disease burden of chronic obstructive pulmonary diseases in China from 1990 to 2019

Objective: To examine the trend of the burden on chronic obstructive pulmonary diseases (COPD) and epidemiologic transition on related risk factors among the Chinese population from 1990 to 2019. Methods: Based on the data from the Global Burden of Disease 2019 Study, we used the indicator numbers such as disability-adjusted life year (DALY), years of life lost (YLD), years lived with disability (YLL), and prevalence rate to describe the changes of COPD burden stratified by different sex and age groups from 1990 to 2019. We applied population attribution faction (PAF) to analyze the burden attributed to risk factors and epidemiological transition. Results: In 2019, the age-standard rate for DALY, YLD, and YLL and prevalence rate for COPD were 1 102.77/100 000 population,862.37/100 000 population, 240.40/100 000 population, and 2 404.41/100 000. Both age-standardized DALY and YLL rates for COPD in males were higher than in females, except for the YLD rate in females. COPD's top five risk factors were particulate matter pollution, smoking, occupational particulate matter, gases, and fumes, low temperature, and secondhand smoke. Smoking surpassed environmental particulate pollution in 1994 and became the first factor causing the disease burden of COPD. Since then, the order of risk factors has not changed. The PAF of environmental particulate pollutants increased by 1.78% annually, from 15.22% in 1990 to 25.37%, and the PAF of household air pollution from solid fuels decreased by 5.59% annually, from 40.30% in 1990 to 7.59%. Conclusions: From 1990 to 2019, the per person health loss caused by COPD in China showed an overall downward trend. The PAF of relevant risk factors has also changed, the importance of environmental factors is relatively declined, and the status of smoking and other related risk behaviors has become increasingly prominent. The prevention and control of COPD can focus on screening high-risk groups (≥40 years old, smoking, heavy air pollution, having occupational exposure), smoking cessation, and environmental treatment.

The Burden of Osteoarthritis in the Middle East and North Africa Region From 1990 to 2019.

ObjectiveWe aimed to report the most current data on the prevalence, incidence, and years lived with disability (YLDs) associated with osteoarthritis (OA) for the 21 countries and territories located in the Middle East and North Africa (MENA) region from 1990 to 2019 by age, sex, cause, and sociodemographic index (SDI).MethodsPublicly available data from the Global Burden of Disease 2019 study were used to report the OA-related burden. Estimates are reported as counts and age-standardized rates, along with their corresponding 95% uncertainty intervals (UIs).ResultsIn 2019, the age-standardized prevalence of OA in MENA was 5,342.8 per 100,000 (95% UI: 4,815.9–5,907.8), which is 9.3% higher than in 1990 (8.1–10.5%). Similarly, the age-standardized annual incidence of OA per 100,000 was 430.4 (382.2–481.9), demonstrating a 9.4% increase since 1990 (8.3–10.5). OA was the cause of 185.4 (92.8–370.2) age-standardized YLDs per 100,000 in 2019, which was 10% higher than in 1990 (8.7–11.4). Saudi Arabia, Kuwait, and Iran had the highest OA burden in MENA, while Yemen, Afghanistan, and Sudan had the lowest burden. In all MENA countries, OA affected more women than men, had an increasing burden with increased age, and had the highest impact on the knee, hip, and hand joints, respectively. OA was also positively associated with the SDI.ConclusionThe burden of OA increased over 1990–2019 in the MENA region. The study emphasizes the importance of early preventative approaches in order to control any future health, economic, and quality of life crises imposed by OA in this region.

The global burden of decubitus ulcers from 1990 to 2019

There are no studies assessing the epidemiology and burden of decubitus ulcers at global, regional, and national levels. We aim to report this issue from 1990 to 2019 by extracting data from the Global Burden of Disease Study (GBD) 2019 and stratifying it by age, gender, and socio-demographic index (SDI). Globally, the number of prevalent cases of decubitus ulcers in 2019 is 0.85 (95% UI 0.78 to 0.94) million. The age-standardized rates of prevalence, incidence, and years lived with disability (YLDs) in 2019 are 11.3 (95% UI 10.2 to 12.5), 41.8 (37.8 to 46.2), and 1.7 (1.2 to 2.2) per 100,000 population, and compared with 1990, it has decreased by 10.6% (95% UI 8.7% to 12.3%), 10.2% (8.2 to 11.9%), and 10.4% (8.1 to 12.5%), respectively. In addition, the global prevalence rate of decubitus ulcers increases with age, peaking at the > 95 age group among men and women. At the regional and national levels, we observe a positive correlation between age-standardized YLDs and SDI. Malaysia, Saudi Arabia, and Thailand experienced the most significant increases in age-standardized prevalence rates at the national level. Finally, we concluded that the age-standardized prevalence, incidence, and YLDs rates of decubitus ulcer declined from 1990 to 2019, with significant regional differences. In order to monitor the dynamic changes of decubitus ulcers burden, it is recommended to improve the quality of decubitus ulcer health data in all regions and countries.

Change trend in disease burden of stroke and its risk factors in China, 1990 – 2017

Objective To analyze change trend in disease burden of stroke and its risk factors in China from 1990 through 2017 and to provide evidences for rational allocation of health resources and the development of targeted stroke prevention and treatment strategies. Methods Data on disease burden of stroke during the period from 1990 through 2017 in China were extracted from the Global Burden of Disease (GBD) Study of 1990, 2000, 2010 and 2017. Years lived with disability (YLDs), years of life lost (YLLs), disability adjusted life years (DALYs) were used to evaluate the disease burden of stroke and population attributable fraction (PAF) was adopted to analyze risk factors of stroke-related disease burden. Disparities in disease burden of stroke between China and the world were compared. Results During the period of 1990 – 2017 in China, the YLLs rate and DALYs rate of stroke increased gradually; the YLLs rate also increased generally but with a temporary decline in 2010. In 2017 in China, the age-specific YLDs, YLLs, and DALYs rate of stroke increased with the increment of age and the highest rates were observed among the population aged ≥ 70 years (2 617.2/100 000 for YLDs, 16 789.4/100 000 for YLLs, and 16 773.4/100 000 for DALYs); the YLDs rate was lower for the males than that for the females (475.5/100 000 vs. 530.9/100 000) but the YLLs and DALYs rate were higher for the males than those for the females (3 181.7/100 000 vs. 2 060.9/100 000 and 3 657.1/100 000 vs. 2 591.8/100 000); the age-standardized YLDs, YLLs, and DALYs rate of stroke were higher than those in the world (374.5/100 000 vs. 235.0/100 000, 1 967.8/100 000 vs. 1 422.2/100 000, and 2 342.3/100 000 vs. 1 657.2/100 000). Compared to those in 1990 in China, the age-standardized YLDs rate of stroke increased by 30.9%; while, the age-standardized YLLs rate and DALYs rate decreased by 38.8% and 33.1%; the change trend of the three rates were consistent with the changes in global stroke burden (5.9% for YLDs, = – 34.5% for YLLs, and – 30.7% for DALYs). Among the 16 risk factors associated with DALYs (million person-years), PAF, and DALYs rate of stroke, the top five were hypertension (24.974, 56.4%, and 1 768.1/100 000), excessive sodium intake (17. 060, 38.5%, and 1 207.8/100 000), insufficient fruit intake (10.717, 24.2%, and 758.7/100000), insufficient cereal intake (10.690, 24.1%, and 756.8/100 000), and smoking (10.037, 22.7%, and 710.6/100 000) for the population in China in 2017; from 1990 to 2017, PAF for the 10 of the 16 stroke risk factors increased and the other 6 decreased, with the highest increase (90.0%) for high body mass index and the greatest decrease ( – 71.3%) for indoor air pollution. Conclusion In China, the disability caused by stroke is increasing gradually and although being effectively controlled, stroke-related premature death is still the main contribution of disease burden. Primary prevention strategies should be promoted to alleviate the disease burden of stroke.

The global, regional, and national burden of pancreatitis in 195 countries and territories, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017

BackgroundPancreatitis is a critical public health problem, and the burden of pancreatitis is increasing. We report the rates and trends of the prevalence, incidence, and years lived with disability (YLDs) for pancreatitis at the global, regional, and national levels in 195 countries and territories from 1990 to 2017, stratified by sex, age, and sociodemographic index (SDI).MethodsData on pancreatitis were available from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. Numbers and age-standardized prevalence, incidence, and YLDs’ rates per 100,000 population were estimated through a systematic analysis of modeled data from the 2017 GBD study. Both acute and chronic pancreatitis are being modeled separately in the GBD 2017; however, our data show acute and chronic pancreatitis together. Estimates were reported with uncertainty intervals (UIs).ResultsGlobally, in 2017, the age-standardized rates were 76.2 (95% UIs 68.9 to 83.4), 20.6 (19.2 to 22.1), and 4.5 (2.3 to 7.6) per 100,000 population for the point prevalence, incidence, and YLDs, respectively. From 1990 to 2017, the percent changes in the age-standardized prevalence and YLDs rates increased, whereas the age-standardized incidence rate decreased. The global prevalence increased with age up to 60–64 years and 44–49 years in females and males, respectively, and then decreased, with no significant difference between females and males. The global prevalence rate increased with age, peaking in the 95+ age group, with no difference between sexes. Generally, positive correlation between age-standardized YLDs and SDIs at the regional and national levels was observed. Slovakia (297.7 [273.4 to 325.3]), Belgium (274.3 [242.6 to 306.5]), and Poland (266.7 [248.2 to 284.4]) had the highest age-standardized prevalence rates in 2017. Taiwan (Province of China) (104.2% [94.8 to 115.2%]), Maldives (72.4% [66.5 to 79.2%]), and Iceland (64.8% [57.2 to 72.9%]) had the largest increases in age-standardized prevalence rates from 1990 to 2017.ConclusionsPancreatitis is a major public health issue worldwide. The age-standardized prevalence and YLDs rates increased, but the age-standardized incidence rate decreased from 1990 to 2017. Improving the quality of pancreatitis health data in all regions and countries is strongly recommended for better monitoring the burden of pancreatitis.

Burden of Disease in Coastal Areas of South Korea: An Assessment Using Health Insurance Claim Data.

Background: While measuring and monitoring disease morbidity, it is essential to focus on regions experiencing inequitable health outcomes, especially coastal populations. However, no research investigating population health outcomes in coastal areas has been conducted. Therefore, we aimed to investigate the burden of disease morbidity in coastal areas of South Korea. Methods: Using an administrative division map and the ArcGIS, we identified and included 496 coastal districts. In this observational study, years lived with disability (YLDs) were estimated using incidence-based approaches to calculate the burden of disease in 2015. Incidence and prevalence cases were collected using National Health Insurance Service (NHIS) medical claim data using a specialized algorithm. Results: Age-standardized years lived with disability (ASYLDs) in the coastal areas were 24,398 per 100,000 population, which is greater than the 22,613 YLDs observed nationwide. In coastal areas, the burden of disease morbidity was higher in females than in males. Diabetes mellitus was the leading specific disease of total YLDs per 100,000 population, followed by low back pain, chronic obstructive pulmonary disease, osteoarthritis, and ischemic stroke. Conclusion: In this study, the coastal areas of South Korea carry a higher burden than the national population. Additionally, chronic diseases compose the majority of the health burden in coastal areas. Despite the limitation of data, YLD was the best tool available for evaluating the health outcomes in specific areas, and has the advantage of simplicity and timely analysis.

High and rising burden of hip and knee osteoarthritis in the Nordic region, 1990–2015

Background and purpose — Osteoarthritis (OA) imposes a substantial burden on individuals and societies. We report on the burden of knee and hip OA in the Nordic region.Patients and methods — We used the findings from the 2015 Global Burden of Diseases Study to explore prevalence, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) of OA in the 6 Nordic countries during 1990–2015 (population of about 27 million in 2015).Results — During 1990–2015, the number of prevalent OA cases increased by 43% to 1,507,587 (95% uncertainty interval [UI] 1,454,338–1,564,778) in the region. OA accounted for 1.3% (UI 1.0–1.7) of YLDs in 1990, increasing to 1.6% (UI 1.2–2.0) in 2015. Of 315 causes studied, OA was the 15th leading cause of YLDs, causing 52,661 (UI 34,056–77,499) YLDs in 2015; of these 23% were attributable to high body mass index. The highest relative importance of OA was reported for women aged 65–74 years (8th leading cause of YLDs in 2015). Among the top 30 leading causes of YLDs in the region, OA had the 5th greatest relative increase in total YLDs during 1990–2015. From 1990 to 2015, increase in age-standardized YLDs from OA in the region was slightly lower than increase at the global level (7.5% vs. 10.5%). OA was, however, responsible for a higher proportional burden of DALYs in the region compared with the global level.Interpretation — The OA burden is high and rising in the Nordic region. With population growth, aging, and the obesity epidemic, a substantial rise in the burden of OA is expected and should be addressed in health policies.

The disease burden of chronic obstructive pulmonary disease among people aged over 15 years in 1990 and 2010 in China

To analyze the disease burden of chronic obstructive pulmonary disease (COPD) among people aged over 15 years in 1990 and 2010 in China. The estimation of China data for the Global Burden of Disease Study 2010 (GBD 2010) was used to analyze the mortality and prevalence as well as the years of life lost due to premature mortality (YLL), years lived with disability (YLD) and disability-adjusted life years (DALY) of COPD in China in 1990 and 2010 for Chinese people aged 15 years and above. The death rate and DALY rate of COPD in China in 1990 and 2010 were compared. In 2010, 0.934 million people (0.534 million men and 0.400 million women) aged over 15 years died from COPD, decreased 34.5% (24.3% for men and 44.4% for women) compared with that in 1990 (1.425 million with 0.705 million men and 0.720 million women). There were 41.764 million COPD patients in 2010 (22.111 million men and 19.653 million women), increased 42.1% (41.7% for men and 42.6% for women) compared with 1990 (29.382 million patients with 15.599 million men and 13.783 million women). The mortality rate of COPD decreased for 61.5% from 2.352/100 000 in 1990 to 90.5/100 000 in 2010. The prevalence rate of COPD was 4.2% and 3.9% in 1990 and 2010, respectively. The DALY, YLL and YLD due to COPD was 16.598, 12.946, and 3.652 million person years, respectively in 2010. The YLD increased 42.3% compared with 1990 (2.567 million person years). From 1990 to 2010, the age-standardized DALY rate, YLL rate and YLD rate decreased from 4 120.1/100 000 to 1 575.9/100 000, from 3 756.9/100 000 to 1 235.6/100 000 and from 363.2/100 000 to 340.3/100 000, respectively. Although there was significant decrease of DALY due to COPD in 2010, compared to 1990, the YLD burden is still increasing.