Global Estimates Research Articles

Global birth prevalence of major congenital anomalies: a systematic review and meta-analysis

BackgroundThere is a lack of systematic review on the global prevalence of major congenital anomalies. We performed a systematic review and meta-analysis of population-based studies on global birth prevalence of eight major congenital anomalies (esophageal atresia, congenital diaphragmatic hernia, duodenal atresia, intestinal atresia, gastroschisis, omphalocele, Hirschsprung’s disease and anorectal malformation).MethodsPopulation-based studies reporting the birth prevalence of these anomalies were included from 1969 to 2024. Data from eligible studies were pooled in meta-analysis to get global estimates of birth prevalence and prevalence in subgroups of geographic regions, countries with varying income levels and time periods.ResultsOne hundred and twenty-three studies including a total of 256,507 cases of congenital anomalies and 769,455,220 births were included in this study. Overall birth prevalence of theses eight anomalies ranged from 0.86 to 3.11 cases per 10,000 births. Anorectal malformation had the highest birth prevalence among these anomalies with 3.11 cases (95% confidence intervals (CI): 2.77–3.50) per 10,000 births. Birth prevalence of congenital diaphragmatic hernia had a great decrease from 4.19 per 10,000 births in the 1960s to 1.30 per 10,000 births in the 2020s. Omphalocele had high prevalence in Africa and low-income countries.ConclusionThis systematic review summarizes birth prevalence of eight major congenital anomalies. The burdens of these anomalies had variations in the world. Information of this study could help with better understanding of epidemiology and etiology of these anomalies.

An organic matter database (OMD): consolidating global residue data from agriculture, fisheries, forestry and related industries

Abstract. Agricultural, fishery, forestry and agro-processing activities produce large quantities of residues, by-products and waste materials every year. Inappropriate disposal and inefficient use of these resources contribute to greenhouse gas emissions and non-point pollution, placing significant environmental and economic burdens on society. Since many nations do not keep statistics on these materials, it has not been possible to accurately quantify the amounts produced, their competing uses and the quantities potentially available for recycling at a local level. Therefore, the objectives of the present work were to provide (1) definitions, typologies and methods to aid consistent classification, estimation and reporting of the various residues and by-products, (2) a global organic matter database (OMD) of residues and by-products from agriculture, fisheries, forestry and related industries and (3) regional and global estimates of residues and by-products potentially available for use in a circular bio-economy. To the best of our knowledge, the OMD is the first of its kind to consolidate quantities and nutrient concentrations of residues and by-products globally from agriculture, fisheries, forestry and related industries (available at https://doi.org/10.5281/zenodo.10450921; Sileshi et al., 2024). The OMD will be updated continuously as new production data are published in FAOSTAT and country-specific conversion coefficients become available. This information is expected to contribute to evidence-based policies and actions in support of sustainable utilization and the transition towards a circular economy. The database could be used for a variety of purposes, including estimation of residue availability for soil amendment, livestock feed, bioenergy and other industrial applications as well as assessment of the environmental impacts of residue management practices such as soil application and burning. The estimates in the OMD are only available at the national level. Due to the lack of a uniform methodology, conversion coefficients and data on competing uses across countries, it was difficult to accurately estimate the quantities of all agricultural, fishery and forestry residues and by-products. Therefore, we strongly recommend investment in the inventory of agricultural, fishery and forestry residues as well as by-products and wastes at the national and sub-national levels for use in a circular bio-economy.

Suicides in Czech Republic, Slovakia, Hungary, and Poland in 1990–2019: Epidemiological patterns and trends in European and Global context

Background. Suicides are a major public health problem with serious consequences for societies. Aim. To compare epidemiological patterns and trends of suicides in the Czech Republic, Slovakia, Hungary, and Poland in 1990–2019, and analyze them in the European and Global context. Methods. A trend analysis was conducted in Czech Republic, Slovakia, Hungary, Poland, in Western Europe and on global level for 1990–2019. All data were obtained from the Global Burden of Diseases study 2019. Numbers and age-standardized rates of deaths and Years of Life Lost (YLL) due to suicides were analyzed, stratified by sex and age (0–14 years old, 15–49 years old, 50–69 years old, 70+ years). Results. In 2019, 759,028 suicides occurred globally, 17,408 (2.3%) in Central Europe. The proportion of males was substantially larger, compared to the global and Western European levels (E.g., 82 vs. 69% and 75%, respectively). The highest rates of suicide were in Hungary (19.7 per 100,000), lowest in Slovakia (12.8); the rate in Central Europe was higher than the global rate (15.2 vs. 9.8), and the rate in Western Europe (11.4). A steady decline of rates was observed in all countries, particularly in Hungary. In Czech Republic we found an increasing relative importance of suicides among people 70 years and older. Conclusions. Death rates due to suicides have been declining in the analyzed countries, but some characteristics and trends when compared to global and regional estimates, such as substantially higher proportion of male suicides or high death rates among the elderly warrant specifically tailored preventative action coordinated by governments with community involvement.

Advancements and opportunities to improve bottom–up estimates of global wetland methane emissions

Abstract Wetlands are the single largest natural source of atmospheric methane (CH4), contributing approximately 30% of total surface CH4 emissions, and they have been identified as the largest source of uncertainty in the global CH4 budget based on the most recent Global Carbon Project CH4 report. High uncertainties in the bottom–up estimates of wetland CH4 emissions pose significant challenges for accurately understanding their spatiotemporal variations, and for the scientific community to monitor wetland CH4 emissions from space. In fact, there are large disagreements between bottom–up estimates versus top–down estimates inferred from inversion of atmospheric CH4 concentrations. To address these critical gaps, we review recent development, validation, and applications of bottom–up estimates of global wetland CH4 emissions, as well as how they are used in top–down inversions. These bottom–up estimates, using (1) empirical biogeochemical modeling (e.g. WetCHARTs: 125–208 TgCH4 yr−1); (2) process-based biogeochemical modeling (e.g. WETCHIMP: 190 ± 39 TgCH4 yr−1); and (3) data-driven machine learning approach (e.g. UpCH4: 146 ± 43 TgCH4 yr−1). Bottom–up estimates are subject to significant uncertainties (∼80 Tg CH4 yr−1), and the ranges of different estimates do not overlap, further amplifying the overall uncertainty when combining multiple data products. These substantial uncertainties highlight gaps in our understanding of wetland CH4 biogeochemistry and wetland inundation dynamics. Major tropical and arctic wetland complexes are regional hotspots of CH4 emissions. However, the scarcity of satellite data over the tropics and northern high latitudes offer limited information for top–down inversions to improve bottom–up estimates. Recent advances in surface measurements of CH4 fluxes (e.g. FLUXNET-CH4) across a wide range of ecosystems including bogs, fens, marshes, and forest swamps provide an unprecedented opportunity to improve existing bottom–up estimates of wetland CH4 estimates. We suggest that continuous long-term surface measurements at representative wetlands, high fidelity wetland mapping, combined with an appropriate modeling framework, will be needed to significantly improve global estimates of wetland CH4 emissions. There is also a pressing unmet need for fine-resolution and high-precision satellite CH4 observations directed at wetlands.

Development of Energy Demand Profile Based on Non-Historical and Non-Energy Variables: A Headquarters’ Offices Case Study

Under the Positive Energy Districts framework, cities authorities must be informed of the energy demand of districts to design tailor-made policies and strategies to promote the deployment of energy efficiency, sharing and transition actions. However, the diverse data sources and long procedures to collect data because of privacy permissions may result in a slow-down of the development of these roadmaps. To overcome these challenges, this paper is the outcome of the methodology developed under the UP2030 Project designed to estimate the energy demand and energy profile consumptions within urban areas to contribute to the stakeholders involved in decision making processes to inform them about the savings potential related with the use of energy in geographically delimitated areas. The methodology was validated in CIRCE’s headquarters, where the yearly energy estimation consumption is about 98% of the real energy consumed. The main finding of this study is obtaining a model that can estimate the energy usage for occupants’ comfort with minimal data required from the citizens’ side, which will allow stakeholders to consider global energy estimations at the district level in a fast and reliable way to design strategies in a timely manner as required by the energy transition and efficiency standards proposed by the European Union.

The global, regional, and national burden of oral cancer, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

PurposeThis epidemiological study leverages data from the Global Burden of Disease (GBD) database spanning from 1990 to 2021 to analyze the global burden of oral cancer. The research aims to provide a comprehensive assessment of the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASDR), and disability-adjusted life years (DALYs) for oral cancer, examining trends over three decades.MethodsThe study used age standardized rate (ASRs) as an indicator of oral cancer epidemiological data. Trend analysis uses estimated annual percentage change (EAPC) to track changes in oral cancer indicators.ResultsThe study identifies a global increase in oral cancer incidence, mortality, and DALYs. From 1990 to 2021, the global incidence rate increased significantly from 3.26 (95% UI 3.14–3.41) to 5.34 (95% UI 4.94–5.70), the global mortality rate rose from 1.83 (95% UI 1.73–1.92) to 2.64 (95% UI 2.42–2.84), and the global estimate of DALYs increased from 55.05 (95% UI 52.38–57.97) to 74.44 (95% UI 67.50–80.44). High-risk regions include Palau and certain areas in Asia. Middle SDI regions show the most significant growth, while economically underdeveloped areas like parts of Africa show less significant trends.ConclusionThe research underscores the need for heightened awareness, surveillance, and prevention efforts, especially in regions with high oral cancer incidence. Policymakers are urged to implement screening programs and public health education to combat the disease.

Incompressible limit for the compressible viscoelastic fluids in critical space

Abstract In this article, we consider the incompressible limit of global-in-time strong solutions with arbitrary large initial velocity for the compressible viscoelastic fluids in the sense of critical Besov framework. We decouple our compressible system into two coupling sub-systems by introducing a skew symmetric matrix, which is related to the deformation tensor. This work generalizes the similar result obtained by Hu et al. (Incompressible limit for compressible viscoelastic flows with large velocity, Advances in Nonlinear Analysis 12 (2023), 20220324) to the critical functional space with respective to the natural scaling of the system. The proof relies on the dispersive property of the linear system on the high-frequency regime and the parabolic property on the low-frequency regime. The dispersion tends to disappear when λ \lambda tends to infinite, but having large λ \lambda provides strong dissipation on the potential part of the velocity and thus makes the flow almost incompressible. In addition, by exploiting the intrinsic structure of the viscoelastic system, we obtain the global uniform estimates of the solutions near equilibrium.

A pilot protocol for surveillance of infection and antibiotic prescribing in primary healthcare across the globe: Antibiotic Prescribing in Primary Healthcare Point Prevalence Survey (APC-PPS)

Little data is available from the primary healthcare setting in low- and middle-income countries to describe the burden of clinical infections and antibiotic prescribing proportions for those infections. The AWaRe Antibiotic Book provides a framework for assessing antibiotic prescribing in primary healthcare but requires understanding both frequency of clinical infections and their antibiotic prescribing proportions. The Antibiotic Prescribing in Primary Healthcare Point Prevalence Survey (APC-PPS) project is a series of point prevalence surveys conducted at primary healthcare facilities in LMICs to capture the frequency of consultation for different clinical infections and diagnoses and the frequency and type of antibiotic prescribing associated with these infections in primary healthcare facilities. This study aims to assess the feasibility of using a PPS methodology to collect data on clinical presentation and antibiotic prescribing in primary healthcare settings. The data collected are necessary to be able to summarise relative rates of presentation of different clinical infections and antibiotic prescribing practices to inform global estimates of antibiotic use and inform the development of surveillance methods and representative sampling frames. Each site will conduct 6-8 point prevalence surveys over the course of 12 months. Completely anonymous data on age, sex, relevant comorbidities, infection symptoms and diagnoses and antibiotic prescription are collected for patients of all ages with acute infection symptoms (up to 14 days of symptoms) who present to the facility on the day of the survey. No identifiable data will be collected from individuals. Data is collected via ODK Collect and stored in a secure ODK Cloud server hosted by City St. George’s, University of London. Sites will be active between early 2023- end 2024, with regular interim data analysis scheduled and final data analysis planned by mid 2025. All required local and national ethical and regulatory approvals will be obtained prior to sites starting.

Evolving landscape of colorectal cancer: Global and regional burden, risk factor dynamics, and future scenarios (the Global Burden of Disease 1990-2050).

Presently, colorectal cancer (CRC) is the second leading cause of cancer-related deaths worldwide. We provided global, regional, and national estimates of the burden of CRC and their attributable risks from 1990 to 2021, aiming to guide screening, early detection, and treatment strategies, optimize healthcare resource allocation, and facilitate the rational management of burden of CRC. Using data derived from the Global Burden of Disease database, we estimated the incidence, mortality, and disability-adjusted life years (DALYs) of CRC. The temporal trends of the age-standardized rate of CRC were quantified by calculating the estimated annual percentage changes (EAPC). Deaths from CRC attributable to each risk factor that had evidence of causation with CRC were estimated. CRC's deaths and DALYs was forecast through 2050 by logistic regression with Socio-Demographic Index as a predictor, then multiplying by projected population estimates. Globally, between 1990 and 2021, the incident cases, death cases, and DALYs attributed to CRC have doubled, the age-standardized incidence rate (ASIR) presented a slightly upward tendency, while the age-standardized death rate (ASMR) and the age-standardized DALYs rate (ASDR) exhibited a decreasing trend. From 1990-2021, the ASIR for males has an increased trend, while females presented a downward trend. The ASIR and ASDR of CRC were higher in high and high-middle sociodemographic index (SDI) countries. The ASIR of CRC in 165 countries and territories showed escalating trend. Globally, for males and both sexes combined, diet low in whole grains was the leading risk factor for age-standardized deaths from CRC in 2021. However, among females, diet low in milk was the leading risk factor. We forecast that 2.18 million (1.53-2.94) individuals will death for CRC worldwide by 2050, and the DALYs achieve 41.7 million (29.9-55.4) by 2050. The doubling of incidence counts and mortality cases and the rising ASIR in most countries indicates a significant burden of CRC. Authorities should devise suitable measures to address the increasing burdens, such as optimizing screening programs, enhancing awareness and screening efforts for males, and reducing exposure to modifiable risk factors.

Global estimates of the storage and transit time of water through vegetation

Global estimates of the storage and transit time of water through vegetation

Global estimates of prevalence of chronic painful neuropathy among patients with chemotherapy-induced peripheral neuropathy: systematic review and meta-analysis of data from 28 countries, 2000–24

IntroductionAlthough the prevalence of chemotherapy-induced peripheral neuropathy (CIPN) has been reported, the proportion of patients with CIPN who report chronic painful neuropathy remains poorly understood, despite its significant impact on...

Retraction-Country, regional, and global estimates for lactose malabsorption in adults: a systematic review and meta-analysis.

Retraction-Country, regional, and global estimates for lactose malabsorption in adults: a systematic review and meta-analysis.

Pooled prevalence and subgroup variations of Tetralogy of Fallot among children and adolescents with congenital heart defect in Sub-Saharan Africa: A systematic review and meta-analysis.

Tetralogy of Fallot is one of the critical congenital heart defects needing intervention within the first year of life. This review aims to systematically assess the prevalence of Tetralogy of Fallot among children and adolescents with congenital heart defects in Sub-Saharan Africa from January 2000 to January 2024. All original observational studies focused on children and adolescent population diagnosed with congenital heart defects within Sub-Saharan Africa; reported the primary outcome of interest were included. Prisma guidelines were utilized to perform this systematic review and meta-analysis. Electronic databases including Medline (PubMed), Scopus, Google Scholar, and African Index Medicus were searched. A weighted inverse variance random-effects model was employed to estimate the pooled prevalence of Tetralogy of Fallot. Thirty-one studies included encompassing a total of 11,265 participants from 15 Sub-Saharan African countries with representation from Southern (4 studies, 619 participants), Central (5 studies, 2,220 participants), Eastern (11 studies, 3,384 participants), and Western (11 studies, 5,042 participants). Cross-sectional studies comprised (25 studies, 8,909 participants), and cohort design (6 studies, 2,356 participants). The analysis revealed a pooled prevalence of 10% (95% CI: 9%; 12%) with I2 (77%, p-value < 0.01). The subgroup analysis based on geographic regions revealed statistically significant difference. The prevalence of Tetralogy of Fallot observed was found considerably higher compared to global estimate and reports of developed countries. In a subgroup analysis based on the geographic region, a surprisingly high prevalence was reported across all regions of Sub-Saharan Africa. The substantial disparities and high prevalence observed underscores the complex interplay of factors influencing occurrence of Tetralogy of Fallot. Identifying the true scope of Tetralogy of Fallot burden may help policymakers and healthcare providers to prioritize interventions, optimize resource allocation, and potentially improve its outcomes in Sub-Saharan Africa.

Development and Validation of a Global Thin Ice Thickness Algorithm for SMMR

Abstract Thin ice thickness algorithms using satellite passive microwave radiometers are frequently used to quantify sea ice production in coastal polynyas. The objective of this paper is to develop and validate a thin ice thickness algorithm using only low-frequency (LF) data (19- and 37-GHz channels), applicable back to 1978 when the Scanning Multichannel Microwave Radiometer (SMMR) observations started. We compared several recent satellite observations for 22 cases of typical polynya events in the Southern Ocean and developed a new method to discriminate three types of thin ice (active frazil, thin solid ice, and a mixture of the two) using only LF data. Combined with ice-type discrimination, the obtained LF ice thickness (20 cm or less) has a bias of less than 1 cm and an RMSD of about 5 cm, as shown by validation data from 24 cases of typical polynya events that occurred prior to 1992 in the Southern Ocean and the Bering Sea. Although the error in ice-type discrimination with LF data is relatively large in comparison with previous studies, these results still suggest that the LF ice thickness could be a continuous global data since 1978. We also developed a false thin ice detection algorithm using only LF data and created daily false thin ice masks from 1978 to the present, which are also essential for estimating global sea ice production. The use of our new LF algorithm will allow quantification of the global sea ice production over nearly half a century since 1978. Significance Statement Sea ice production is a key element for dense water formation and thus deep/intermediate overturning circulation. Global estimation of sea ice production will be achieved through a heat budget analysis incorporating a thin ice thickness algorithm of satellite passive microwave radiometers. The previous algorithms use high-frequency channel data that only became available after 1992. In this study, we have developed an algorithm of ice type and thin ice thickness using only low-frequency channels (19 and 37 GHz) data, which allows us to obtain the thin ice thickness distribution on a global scale from 1978 to the present. This will further lead to a unified global estimate of sea ice production over a time scale of nearly half a century.

Causes of death among older children and adolescents (5–19 years) in the Magu Health and Demographic Surveillance Study, Tanzania, 1995–2022

ABSTRACT Background Population data on mortality and causes of death among 5–19-year-olds are limited. Objectives To assess levels, trends, and risk factors of cause-specific mortality and place at death among 5–19-year-olds in Tanzania (1995–2022). Methods Using longitudinal data from the Magu Health and Demographic Surveillance System in northwest Tanzania, we identified leading causes of death among 5–19-year-olds from verbal autopsy interviews, using physician review and a Bayesian probabilistic model (InSilicoVA). We analyzed trends in cause and place of death using three periods: 1995–2004, 2005–2014 and 2015–2022, and assessed risk factors in a Cox-proportional hazards model. We compared the results with children aged 1–4 years and global estimates for Tanzania. Results Between 1995 and 2022, communicable disease mortality decreased by 73%, similar to the 76% decline among 1–4-year-olds. This decline in communicable disease mortality drove all-cause mortality declines of 43% and 48% among 5–14- and 15–19-year-olds, respectively. Non-communicable diseases and injuries gained importance, with their relative share of all deaths increasing from 15% in 1995–2004 to 58% in 2015–2022. Mortality risks were significantly higher among boys (particularly for injuries), those residing in rural areas (for non-communicable diseases), and those from the poorest households (for communicable diseases). By 2015–2022, 48% of 5–14 and 42% of 15–19-year-olds died in health facilities, up from 25% in 1995–2002. Conclusions Since 1995, the decline in communicable disease mortality drove a major all-cause mortality reduction among 5–19-year-olds. Further progress will depend on continued reduction in communicable disease mortality, particularly among the poorest, and effectively addressing non-communicable and injury mortality.

Global Impact of Antibiotic Resistance

Antibiotic resistance (AMR) is a growing global health crisis that poses a significant threat to public health, economies, and healthcare systems worldwide. The emergence of resistant bacteria, fungi, and viruses has been driven by the overuse and misuse of antibiotics in human medicine, agriculture, and animal farming. AMR reduces the effectiveness of treatment options, leading to longer hospital stays, increased medical costs, and higher mortality rates. Furthermore, infections caused by resistant pathogens are becoming harder to treat, complicating efforts to combat common diseases such as pneumonia, tuberculosis, and urinary tract infections. The global impact of antibiotic resistance is not limited to individual countries; it is a cross-border issue that requires international cooperation and a multifaceted approach, involving surveillance, regulation, and public awareness campaigns. Low- and middle-income countries, where access to antibiotics is often unregulated, face the highest risks. In addition to human health, the economic toll of AMR is severe, with global estimates suggesting that antibiotic resistance could lead to a reduction in global GDP by up to 3.5% by 2050. Combating AMR requires urgent action from governments, healthcare providers, pharmaceutical companies, and the public to implement better stewardship practices, invest in research and development of new antibiotics, and adopt preventative measures. A united global response is essential to mitigate the long-term consequences of this silent pandemic.

Clinicodemographic Profile of Adult Patients With Chronic Urticaria in an Allergy Specialty Clinic

Background: There is variability among the prevalence and characteristics of chronic urticaria. Objectives: This study aimed to determine clinicodemographic characteristics of adult patients diagnosed with chronic urticaria in an allergy clinic in Metro Manila, Philippines, from 2019 to 2023. Methodology: A cross-sectional review of medical records from patients aged 19 and above at an allergy clinic in Metro Manila was conducted from 2019 to 2023. Clinicodemographic features, along with their frequencies and percentages, were obtained. Results: Seventy-five patients with chronic urticaria were investigated. The majority were women (72%) aged 30 to 39 (30.7%) from the National Capital Region (85.3%). Most were married (36%), college graduates (30.7%), and employed (54.7%), with 62.7% seeking their initial consultation 2 to 12 months after the onset of the disease. Fifty-seven percent of patients had a personal history of atopy and 54.7% had a family history of atopy. Thirty-seven percent of patients had comorbidities, with hypertension as the most frequent (18.7%). Thirty-three percent of patients were suspected with chronic inducible urticaria with dermographism as the most common suspected trigger (21.3%). Fifty-eight percent of patients had urticaria before COVID-19 vaccination, while 42% had a previous history of COVID-19 vaccine before the onset of symptoms. However, no further tests were done to confirm its association with the disease. Fifteen patients underwent skin prick tests, and all demonstrated positive skin test reactivity to some form of aeroallergen or food allergens. All patients were given second-generation H1-antihistamine at varying doses. The majority of patients (65.3%) reported an improvement in symptoms. Only 26.7% of patients used the 7-day Urticaria Activity Score, while 29.3% used the Urticaria Control Test to monitor their symptoms. Conclusion: The prevalence of chronic urticaria (13%) was higher than the global estimate of 1%. Most chronic urticaria patients were female, aged 30 to 39, married, college graduates, and employed who showed symptoms within 2 to 12 months after the onset of the disease. Approximately 50% of them had a personal and family history of atopy. Most patients do not have comorbidities and suspected inducible triggers. All patients who underwent skin prick tests showed reactivity to some allergens (aeroallergens, food allergens). All patients were given second-generation H1-antihistamines at varying doses. Many patients experienced symptom improvement with the prescribed medications despite poor compliance with the recommended monitoring tools. According to clinical history, the onset of chronic urticaria was not attributed to COVID-19 vaccination in most cases.

Research Among People Living With Dementia or Mild Cognitive Impairment in Physiotherapy Journals: A Scoping Review.

Global estimates forecast an increase in the number of people living with dementia (PLWD) or mild cognitive impairment (MCI). Physiotherapists play an important role in the delivery of care to PLWD or MCI; however, physiotherapists report less confidence when working with PLWD or MCI, citing limited educational opportunities. Our scoping review sought to quantify and assess the type of research published in physiotherapy journals related to these groups of people. Fifteen journals were selected based on global physiotherapy representation, indexing, and online accessibility of archives. Extraction of all articles published within a decade (2011-2021) for the selected journals was completed. Inclusion criteria: (1) research reports, reviews, case studies, or expert opinion pieces related to PLWD or MCI and (2) published in English. Each article was categorized by type of article, clinical setting, type of dementia, physiotherapy focus, and Sackett's system of hierarchy of evidence. An analysis of trends over time and a bibliometric assessment of research impact were performed. Of 11091 articles identified, 67 were included. The most common country of origin was the United States (38.8%). Articles were mainly research reports (70.1%), from a community-dwelling setting (50.8%), with a combined physiotherapy focus (28.4%), and a level IV (37.3%) of hierarchy of evidence. Close to half of studies did not identify the underlying dementia type (43.3%, n =29), followed by people living with Alzheimer's dementia (28.4%, n =19), combined groups of PLWD or MCI (20.9%, n =14), and individuals with only MCI (7.5%, n =5). Six articles on average related to PLWD or MCI were published annually (32.7 citation per article), and no growing trend was observed. Few articles published in prominent physiotherapy journals over the last decade were related to PLWD or MCI. Publication trends remained unchanged, and publication origins were from the Americas which impacts generalizability. Physiotherapists should attain complementary information on care for PLWD or MCI through more general rehabilitation journals. Physiotherapy journals should seek to promote research related to PLWD or MCI through different avenues (eg, special issues) as increased information is needed for clinicians to feel confident in providing informed care.

Increased mortality from alcohol use disorder, alcohol-associated liver disease, and liver cancer from alcohol among older adults in the United States: 2000 to 2021.

To investigate the trends in alcohol-associated liver disease (ALD), liver cancer from alcohol, and alcohol use disorder (AUD) burden among older adults in the United States (US). We gathered the ALD, liver cancer from alcohol, and AUD prevalence, mortality, and age-standardized rates (ASRs) from the Global Burden of Disease (GBD) Study 2021 between 2010 and 2021. We estimated the annual percent change (APC) with confidence intervals (CIs) for the burden of ALD, liver cancer from alcohol, and AUD in older adults (>70 years) in the United States. The findings were contrasted with global estimates and categorized by sex and state. In 2021, there were approximately 512,340 cases of AUD, 56,990 cases of ALD, and 4490 cases of primary liver cancer from alcohol among older adults in the United States. In contrast to declining ASRs of prevalence and mortality in the global burden, these parameters were increased in older adults in the United States. From 2000 to 2021, prevalence from AUD (APC: 0.54%, 95% CI 0.43% to 0.65%), ALD (APC + 0.54%, 95% CI 0.22% to 0.86%), and primary liver cancer from alcohol (APC 2.93%, 95% CI 2.76% to 3.11%) increased. Forty states in the United States exhibited a rise in the prevalence rates of ALD in older adults. Our findings highlighted the increased prevalence and mortality of AUD, ALD, and primary liver cancer from alcohol among older adults in the United Sates, contrasting with the decline in global trends. Public health strategies on ALD, AUD, and primary liver cancer from alcohol, which targets older adults, are urgently needed.

Dementia and Cognitive Impairment in an Urban Multiethnic Indigenous Community from Amazonas

Introduction: Studies about dementia in Indigenous communities are still scarce worldwide, especially in low-middle-income countries, limiting timely intervention in minority groups. Our research aimed to bridge this gap by determining the prevalence of dementia and mild cognitive impairment no dementia (CIND), and the associated factors, in a multiethnic Indigenous community in Manaus, Brazil. Methods: A cross-sectional observational study evaluated the cognitive and functional performances of 141 Indigenous individuals (aged 50 and above). A panel of dementia neurologist experts independently analyzed cognitive (Mini-Mental State Exam [MMSE], Brief Cognitive Screening Battery, verbal fluency), functional (Pfeffer questionnaire) performances, and depression symptoms (Geriatric Depression Scale) to classify participants as cognitively unimpaired, CIND, and dementia. Results: CIND rate was 11.3% and 12.8% for dementia. None of the participants classified as CIND had a prior diagnosis, and only three out of 18 participants with dementia had a diagnosis. Stratified analysis showed that age (p = 0.017) and lower education (p = 0.047) were associated with higher CIND and dementia. However, only age was significantly associated with dementia in the regression models (OR = 1.078; 95% CI: 1.011–1.149). Sex, living in extreme poverty, hypertension, diabetes, smoking, or excessive alcohol use was not linked to CIND or dementia. Conclusion: The Indigenous community of Manaus exhibited higher rates of dementia and CIND than national and global estimates. These findings may set the stage for additional research into the interplay of social, economic, biological, and behavioral factors affecting dementia risk in underrepresented groups such as Indigenous communities.