Division of Neurology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON.
Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.
Eur J Neurol. 2019 Oct;26(10):1252-1265. doi: 10.1111/ene.13972. Epub 2019 May 31.
The Eastern Mediterranean Region (EMR) is experiencing a demographic shift towards rapid aging at a time of political unrest. We aimed to estimate the burden of neurodegenerative disorders and its relationship with sociodemographic index in the EMR countries from 1990 to 2016.
Using data from the Global Burden of Disease Study 2016, we calculated country-specific trends for prevalence, mortality, disability-adjusted life-years (DALY), years of life lost and years lived with disability (YLD) for Alzheimer's disease/other dementias and Parkinson's disease in the EMR during 1990-2016.
In the EMR, the age-standardized prevalence rate of Alzheimer's disease/other dementias and Parkinson's disease was estimated at 759.8/100 000 (95% uncertainty intervals, 642.9-899.9) and 87.1/100 000 (95% uncertainty intervals, 69.8-108.2) people in 2016, demonstrating 0.01% and 42.3% change from 1990, respectively. Neurodegenerative disorders contributed to 5.4% of total DALY and 4.6% of total YLD among the older EMR population (70 years of age or older in 2016). Age-standardized DALY due to Parkinson's disease were strongly correlated with the sociodemographic index level (r = 0.823, P < 0.001). The YLD:DALY ratio of neurodegenerative diseases declined during this period in the low-income but not the high-income EMR countries.
Our findings demonstrated an increasing trend in the burden of dementias and Parkinson's disease in most EMR countries between 1990 and 2016. With aging of the EMR populations, countries should target the modifiable risk factors of neurodegenerative diseases to control their increasing burden.
东地中海区域(EMR)正经历人口结构向快速老龄化转变,同时也面临着政治动荡。我们旨在评估 1990 年至 2016 年 EMR 国家神经退行性疾病的负担及其与社会人口指数的关系。
使用 2016 年全球疾病负担研究的数据,我们计算了 EMR 国家在 1990-2016 年期间阿尔茨海默病/其他痴呆症和帕金森病的患病率、死亡率、残疾调整生命年(DALY)、寿命损失年和残疾生活年(YLD)的特定国家趋势。
在 EMR,阿尔茨海默病/其他痴呆症和帕金森病的年龄标准化患病率估计值在 2016 年分别为 759.8/100000(95%不确定性区间为 642.9-899.9)和 87.1/100000(95%不确定性区间为 69.8-108.2),与 1990 年相比分别变化了 0.01%和 42.3%。在老年 EMR 人群(2016 年 70 岁及以上)中,神经退行性疾病占总 DALY 的 5.4%,占总 YLD 的 4.6%。帕金森病导致的年龄标准化 DALY 与社会人口指数水平呈高度相关(r=0.823,P<0.001)。在此期间,在低收入 EMR 国家而不是高收入 EMR 国家,神经退行性疾病的 YLD:DALY 比值下降。
我们的研究结果表明,1990 年至 2016 年期间,EMR 大多数国家的痴呆症和帕金森病负担呈上升趋势。随着 EMR 人口老龄化,各国应针对神经退行性疾病的可改变风险因素进行干预,以控制其不断增加的负担。