Global, regional, and national burden of ischemic stroke in older adults (≥60 years) from 1990 to 2021 and projections to 2030
Shuting Hua, Zexian Dong, Hui Wang, Tong Liu
Abstract
Background: Ischemic stroke is a leading cause of disability and mortality among adults worldwide, particularly in the older population (≥60 years). With the accelerating global aging population, it is crucial to analyze the trends and influencing factors of the global, regional, and national burden of ischemic stroke and forecast future trends. These insights are essential for informing the formulation of public health policies. Methods: Using data from the Global Burden of Disease (GBD) 2021 database, this study examined the age-standardized incidence, age-standardized prevalence, age-standardized mortality, and age-standardized disability-adjusted life years (DALYs) of ischemic stroke in individuals aged 60 years and above from 1990 to 2021. A combination of variables, including the socio-demographic index (SDI), sex, and age groups, was applied in regression analyses and Bayesian predictive models to examine trends and forecast the burden of ischemic stroke up to 2030. Results: From 1990 to 2021, despite global population growth among older adults, the age-standardized incidence, age-standardized prevalence, age-standardized mortality, and age-standardized disability-adjusted life years of ischemic stroke demonstrated an overall declining trend (all EAPCs were negative). The decline in disease burden was most pronounced in high-SDI regions, while low-SDI regions faced a significantly higher disease burden and exhibited notable regional disparities. The overall burden of ischemic stroke was higher in males than in females; however, in the 80-84 age group, females exceeded males in disease burden. Projections indicate that by 2030, the burden of ischemic stroke in older adults globally will continue to decline. Nevertheless, due to the aging population, the absolute number of patients is expected to increase. Conclusion: The global burden of ischemic stroke has significantly decreased, particularly in high-SDI regions with abundant healthcare resources. However, low-SDI regions face more substantial public health challenges. It is recommended to enhance the control of high-risk factors such as hypertension, smoking, and high BMI, and to optimize healthcare services in low-income regions to further reduce the burden of ischemic stroke and improve the quality of life for older adults.