Neuroepidemiology最新文献

Background: Childhood idiopathic epilepsy poses a major public health issue in Asia. This study aimed to characterize the burden of idiopathic epilepsy among children aged 0-14 years across Asia between 1990 and 2021, using data from the Global Burden of Disease (GBD) Study 2021.

Methods: Data on the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for children idiopathic epilepsy in Asia were extracted from the GBD 2021. The analyses involved evaluating trends by calculating age-standardized rates (ASRs) and the estimated annual percentage change (EAPC). Stratification was conducted by region, sex, age, and Socio-demographic Index (SDI). Temporal trends were assessed using joinpoint regression analysis, which calculated the average annual percentage change (AAPC). Future trends through 2035 were projected with an Autoregressive Integrated Moving Average (ARIMA) model.

Results: From 1990 to 2021, the age-standardized incidence rate (ASIR) exhibited a slight upward trend (EAPC = 0.17, 95% CI: 0.10 to 0.25). In contrast, significant declines were observed in the age-standardized prevalence rate (ASPR; EAPC = -0.16, 95% CI: -0.25 to -0.07), mortality rate (ASMR; EAPC = -1.81, 95% CI: -1.93 to -1.69), and DALY rate (ASDR; EAPC = -1.32, 95% CI: -1.40 to -1.24). All four metrics were consistently higher in males than females across all age groups. The age group <5 years carried the highest burden for incidence, mortality, and DALYs, while prevalence was highest in the 10-14 years age group. Projections to 2035 indicate a continuing upward trend in incidence and prevalence but a decline in mortality.

Conclusion: Despite overall ASPR, ASMR, ASDR declines, slight ASIR rise as well as regional, age, and sex disparities highlights that childhood idiopathic epilepsy remains a persistent health issue in Asia. Future public health efforts should prioritize strengthening healthcare system development and enhancing enhanced early intervention, particularly in resource - limited regions.

Introduction: Considering the globally growing population and the rising incidence of dementia, it is important to understand the proportion of dementia cases affected by vascular brain disease. We aimed to study the incidence of vascular dementia (VD) and other dementias in a defined population in Finland to better understand VD's contribution to the total incidence of dementias and to assess the sensitivity of their diagnostics.

Methods: We aimed to collect all dementia diagnoses made in Northern Savo, Finland, in 2020. The memory disorder diagnoses were identified using the International Classification Codes 10th Revision (ICD-10) diagnosis codes. Finally, we studied the diagnoses in relation to demographic data, focusing on VD.

Results: The total number of new diagnoses of dementia with a vascular component or vascular alone was 202, with 20 cases attributable to pure VD. The annual incidence of dementias with a vascular component in Northern Savo was 81.4 per 100,000 across the population and 310.8 per 100,000 in the age group of ≥65. In our study population, 23.8% of all incident dementia cases were associated with vascular disease.

Conclusion: According to our findings, dementia associated with vascular pathology has the second highest incidence after Alzheimer's disease, while pure VD is rarely diagnosed. Our findings align with previous international studies and a recent national registry study. Future studies with a prospective study setting, potentially incorporating extensive neuroimaging, would be critical in further understanding the epidemiology of VD.

Introduction: People with epilepsy present an excess risk of mortality, but questions remain regarding the underlying causes and risk distribution. Here, we estimated the excess mortality by age and sex among adults and adolescents with epilepsy in France and identified their main causes.

Methods: A national cohort study was conducted between 2009 and 2019, with adults and adolescents aged between 12 and 60 years and having at least one hospitalization, assurance record, or delivery of anti-seizure medication linked to epilepsy on the French National Health Data System (SNDS). Mortality rates and standardized mortality ratios (SMR) were estimated according to age and sex. Specific causes of death from death certificates were also explored.

Results: Between 2009 and 2019, 619,753 patients were included, of whom 60,033 (9.7%) died during follow-up, corresponding to a mortality rate of 9.55 [9.30; 9.79] per 1,000 person-years. Compared with the general population, people with epilepsy had a 3.33-fold higher risk of death [3.24; 3.41], with a higher risk in women than in men, with SMRs of 4.11 [3.94; 4.29] and 2.99 [2.90; 3.09], respectively. Excess mortality was found for all causes of death, particularly neurological causes. Women with epilepsy presented a higher excess risk of death than men, especially between 20 and 40 years old.

Conclusion: Our findings provide further evidence of increased mortality in patients with epilepsy. Remarkably, we found major differences according to sex, which have been largely overlooked so far. The fact that young women with epilepsy are at risk poses additional clinical and societal challenges.

Introduction: Epilepsy is one of the most common neurological conditions worldwide, with large variation in prevalence across sub-Saharan African countries. Northern Uganda is one of the poorest areas of the country and has seen a high density of pigs and a prevalence of Taenia solium, a zoonotic tapeworm transmitted which causes neurocysticercosis in humans. The objective of this study was to estimate the population-level prevalence of active epilepsy in 25 sub-counties of northern Uganda.

Methods: This cross-sectional study was conducted in 2010-2011 in 25 sub-counties of Moyo, Adjumani, and Gulu districts, northern Uganda. Participants were sampled using a multistage cluster sampling strategy including sub-counties, parishes, villages, and households as sampling levels. Eligible individuals were interviewed using a previously validated screening questionnaire for epilepsy. Screen positive individuals were further examined by a team of neurologists for confirmation of active epilepsy. Sampling weights and post-stratification to account for sex distribution in each of the 25 sub-counties sampled based on projected 2010 population sizes were applied.

Results: A total of 38,303 individuals were sampled across 299 villages from 25 sub-counties. The overall weighted and post-stratified prevalence estimate of active epilepsy was 3.7% (95% confidence interval [CI]: 3.4%-3.9%). However, there was large variation across sex (4.6% (95% CI: 4.2%-5.0%) in men and 2.7% (95% CI: 2.4%-3.0%) in women) and across sub-counties ranging from 1.7% in Pece Division (Gulu District) and Moyo Town Council (Moyo District) to 6.6% in Awach (Gulu District). People aged between 10 and 19 were the most affected.

Conclusions: In northern Uganda, active epilepsy was very prevalent but varied largely across sub-counties. Males were a lot more affected than women, making the use of weighted and post-stratified methods to estimate the prevalence of epilepsy essential. Implementing programs and interventions targeting the control of local risk factors of epilepsy such as neurocysticercosis and improving population health care access could help reduce the rather high prevalence of epilepsy in this area of the country.

Introduction: Migraine and other types of primary headache are widely prevalent and are thought to have substantial economic implications on a global scale. Nevertheless, the precise prevalence rates in China exhibited discrepancies across various studies. The present study aimed to ascertain the prevalence of migraine and other primary headache disorders in China.

Methods: A systematic search of peer-reviewed literature was conducted in the Chinese Wanfang, CNKI, PubMed, and MEDLINE databases from January 1988 to December 2023 to identify prevalence data on migraine and other primary headache disorders among the Chinese population, published in either English or Chinese language. The study utilized a random-effects model to summarize pooled prevalence estimates, with subgroup analyses conducted based on sex, age, publication year, and geographical region.

Results: A total of 18 studies were included for detailed review and meta-analysis. The pooled prevalence of migraine and tension-type headache (TTH) in China was found to be 6.1% (95% CI: 4.1-8.6%) and 13.4% (95% CI: 7.2-21.2%), respectively. The prevalence of migraine in the years 1988-1999 was 1.3% (95% CI: 1.1-1.5%), while the prevalence of TTH was 5.0% (95% CI: 4.5-5.4%). In contrast, the prevalence of migraine in the years 2000-2023 increased to 7.0% (95% CI: 4.9-9.4%), with TTH prevalence at 13.2% (95% CI: 7.1-20.8%). The weighted-pooled prevalence of both migraine and TTH were higher in females than in males. Subgroup analyses suggested that factors such as geographical region, age, sex, and publication year may be associated with the prevalence of these headache disorders. A single study encompassing 3,457,170 participants revealed a prevalence rate of 0.0068% for cluster headache.

Conclusion: Our research suggested an increasing trend in the prevalence of migraine and TTH in China over time, with females being more susceptible to primary headaches than males. This underscores the significance of not disregarding these conditions, especially in females. Future epidemiological studies of high quality are warranted to further investigate the prevalence of migraine and other primary headaches in China.

Background: Tea is widely consumed around the world, with green tea showing potential protective effects against cognitive decline, as indicated by multiple studies. These effects are thought to stem from its polyphenols and neuroprotective properties. This study aimed to systematically review and meta-analyze recent observational research on the link between green tea consumption and the risk of cognitive impairment.

Methods: A systematic search was performed in PubMed, Embase, Web of Science, and the Cochrane Library for observational studies published between September 2004 and September 2024. The relationship between green tea consumption and cognitive impairment was summarized using odds ratios with 95% confidence intervals. Additionally, the study conducted subgroup analyses, assessed heterogeneity, evaluated publication bias, and performed sensitivity analyses.

Results: Eighteen studies were included, comprising a total of 58,929 participants. The quality of these studies was evaluated using the Newcastle-Ottawa Scale, and overall, the quality was found to be high. The random-effects meta-analysis indicated that green tea consumption was inversely associated with cognitive impairment OR 0.63 (95% CI: 0.54-0.73), with the greatest benefit observed in individuals aged 50-69 years. Subgroup analysis showed protective effects for dementia OR 0.74 (95% CI: 0.56-0.99) and mild cognitive impairment OR 0.64 (95% CI: 0.43-0.96). Additionally, a significant reduction in the risk of cognitive impairment was observed in Asian populations, whereas no such association was found in European populations. Both women OR 0.51 (95% CI: 0.28-0.95) and men OR 0.47 (95% CI: 0.28-0.80) showed significant associations. High consumption groups had reduced cognitive impairment risk OR 0.64 (95% CI: 0.50-0.82).

Conclusion: Green tea consumption is associated with a reduced risk of cognitive impairment, suggesting potential cognitive benefits. However, large-scale longitudinal studies are needed to confirm dose-response relationships and long-term effects. Future studies should also investigate the long-term effects of green tea and its role in personalized nutrition based on genetic predispositions.

Introduction: Although hearing loss is associated with dementia, the exact causal relationship between hearing loss and dementia remains unclear. Early detection and prevention of hearing loss are essential. In this study, data from the National Health Insurance Research Database (NHIRD) of Taiwan were used to monitor patients with hearing loss for 15 years to determine whether hearing loss leads to dementia.

Methods: This retrospective matched-cohort study involved 208,570 individuals, divided into 41,714 patients with hearing loss and 166,856 controls matched by sex, age, and chronic diseases. Cox regression analysis was conducted on data obtained from the NHIRD for the period 2000-2015 to determine the hazard ratio (HR) associated with dementia.

Results: The percentage of patients with hearing loss who developed dementia was higher than that of the control group (18.67% vs. 14.10%). The onset age of dementia was younger in the hearing loss group (69.95 vs. 70.31 years, p = 0.001). Middle-aged individuals (45-65 years) with hearing loss were more likely to develop dementia compared with those without hearing loss (48.53% vs. 47.94%, p = 0.03). Compared with the controls, the patients with hearing loss were more likely to develop hyperlipidemia and stroke. In the patients with hearing loss, the adjusted HRs for Alzheimer's disease (AD), vascular dementia, and other types of dementia were significant. The patients were followed up for an average of 7.82 years. Compared with the controls, the patients with hearing loss exhibited a shorter mean time to dementia onset (5.21 vs. 5.49 years, p < 0.001).

Conclusion: Hearing loss may increase the risks of AD, dementia, hyperlipidemia, and stroke. Therefore, health-care providers should closely monitor cardiovascular complications in patients with hearing loss.

Introduction: Pediatric stroke, though less common than in the elderly population, imposes a significant societal burden. With the increasing impact of climate change, this study aimed to assess the burden of different pediatric stroke subtypes attributable to nonoptimal temperatures in the USA.

Methods: This study analyzed data from the Global Burden of Disease (GBD) Database 2019. The pediatric stroke burden attributable to nonoptimal temperatures was estimated by sex, age, and subtypes. R and Joinpoint were used to conduct the statistical analyses in this study. A p value <0.05 was considered statistically significant.

Results: Nationally, there has been a decrease in pediatric stroke death rate and DALY rate attributable to nonoptimal temperature from 1990 to 2019, with an AAPC of -2.36 (95% UI: -3.06 to -1.66, p value <0.05) for death and -2.45 (95% UI: -3.10 to -1.80, p value <0.05) for DALY. Similar trends were observed across sexes, age groups, stroke subtypes, and most states.

Conclusion: This study highlighted the pediatric stroke burden attributable to nonoptimal temperature in the USA. More resources should be directed to address the geographic health disparities observed in this study.

Introduction: In most countries and territories, current data on the burden of Alzheimer's disease (AD) and other dementias are lacking. We aimed to assess the trends, burden, and inequalities of AD and other dementias at global, regional, and national level from 1990 to 2021.

Methods: The data on disease burden of AD and other dementias during 1990-2021 were extracted from Global Burden of Disease and Risk Factors Study 2021 (GBD 2021). Average annual percentage changes (AAPCs) of age-standardized prevalence, mortality, and disability-adjusted life-years (DALYs) were estimated as an indicator to evaluate the healthcare system.

Result: The global age-standardized prevalence of AD and other dementias increased from 672 (95% uncertainty interval: 589 to 764) per 100,000 population in 1990 to 694 (603 to 794) per 100,000 population in 2021, with AAPCs of 0.09% (95% confidence interval: 0.06% to 0.11%). However, age-standardized mortality did not change (AAPCs: 0.00% [-0.01% to 0.02%]) and age-standardized DALYs slightly increased from 446 (206 to 958) to 451 (213 to 950) per 100,000 population (AAPCs: 0.01% [0.00% to 0.03%]). While the highest prevalence remained in population aged 65-69 and the countries with a high-middle sociodemographic index (SDI) such as East Asia (e.g., China), the highest mortality and DALYs were found in population aged 65-69 and the countries with a low-middle SDI such as South Asia (e.g., India). High fasting plasma glucose ranked the highest risk factor for DALYs during 1990-2021.

Conclusion: The global increased prevalence of AD and other dementias may partly be attributed to population aged 65-69 in the countries with a high-middle SDI (e.g., China), whereas mortality and DALY ratio of population aged 65-69 from the countries with a low-middle SDI (e.g., India) is most significantly growing. Controlling of high fasting plasma glucose may be needed for the reduction of DALYs from AD and other dementias.

Introduction: The COVID-19 pandemic has had a major impact on health care. Shifts in inpatient and outpatient case numbers and morbidity have been quantified in other medical specialties (e.g., oncology and psychiatry). Such an analysis is lacking in neurological cases. Thus, we performed an anonymized, retrospective, multicenter analysis of administrative data from a network of 86 hospitals in Germany.

Methods: Over 350,000 neurological cases admitted between January 2019 and December 2022 were included. The main outcome measures were (1) deficit in inpatient hospital admissions during the pandemic compared to changes in outpatient cases; (2) morbidity, mortality, and complication rates during the pandemic; and (3) length of stay for inpatients.

Results: There was an evident deficit in inpatient admissions between -11% and -20%, which was not compensated for by outpatient cases. Furthermore, hospitalized patients exhibited several significantly increased measures of mortality (3.7% vs. 3.2%, p < 0.001) and morbidity compared to the pre-pandemic period. Interestingly, the proportion of patients with specific chronic comorbidities at risk for severe COVID-19, such as congestive heart failure, was lower during the pandemic (10% vs. 12%, p < 0.001). Finally, the length of hospital stay was shorter during the pandemic (i.e., 6.5 vs. 6.4 days during the wildtype period, p < 0.001).

Conclusion: These findings suggest a significant shift in hospital utilization patterns among neurology departments during the COVID-19 pandemic. While overall admissions decreased, average case severity was significantly higher. The latter was due to a selection bias because elective cases, less urgent and less morbid patients avoided hospital admission, or because their admission may have been delayed. A shorter length of stay was indicative of more efficient treatment. The avoidance of hospital care by patients with severe comorbidities could indicate a changed prioritization and utilization pattern but could also point to unmet health care needs. These observations underline the necessity for healthcare systems to adapt resource allocation and patient management strategies to ensure continuous quality of care during a pandemic.