Burden of disease attributable to obesity and overweight in Korea

OBJECTIVE: To estimate the burden of disease attributable to overweight and obesity using disability-adjusted life-year (DALY) in Korea. RESEARCH METHODS: Firstly, overweight and obesity-related diseases and their relative risk (RR) were selected by the systematic review. Secondly, population-attributable fractions (PAFs) were computed by using the formula including RR and the prevalence of exposure (Pe) of overweight and obesity. Thirdly, DALYs of overweight and obesity-related diseases in Korea were estimated. Finally, the attributable burden (AB) of diseases due to overweight and obesity was calculated as the sum of the products from multiplying DALYs of overweight and obesity-related diseases by their PAFs. RESULTS: The disease burden attributable to overweight was 827.1 person years (PYs) overall, 732.6 for men, 922.9 for women per 100,000 persons. The disease burden attributable to obesity was 260.0 PYs overall, 144.2 for men, 377.3 for women. Diabetes attributable to overweight and obesity accounts for highest burden among other diseases in both genders. The disease burden attributable to overweight was 3.2 times higher than that attributable to obesity. CONCLUSION: Most proportion of disease burden attributable to high body mass index (BMI) occurred among those with only moderately raised levels such as overweight, not the extremes such as obesity. It suggests that population-based, public health intervention rather than high-risk group-focused strategies are more effective to reduce the burden of disease attributable to overweight and obesity in Korea.     

1990年和2016年北京市心脑血管疾病负担及其变化

目的调查1990年和2016年北京市心脑血管疾病负担及其变化情况。方法利用2016年全球疾病负担研究数据,分析1990年和2016年北京市心脑血管疾病死亡情况和疾病负担。主要指标包括死亡人数、过早死亡损失寿命年(YLL)、伤残损失寿命年(YLD)和伤残调整寿命年(DALY),同时使用2000—2025年世界人口的平均人口作为标准人口,计算标化死亡率、DALY率、YLL率和YLD率。结果2016年,北京市居民心脑血管病标化死亡率为209.24/10万;心脑血管病DALY、YLL和YLD分别为87.56、73.36和14.20万人年,较1990年分别增加了58.05%、44.24%和213.47%;标化DALY率和标化YLL率分别为3552.24/10万和2988.01/10万,较1990年分别下降47.90%和52.43%,标化YLD率为564.23/10万,较1990年增加5.10%。2016年,脑血管疾病和缺血性心脏病的死亡数分别为1.76万例和2.37万例;DALY分别为39.63和39.36万人年,较1990年(DALY分别为33.02和16.27万人年)分别增加20.02%和141.92%。结论北京市心脑血管疾病负担重,其中以脑血管疾病和缺血性心脏病最为显著;脑血管疾病的伤残负担严重,缺血性心脏病的疾病负担成倍增长。     

The Burden of Disease and the Cost of Illness Attributable to Alcohol Drinking—Results of a National Study

Background and Aims: The World Health Organization estimated that 3.2% of the burden of disease around the world is attributable to the consumption of alcohol. The aim of this study is to estimate the burden of disease attributable to alcohol consumption in Portugal. Methods: Burden and costs of diseases attributable to alcohol drinking were estimated based on demographic and health statistics available for 2005, using the Disability‐Adjusted Life Years (DALY) lost generated by death or disability. Results: In Portugal, 3.8% of deaths are attributable to alcohol (4,059 of 107,839). After measuring the DALY generated by mortality data, the proportion of disease attributable to alcohol was 5.0%, with men having 5.6% of deaths and 6.2% of disease burden, while female figures were, respectively, 1.8 and 2.4%. Considering the sum of death and disability DALYs, liver diseases represented the main source of the burden attributable to alcohol with 31.5% of total DALYs, followed by traffic accidents (28.2%) and several types of cancer (19.2%). As for the cost of illness incurred by the health system, our results indicate that €95.1 millions are attributable to alcohol‐related disease admissions (liver diseases, cancer, traffic accidents, and external causes) while the ambulatory costs of alcohol‐related diseases were estimated in €95.9 million, totaling €191.0 million direct costs, representing 0.13% of Gross Domestic Product and 1.25% of total national health expenditures. An alternative analysis was carried out using higher consumption levels so as to replicate aggregate alcohol consumption statistics. In this case, DALYs lost increased by 11.7% and health costs by 23%. Conclusion: Our results confirm that alcohol is an important health risk factor in Portugal and a heavy economic burden for the health system, with hepatic diseases ranking first as a source of burden of disease attributable to alcohol.     

Burden of Chronic Viral Hepatitis and Liver Cirrhosis in Brazil - the Brazilian Global Burden of Disease Study

Introduction and aimData on epidemiology of liver diseases in Brazil is scarce. This study aimed to estimate the burden of chronic viral hepatitis and liver cirrhosis in the country.Materials and MethodsThe indicator used was disability-adjusted life year (DALY), a sum of years of life lost due to premature mortality (YLL) and years lived with disability (YLD). Liver cirrhosis was analyzed in etiologic categories and cirrhosis of viral origin was considered part of the burden of chronic hepatitis.ResultsThere were 57,380 DALYs (30.3 per 100,000 inhabitants) attributable to chronic hepatitis B and cirrhosis due to hepatitis B, with 41,262 DALYs in men. Most burden was caused by YLL (47,015 or 24.8/100,000) rather than YLD (10,365 or 5.5/100,000). Chronic hepatitis C and cirrhosis due to hepatitis C were responsible for 207,747 DALYs (109.6/100,000), of which 137,922 were YLL (72.7/100,000) and 69,825 (36.8/100,000) were YLD, with a higher proportion of DALYs in men (73.9%). Cirrhosis due to alcohol or other causes had a total of 536,169 DALYs (1,4% of total DALYs in Brazil), with 418,272 YLL (341,140 in men) and 117,897 YLD (97,965 in men). Highest DALYs’ rates occurred at ages 60-69 in chronic hepatitis and at ages 45-59 in cirrhosis due to alcohol or other causes.ConclusionChronic viral hepatitis and liver cirrhosis are responsible for a significant burden in Brazil, affecting mainly men and individuals still in their productive years. Most burden is related to non-viral causes of cirrhosis, with a major contribution of alcohol.     

Population health impact of cancer in Canada, 2001

Summary measures of population health that incorporate morbidity provide a new perspective for health policy and priority setting. Health-adjusted life years (HALYs) lost to a disease combine the impact of years of life lost to premature mortality and morbidity, measured as year-equivalents lost to reduced functioning. HALYs for 25 cancers were estimated from mortality and incidence in 2001 in Canada; population-attributable fractions were estimated for major risk factors contributing to these cancers. Results from this analysis indicate that Canadians would lose an estimated 905,000 health-adjusted years of life to cancer for 2001, including 771,000 to premature mortality and 134,000 to morbidity from incident cases (years discounted at 3 percent). Most of the estimated premature mortality was due to lung cancer; morbidity was largely due to breast, prostate and colorectal cancers. An estimated one quarter of HALYs lost to cancer were attributable to smoking and almost one quarter were attributable to alcohol consumption, lack of fruit and vegetables, obesity and physical inactivity combined. These results are a significant advance in measuring the population health impact of cancer in Canada because they incorporate morbidity as well as mortality. Key words: burden of disease, cancer, DALY, HALY, health status indicators, population health, quality of life, summary measures.     

广东省居民健康、伤残、死亡三者间的量效关系研究

目的采用图谱法解析居民健康、伤残、死亡三者间的量效关系.方法以居民年龄别为横坐标,以年龄别期望寿命（LE）、健康期望寿命（DALE）、伤残调整寿命年（DALY）为纵坐标,分别绘制出健康、伤残、死亡三者关系的量效图谱.结果居民健康、伤残、死亡三者关系量效图谱中LE=A＋B,DALE=A＋f（B）,DALY=C＋g（B）.女性的心血管疾病负担明显高于男性,男性的损伤与中毒疾病负担则明显高于女性.男性在呼吸疾病、恶性肿瘤、脑血管疾病和糖尿病等4类疾病的疾病负担上也均较女性为重.结论f（B）、g（B）是一种量效关系函数,它根据居民伤残状态的严重性权重,将在这种伤残状态下生活的年数转化成相当于在完全健康状态下生活的年数与死亡状态下损失的年数,从而直观反映居民健康、伤残与死亡的量效关系.     

Overweight and obesity and the burden of disease and disability in elderly men

OBJECTIVE: To examine the prevalence of disease burden and disability associated with overweight and obesity in men aged 60-79 y and to assess whether the current WHO weight guidelines are appropriate in the elderly. DESIGN: Cross-sectional survey 20 y after enrollment. SETTING: General practices in 24 British towns. PARTICIPANTS: In total, 4232 men aged 60-79 y (77% of survivors) with measured weight and height. MAIN OUTCOME MEASURES: Cardiovascular (CV) risk factors, prevalence of diabetes, cardiovascular disease, cancer, disability and regular medication. RESULTS: In total, 17% of the men were obese (body mass index (BMI) >/=30 kg/m(2)) and a further 52% were overweight (BMI 25-29.9 kg/m(2)). Prevalence of hypertension, low HDL-cholesterol, high triglycerides and insulin resistance and the prevalence of most disease outcomes increased with increasing degrees of overweight/obesity. Men in the normal weight range (18.5-24.9 kg/m(2)) had the lowest prevalence of ill health. Compared with normal weight men, obese men showed a two-fold risk of major CVD (odds ratio (OR)=1.96, 95% CI 1.44-2.67) and locomotor disability (OR=2.26, 95% CI 1.66, 3.09) and were nearly three times as likely to have diabetes, CV interventions or to be on CV medication. Over 60% of the prevalence of high insulin resistance was attributable to overweight and obesity as was over a third of diabetes and hypertension, a quarter of locomotor disability and a fifth of major CVD. CONCLUSION: In elderly men, overweight and obesity are associated with a significantly increased burden of disease, in particular CV-related disorders and disability. The current guidelines for overweight and obesity appear to be appropriate in elderly men.     

Volume of alcohol consumption, patterns of drinking and burden of disease in the European region 2002

AIMS: To describe the volume of alcohol consumption and patterns of drinking in the World Health Organization (WHO) European regions in 2002 and to estimate quantitatively the burden of disease attributable to alcohol in that year. METHODS: Secondary data analysis. Exposure data were taken from the WHO Comparative Risk Assessment, outcome data from the WHO Measurement and Health Information department, and used to derive three outcome measures: deaths, years of life lost (YLL) and disability adjusted life years (DALY) for 2002. All calculations were conducted according to age, sex and region. RESULTS: Alcohol consumption in the WHO regions for Europe was high, with 12.1 litres pure alcohol per capita, on average more than 100% above the global consumption. Alcohol consumption caused a considerable disease burden: 6.1% of all the deaths, 12.3% of all YLL and 10.7% of all DALY in all European regions in 2002 could be attributed to this exposure. Intentional and unintentional injuries accounted for almost 50% of all alcohol-attributable deaths and almost 44% of alcohol-attributable disease burden. Young people and men were affected the most. Geographically, the most eastern region around Russia had the highest alcohol-attributable disease burden. CONCLUSIONS: Interventions should be implemented to reduce the high burden of alcohol-attributable disease in the European regions. Given the epidemiological structure of the burden, injury prevention, including but not restricted to the prevention of traffic injuries, and specific prevention for young people should play the most important role in a comprehensive plan to reduce alcohol-attributable burden.     

Estimating the burden of scleroderma disease in Spain

OBJECTIVE: Scleroderma (systemic sclerosis) is a rare disease that results in great suffering. We estimated the burden of disease posed by scleroderma and its relative importance in the health of the Spanish population. METHODS: We estimated scleroderma-based burden of disease following procedures developed for the Global Burden of Disease study to ensure comparability. RESULTS: Despite its low prevalence, scleroderma generated 1732 disability-adjusted life-years (DALY) in Spain in 2001, comprising 562 (32%) years of life lost and 1170 (68%) years lived with disability. Most scleroderma-related DALY (73%) occurred in the population aged 15-54 years. Estimated DALY accounted for 0.59% of other musculoskeletal disorder-related DALY in the European A subregion (countries with low mortality rate in both adults and children in the World Health Organization classification), a significant value in the overall burden of disease. CONCLUSION: The burden of scleroderma in Spain was high, with disability being the major contributing factor. Burden of disease is an important measure in rare diseases, and may be an important indicator to be considered as a health unit in developed countries.     

广东惠州地区大肠癌疾病负担研究

目的 通过计算本地区大肠癌病人的疾病负担,了解本市不同性别、不同年龄段的大肠癌疾病负担及其变化趋势,进一步从社会经济角度认识和理解大肠癌.方法 应用伤残调整寿命年(DALY)、疾病死亡损失健康生命年(YLL)与疾病伤残损失健康生命年(YLD)等健康状况评价指标,对近5年来在本院就诊的大肠癌所造成的疾病负担进行测量和分析...     

Arthritis and arthritis‐attributable activity limitations in the United States and Canada: A cross‐border comparison

Objective

To compare directly the prevalence and risk factors for arthritis and arthritis‐attributable activity limitations (AAL) between the US and Canada, and to estimate the population attributable risk percentage (PAR%) for obesity and leisure time physical inactivity.

Methods

We conducted analyses of the 2002–2003 Joint Canada/US Health Survey, which asked about health professional–diagnosed arthritis, and arthritis reported as a cause of disability in specified activities of daily living. We used log‐Poisson regression to obtain prevalence ratios for arthritis and AAL, adjusting for education, income, having a regular doctor, physical inactivity, and obesity. PAR% for obesity and physical inactivity were calculated.

Results

The estimated crude prevalence of arthritis and AAL were 18.7% and 9.3%, respectively, in the US and 16.9% and 7.4%, respectively, in Canada. Being American was a significant bivariate predictor of arthritis and AAL, but not after adjustment for obesity and physical inactivity. PAR% for obesity were 14% and 20% for arthritis and AAL, respectively, for Americans and 13% and 17%, respectively, for Canadians, and for physical inactivity were 15% and 21%, respectively, for Americans and 4% and 5%, respectively, for Canadians, with estimates being higher among women.

Conclusion

The higher prevalence of arthritis and AAL in the US may be accounted for by the higher prevalence of obesity and physical inactivity, particularly in women. The high PAR% related to obesity in both countries, and physical inactivity in the US, point to the importance of public health initiatives to reduce obesity and increase physical activity to reduce the prevalence of arthritis and AAL.     

Measuring the global burden of disease and epidemiological transitions: 2002-2030

Any planning process for health development ought to be based on a thorough understanding of the health needs of the population. This should be sufficiently comprehensive to include the causes of premature death and of disability, as well as the major risk factors that underlie disease and injury. To be truly useful to inform health-policy debates, such an assessment is needed across a large number of diseases, injuries and risk factors, in order to guide prioritization. The results of the original Global Burden of Disease Study and, particularly, those of its 2000-2002 update provide a conceptual and methodological framework to quantify and compare the health of populations using a summary measure of both mortality and disability: the disability-adjusted life-year (DALY). Globally, it appears that about 56 million deaths occur each year, 10.5 million (almost all in poor countries) in children. Of the child deaths, about one-fifth result from perinatal causes such as birth asphyxia and birth trauma, and only slightly less from lower respiratory infections. Annually, diarrhoeal diseases kill over 1.5 million children, and malaria, measles and HIV/AIDS each claim between 500,000 and 800,000 children. HIV/AIDS is the fourth leading cause of death world-wide (2.9 million deaths) and the leading cause in Africa. The top three causes of death globally are ischaemic heart disease (7.2 million deaths), stroke (5.5 million) and lower respiratory diseases (3.9 million). Chronic obstructive lung diseases (COPD) cause almost as many deaths as HIV/AIDS (2.7 million). The leading causes of DALY, on the other hand, include causes that are common at young ages [perinatal conditions (7.1% of global DALY), lower respiratory infections (6.7%), and diarrhoeal diseases (4.7%)] as well as depression (4.1%). Ischaemic heart disease and stroke rank sixth and seventh, retrospectively, as causes of global disease burden, followed by road traffic accidents, malaria and tuberculosis. Projections to 2030 indicate that, although these major vascular diseases will remain leading causes of global disease burden, with HIV/AIDS the leading cause, diarrhoeal diseases and lower respiratory infections will be outranked by COPD, in part reflecting the projected increases in death and disability from tobacco use.     

The burden of overweight and obesity-related ill health in the UK

This paper reviews previous cost studies of overweight and obesity in the UK. It proposes a method for estimating the economic and health costs of overweight and obesity in the UK which could also be used in other countries. Costs of obesity studies were identified via a systematic search of electronic databases. Information from the WHO Burden of Disease Project was used to calculate the mortality and morbidity cost of overweight and obesity. Population attributable fractions for diseases attributable to overweight and obesity were applied to National Health Service (NHS) cost data to estimate direct financial costs. We estimate the direct cost of overweight and obesity to the NHS at pound 3.2 billion. Other estimates of the cost of obesity range between pound 480 million in 1998 and pound 1.1 billion in 2004 [Correction added after online publication 11 June 2007: 'of the cost of obesity' added after 'Other estimates']. There is wide variation in methods and estimates for the cost of overweight and obesity to the health systems of developed countries. The method presented here could be used to calculate the costs of overweight and obesity in other countries. Public health initiatives are required to address the increasing prevalence of overweight and obesity and reduce associated healthcare costs.     

Mortality landscape in the Global Burden of Diseases,Injuries and Risk Factors Study

The Global Burden of Diseases, Injuries and Risk Factors Study 2010 (GBD 2010) is an initiative that involved 486 scientists from 302 institutions in 50 countries, under the leadership of a consortium formed by the Institute for Health Metrics and Evaluation of the University of Washington, World Health Organization, the University of Queensland School of Population Health, the Harvard School of Public Health, the Johns Hopkins Bloomberg School of Public Health, the University of Tokyo and Imperial College London. The study has provided a state of the art understanding of the burden of 67 risk factors and their clusters, 291 diseases and injuries on global, regional and national levels in period from 1990 to 2010 for 187 countries. GBD 2010 estimates covered both mortality (expressed in number of deaths, years of life lost (YLL) due to premature mortality) and morbidity (mainly expressed as years lived with disability (YLD)), while the incidence and prevalence were not reported for majority of causes so far, although they were accounted and used for YLD calculations. Finally, each disease and risk factor was presented in terms of the disability-adjusted years of life (DALY) that is merely a sum of YLL and YLD. The major published results of GBD 2010 cover global and regional levels for all diseases and risk factors. Reports focused on specific conditions are also available. At country-level detailed estimates are published for UK, China and USA, and data on other countries are accessible only as aggregate partial representation via web-based tools.     

Obesity and overweight in Canada: an updated cost-of-illness study

This study is to update the estimates of the economic burden of illness because of overweight and obesity in Canada by incorporating the increase in prevalence of overweight and obesity, findings of new related comorbidities and rise in the national healthcare expenditure. The burden was estimated from a societal perspective using the prevalence-based cost-of-illness methodology. Results from a literature review of the risks of 18 related comorbidities were combined with prevalence of overweight and obesity in Canada to estimate the extent to which each comorbidity is attributable to overweight and obesity. The direct costs were extracted from the National Health Expenditure Database and allocated to each comorbidity using weights principally from the Economic Burden of Illness in Canada. The study showed that the total direct costs attributable to overweight and obesity in Canada were $6.0 billion in 2006, with 66% attributable to obesity. This corresponds to 4.1% of the total health expenditures in Canada in 2006. The inclusion of newly identified comorbidities increased the direct cost estimates of obesity by 25%, while the rise in national healthcare expenditure accounted for a 19% increase. Policies to reduce being overweight and obese could potentially save the Canadian healthcare system millions of dollars.     

The obesity epidemic, metabolic syndrome and future prevention strategies.

The epidemic of obesity and overweight poses a major challenge to the prevention of chronic noncommunicable diseases throughout the world. In some developing countries it presents a double burden alongside enduring problems of undernutrition. Current IOTF estimates suggest that at least 1.1 billion adults are overweight including 312 million who are obese. The prevalence of obesity has doubled or even risen threefold in less than two decades, while in children this is rising at an even faster rate in some regions of Europe to levels of up to 36% in parts of Italy and elsewhere.The comparative burden of disease due to raised body mass index is among the top five leading risk factors in both developed and low mortality developing countries. When viewed in conjunction with the burden of raised cholesterol and hypertension, these components of the metabolic syndrome form the major cause of mortality and disease in Europe and are guaranteed to increase with the rising trend in overweight and obesity while amplifying the burden of cardiovascular disease. The increase in childhood obesity will, unchecked, accentuate the rise in early adult type 2 diabetes and cardiovascular disease. CONCLUSIONS: A fundamental policy shift is required to widen responsibility for the prevention of diet, activity and weight-related ill health across the whole of Europe's population. Only such a comprehensive approach offers any realistic prospect of averting a public health catastrophe for Europe and indeed for the whole world.     

Multiple metabolic risk factors and total and cardiovascular mortality in men with low prevalence of obesity

We investigated the association between the multiple metabolic risk factors and cardiovascular and overall mortality among Korean men, a population with a low prevalence of obesity. This prospective cohort study involved 682,597 Korean men, aged 30-69 years at baseline (1992), who were initially without cancer or debilitating diseases. Death due to ischemic heart disease (IHD), stroke, cardiovascular disease (CVD), and any cause among men relative to metabolic risk factors, including overweight, high blood pressure, high fasting glucose, and high total cholesterol was analyzed. There were 17,785 deaths during the 8.5-year follow-up, of which 874 were due to IHD, 1644 to stroke, and 3306 to CVD. As a function of the number of metabolic risk factors, the relative risk of death from CVD was 2.0 (1.7-2.2), 2.9 (2.5-3.3), 3.5 (3.0-4.1), and 5.0 (3.9-6.4) for 1, 2, 3, and 4 risk factors, respectively, whereas the relative risk of death from all causes was 1.3 (1.2-1.4), 1.5 (1.4-1.6), 1.6 (1.5-1.7), and 1.9 (1.6-2.2) for 1, 2, 3, and 4 risk factors, respectively. The relative risk of IHD, stroke, CVD and all-cause mortality increased linearly with the number of metabolic risk factors. Early identification and strict management of metabolic risk factors should be reinforced in Koreans, even though there is a low prevalence of obesity among this population.     

Hypertension: its prevalence and population-attributable fraction for mortality from cardiovascular disease in the Asia-Pacific region

OBJECTIVE: About half of the world's burden of cardiovascular disease is carried by countries in the Asia-Pacific region. This study aimed to quantify the contribution of hypertension to cardiovascular diseases (CVD) at the country level, by calculating the sex-specific, population-attributable fractions (PAFs) for fatal ischaemic heart disease (IHD) and stroke (haemorrhagic and ischaemic) for the World Health Organization Western Pacific and South-east Asian regions. METHODS: The most recent sex-specific prevalence data on hypertension were sought. Age-adjusted hazard ratio (HR) estimates for fatal IHD and stroke associated with hypertension were obtained using Cox analyses of individual participant cohort data from 600,000 adult participants in the Asia-Pacific Cohort Studies Collaboration. HR estimates and prevalence were then used to calculate sex-specific PAFs for fatal IHD and stroke, by country. RESULTS: In 15 countries with available data, the prevalence of hypertension ranged from 5-47% in men and from 7-38% in women. Overall, the fraction of IHD attributable to hypertension ranged from 4-28% in men and from 8-39% in women. Corresponding ranges for haemorrhagic stroke were 18-66% and 15-49%, and for ischaemic stroke were 8-44% and 12-45%. CONCLUSIONS: In the Asia-Pacific region, up to 66% of some subtypes of CVD can be attributed to hypertension, underscoring the immense impact that blood pressure- lowering strategies could have in this populous region.     

How can dementia and disability be prevented in older adults: where are we today and where are we going?

Ageing of the population, together with population growth, has brought along an ample increase in the number of older individuals living with dementia and disabilities. Dementia is the main cause of disability in old age, and promoting healthy brain ageing is considered as a key element in diminishing the burden of age-related disabilities. The World Health Organization recently launched the first risk reduction guidelines for cognitive impairment and dementia. According to recent estimates, approximately 40% of dementia cases worldwide could be attributable to 12 modifiable risk factors: low education; midlife hypertension and obesity; diabetes, smoking, excessive alcohol use, physical inactivity, depression, low social contact, hearing loss, traumatic brain injury and air pollution indicating clear prevention potential. Dementia and physical disability are closely linked with shared risk factors and possible shared underlying mechanisms supporting the possibility of integrated preventive interventions. FINGER trial was the first large randomized controlled trial indicating that multidomain lifestyle-based intervention can prevent cognitive and functional decline amongst at-risk older adults from the general population. Within the World-Wide FINGERS network, the multidomain FINGER concept is now tested and adapted worldwide proving evidence and tools for effective and easily implementable preventive strategies. Close collaboration between researchers, policymakers and healthcare practitioners, involvement of older adults and utilization of new technologies to support self-management is needed to facilitate the implementation of the research findings. In this scoping review, we present the current scientific evidence in the field of dementia and disability prevention and discuss future directions in the field.     

Global burden attributable to high sodium intake from 1990 to 2019

Background and aimsHigh sodium intake is associated with a higher risk of a wide range of diseases. We aimed to estimate the pattern and trend of the global disease burden associated with high sodium intake from 1990 to 2019.Methods and resultsWe obtained numbers and rates of death and disability-adjusted life year (DALY) attributable to high sodium intake by sex, socio-demographic index, and country from the Global Burden of Disease Study 2019. We calculated the estimated annual percentage change to evaluate the age-standardized rate (ASR) of the burden attributable to high sodium intake between 1990 and 2019. We further calculated the contribution of population growth, population aging, and age-specific rates of death and DALY to the net change in the total number of deaths and DALYs attributable to high sodium intake. From 1990 to 2019, global age-standardized rates of death and DALY attributable to high sodium intake substantially decreased for both sexes. However, there were significant increases in the total numbers of deaths and DALYs attributable to high sodium intake, which were driven by population growth and population aging. The attribution of population growth and population aging varied widely across countries, with a higher contribution of population growth in most developing countries and a higher contribution of population aging in countries with slow population growth.ConclusionsAlthough the global burden attributable to high sodium intake in terms of age-standardized rate declined from 1990 to 2019, the absolute burden increased significantly, which was driven by population growth and population aging.