Global, regional, and national temporal trends in prevalence, deaths and disability-adjusted life years for chronic pulmonary disease, 1990–2021: an age-period-cohort analysis based on the global burden of disease study 2021

BackgroundChronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality globally, with significant disparities in disease burden across countries and socioeconomic regions. Despite advancements in public health, the global burden of COPD remains substantial, particularly...

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Main Authors: Wubing Cao, Jun Zheng, Qun Li, Dabin Guo, Xianzhi Fan, Guoning Zhu, Xiao Yuan
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1554442/full
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author Wubing Cao
Jun Zheng
Qun Li
Dabin Guo
Xianzhi Fan
Guoning Zhu
Xiao Yuan
author_facet Wubing Cao
Jun Zheng
Qun Li
Dabin Guo
Xianzhi Fan
Guoning Zhu
Xiao Yuan
author_sort Wubing Cao
collection DOAJ
description BackgroundChronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality globally, with significant disparities in disease burden across countries and socioeconomic regions. Despite advancements in public health, the global burden of COPD remains substantial, particularly in low- and middle-income countries. This study aims to provide a comprehensive analysis of global, regional, and national trends in COPD-related prevalence, deaths, and disability-adjusted life years (DALYs) from 1990 to 2021 using an age-period-cohort (APC) model.MethodsData from the Global Burden of Disease Study 2021 were analyzed for 204 countries and territories, stratified by five Sociodemographic Index (SDI) levels. An APC model was employed to assess the temporal effects of age, time periods, and birth cohorts on COPD burden. Trends in prevalence, deaths, and DALYs were evaluated through metrics such as Net Drift, Local Drift, and risk ratios.ResultsGlobally, from 1990 to 2021, the age-standardized rates of COPD demonstrated a decline of −1.46% (95% UI: −3.36 to 0.39%) in prevalence, −37.12% (95% UI: −43.37% to −27.68%) in deaths, and −36.98% (95% UI: −42.37% to −28.54%) in DALYs. After adjusting for age and cohort effects, the annual changes were −0.35% (95% UI: −0.39% to −0.32%) in prevalence, −3.87% (95% UI: −4.00% to −3.74%) in deaths, and − 2.95% (95% UI: −3.02% to −2.89%) in DALYs. Notably, in middle, low-middle, and low SDI regions, the age-standardized prevalence rates in 2021 showed an increase compared to 1990, with respective changes of 4.03% (95% UI: 2.00–5.89%), 0.13% (95% UI: −2.90 to 2.84%), and 6.71% (95% UI: 4.25–8.91%). However, age-standardized deaths and DALYs significantly decreased across all five SDI regions. From an age effect perspective, globally, over 50% of COPD prevalence is concentrated among individuals aged 65 years and older, particularly in middle, low-middle, and high-middle SDI regions. COPD-related deaths and DALYs have shown a declining trend across all age groups. Globally, the period effect indicates that earlier periods were associated with a higher burden of disease, while cohort effects highlight that birth cohorts around 1920 had a particularly pronounced impact on the COPD burden. Both period and cohort effects exhibited notable heterogeneity across different SDI regions and countries,ConclusionThe prevalence of COPD remains concerning. Compared to 1990, the global prevalence of COPD in 2021 showed a stable or slightly increasing trend, with over half of the countries experiencing an annual increase in prevalence during the 1990–2021 period. Global mortality and DALYs associated with COPD showed a notable decline in 2021 compared to 1990. However, this trend exhibited significant heterogeneity across countries and regions, likely linked to differences in socioeconomic development. Countries in the high-middle and middle SDI regions were found to be more affected by period effects. From an age effect perspective, population aging has undoubtedly exacerbated the COPD burden. Regarding cohort effects, earlier birth cohorts demonstrated a stronger contribution to the increasing disease burden. While Higher levels of socioeconomic development can mitigate the adverse effects associated with earlier birth cohorts.
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spelling doaj-art-de97cfbe0b594001a2f6239441d2d73d2025-08-20T03:16:28ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-03-011210.3389/fmed.2025.15544421554442Global, regional, and national temporal trends in prevalence, deaths and disability-adjusted life years for chronic pulmonary disease, 1990–2021: an age-period-cohort analysis based on the global burden of disease study 2021Wubing CaoJun ZhengQun LiDabin GuoXianzhi FanGuoning ZhuXiao YuanBackgroundChronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality globally, with significant disparities in disease burden across countries and socioeconomic regions. Despite advancements in public health, the global burden of COPD remains substantial, particularly in low- and middle-income countries. This study aims to provide a comprehensive analysis of global, regional, and national trends in COPD-related prevalence, deaths, and disability-adjusted life years (DALYs) from 1990 to 2021 using an age-period-cohort (APC) model.MethodsData from the Global Burden of Disease Study 2021 were analyzed for 204 countries and territories, stratified by five Sociodemographic Index (SDI) levels. An APC model was employed to assess the temporal effects of age, time periods, and birth cohorts on COPD burden. Trends in prevalence, deaths, and DALYs were evaluated through metrics such as Net Drift, Local Drift, and risk ratios.ResultsGlobally, from 1990 to 2021, the age-standardized rates of COPD demonstrated a decline of −1.46% (95% UI: −3.36 to 0.39%) in prevalence, −37.12% (95% UI: −43.37% to −27.68%) in deaths, and −36.98% (95% UI: −42.37% to −28.54%) in DALYs. After adjusting for age and cohort effects, the annual changes were −0.35% (95% UI: −0.39% to −0.32%) in prevalence, −3.87% (95% UI: −4.00% to −3.74%) in deaths, and − 2.95% (95% UI: −3.02% to −2.89%) in DALYs. Notably, in middle, low-middle, and low SDI regions, the age-standardized prevalence rates in 2021 showed an increase compared to 1990, with respective changes of 4.03% (95% UI: 2.00–5.89%), 0.13% (95% UI: −2.90 to 2.84%), and 6.71% (95% UI: 4.25–8.91%). However, age-standardized deaths and DALYs significantly decreased across all five SDI regions. From an age effect perspective, globally, over 50% of COPD prevalence is concentrated among individuals aged 65 years and older, particularly in middle, low-middle, and high-middle SDI regions. COPD-related deaths and DALYs have shown a declining trend across all age groups. Globally, the period effect indicates that earlier periods were associated with a higher burden of disease, while cohort effects highlight that birth cohorts around 1920 had a particularly pronounced impact on the COPD burden. Both period and cohort effects exhibited notable heterogeneity across different SDI regions and countries,ConclusionThe prevalence of COPD remains concerning. Compared to 1990, the global prevalence of COPD in 2021 showed a stable or slightly increasing trend, with over half of the countries experiencing an annual increase in prevalence during the 1990–2021 period. Global mortality and DALYs associated with COPD showed a notable decline in 2021 compared to 1990. However, this trend exhibited significant heterogeneity across countries and regions, likely linked to differences in socioeconomic development. Countries in the high-middle and middle SDI regions were found to be more affected by period effects. From an age effect perspective, population aging has undoubtedly exacerbated the COPD burden. Regarding cohort effects, earlier birth cohorts demonstrated a stronger contribution to the increasing disease burden. While Higher levels of socioeconomic development can mitigate the adverse effects associated with earlier birth cohorts.https://www.frontiersin.org/articles/10.3389/fmed.2025.1554442/fullCOPD—chronic obstructive pulmonary diseaseGBD (global burden disease)age-period-cohort (APC) analysisSDI: Sociodemographic indexpulmanory disease
spellingShingle Wubing Cao
Jun Zheng
Qun Li
Dabin Guo
Xianzhi Fan
Guoning Zhu
Xiao Yuan
Global, regional, and national temporal trends in prevalence, deaths and disability-adjusted life years for chronic pulmonary disease, 1990–2021: an age-period-cohort analysis based on the global burden of disease study 2021
Frontiers in Medicine
COPD—chronic obstructive pulmonary disease
GBD (global burden disease)
age-period-cohort (APC) analysis
SDI: Sociodemographic index
pulmanory disease
title Global, regional, and national temporal trends in prevalence, deaths and disability-adjusted life years for chronic pulmonary disease, 1990–2021: an age-period-cohort analysis based on the global burden of disease study 2021
title_full Global, regional, and national temporal trends in prevalence, deaths and disability-adjusted life years for chronic pulmonary disease, 1990–2021: an age-period-cohort analysis based on the global burden of disease study 2021
title_fullStr Global, regional, and national temporal trends in prevalence, deaths and disability-adjusted life years for chronic pulmonary disease, 1990–2021: an age-period-cohort analysis based on the global burden of disease study 2021
title_full_unstemmed Global, regional, and national temporal trends in prevalence, deaths and disability-adjusted life years for chronic pulmonary disease, 1990–2021: an age-period-cohort analysis based on the global burden of disease study 2021
title_short Global, regional, and national temporal trends in prevalence, deaths and disability-adjusted life years for chronic pulmonary disease, 1990–2021: an age-period-cohort analysis based on the global burden of disease study 2021
title_sort global regional and national temporal trends in prevalence deaths and disability adjusted life years for chronic pulmonary disease 1990 2021 an age period cohort analysis based on the global burden of disease study 2021
topic COPD—chronic obstructive pulmonary disease
GBD (global burden disease)
age-period-cohort (APC) analysis
SDI: Sociodemographic index
pulmanory disease
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1554442/full
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