Background Depression,anxiety and schizophrenia among older persons have become global public health challenges.However,the burden of these disorders in ageing and aged countries has not been analysed.Aims To investig...Background Depression,anxiety and schizophrenia among older persons have become global public health challenges.However,the burden of these disorders in ageing and aged countries has not been analysed.Aims To investigate the burden of depression,anxiety and schizophrenia among older adults in ageing and aged countries.Methods Using data from the Global Burden of Disease Study 2019,we calculated the estimated annual percentage change(EAPC)in the age-standardised incidence rates(ASiR)and age-standardised disability-adjusted life years(DALYs)rates(ASDR)for depression,anxiety and schizophrenia of older people in ageing countries(China,India,Indonesia)and aged countries(Japan,Italy,Portugal)between 1990 and 2019.Trends in incidence and DALYs were analysed by gender and age.Results In 2019,the highest incidence of depression,anxiety and schizophrenia in the older population in aged countries was in Japan(927271.3(752552.3-1125796.5),51498.2(37625.7-70487.3)and 126.0(61.0-223.2),respectively),while the highest incidence in ageing countries was in China(5797556.9(4599403.4-7133006.5),330256.1(246448.9-445987.4)and 1067.7(556.2-1775.9),respectively).DALYs for these disorders were similar,with the highest in Japan and China.From 1990 to 2019,the ASIR for depressive disorders decreased in aged countries but increased in ageing countries;the ASIR for anxiety disorders and schizophrenia declined in both ageing and aged countries.The ASDR for depressive disorders was consistent with the ASIR but not for anxiety disorders and schizophrenia.The ASIR for depressive disorders was higher in older women,while the opposite was observed in anxiety disorders and schizophrenia.Notably,the conditions of burden of depressive disorders,anxiety disorders and schizophrenia in the 65-70-year-old age group were the most burdensome.Conclusions The incidence and DALYs of these three mental disorders increased while exhibiting differences between ageing and aged countries.Raising awareness about formulating health policies for preventing and treating mental disorders in the older population is necessary to reduce the future burden posed by the ageing challenge.展开更多
目的快速评价依达拉奉治疗急性缺血性脑卒中(AIS)的有效性、安全性和经济性,为临床决策提供循证依据。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、CNKI和WanFang Data数据库及国内外卫生技术评估(HTA)机构官方网...目的快速评价依达拉奉治疗急性缺血性脑卒中(AIS)的有效性、安全性和经济性,为临床决策提供循证依据。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、CNKI和WanFang Data数据库及国内外卫生技术评估(HTA)机构官方网站,搜集依达拉奉治疗AIS的HTA报告、系统评价/Meta分析和药物经济学研究文献,检索时限均为从建库至2024年10月1日。2名评价者独立筛选文献、提取资料和质量评价,汇总结果并定性描述与分析。结果共纳入文献12篇,包括9篇系统评价/Meta分析、3篇药物经济学研究。有效性方面,与安慰剂或常规疗法(阿替普酶、奥扎格雷)相比,依达拉奉单用或联合常规疗法可提高有效率、改善短期神经功能缺损评分和提高患者日常生活能力(P<0.05)。安全性方面,依达拉奉与安慰剂、常规疗法或其他神经保护剂相比不良反应发生率差异无统计学意义(P>0.05);与单用阿替普酶相比,依达拉奉联用阿替普酶可降低颅内出血发生率(P<0.05),而全因死亡率差异无统计学意义(P>0.05)。经济性方面,依达拉奉短期使用不具备成本-效果优势,而现有的远期研究显示其可能具有成本-效果优势。结论依达拉奉治疗AIS具有较好的有效性和安全性,但目前研究证据有限,该结论仍需进一步研究和临床试验予以证实,经济性方面也有待进一步评估。展开更多
基金Shanghai'Science and Technology Innovation Action Plan'medical innovation research(21Y11905600)Shanghai'Science and Technology Innovation Action Plan'Natural Science Foundation of Shanghai(21ZR1455100)+1 种基金the National Natural Science Foundation of China(81701344)the Shanghai Mental Health Center General Projects(2021-YJ-02).
文摘Background Depression,anxiety and schizophrenia among older persons have become global public health challenges.However,the burden of these disorders in ageing and aged countries has not been analysed.Aims To investigate the burden of depression,anxiety and schizophrenia among older adults in ageing and aged countries.Methods Using data from the Global Burden of Disease Study 2019,we calculated the estimated annual percentage change(EAPC)in the age-standardised incidence rates(ASiR)and age-standardised disability-adjusted life years(DALYs)rates(ASDR)for depression,anxiety and schizophrenia of older people in ageing countries(China,India,Indonesia)and aged countries(Japan,Italy,Portugal)between 1990 and 2019.Trends in incidence and DALYs were analysed by gender and age.Results In 2019,the highest incidence of depression,anxiety and schizophrenia in the older population in aged countries was in Japan(927271.3(752552.3-1125796.5),51498.2(37625.7-70487.3)and 126.0(61.0-223.2),respectively),while the highest incidence in ageing countries was in China(5797556.9(4599403.4-7133006.5),330256.1(246448.9-445987.4)and 1067.7(556.2-1775.9),respectively).DALYs for these disorders were similar,with the highest in Japan and China.From 1990 to 2019,the ASIR for depressive disorders decreased in aged countries but increased in ageing countries;the ASIR for anxiety disorders and schizophrenia declined in both ageing and aged countries.The ASDR for depressive disorders was consistent with the ASIR but not for anxiety disorders and schizophrenia.The ASIR for depressive disorders was higher in older women,while the opposite was observed in anxiety disorders and schizophrenia.Notably,the conditions of burden of depressive disorders,anxiety disorders and schizophrenia in the 65-70-year-old age group were the most burdensome.Conclusions The incidence and DALYs of these three mental disorders increased while exhibiting differences between ageing and aged countries.Raising awareness about formulating health policies for preventing and treating mental disorders in the older population is necessary to reduce the future burden posed by the ageing challenge.
文摘目的快速评价依达拉奉治疗急性缺血性脑卒中(AIS)的有效性、安全性和经济性,为临床决策提供循证依据。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、CNKI和WanFang Data数据库及国内外卫生技术评估(HTA)机构官方网站,搜集依达拉奉治疗AIS的HTA报告、系统评价/Meta分析和药物经济学研究文献,检索时限均为从建库至2024年10月1日。2名评价者独立筛选文献、提取资料和质量评价,汇总结果并定性描述与分析。结果共纳入文献12篇,包括9篇系统评价/Meta分析、3篇药物经济学研究。有效性方面,与安慰剂或常规疗法(阿替普酶、奥扎格雷)相比,依达拉奉单用或联合常规疗法可提高有效率、改善短期神经功能缺损评分和提高患者日常生活能力(P<0.05)。安全性方面,依达拉奉与安慰剂、常规疗法或其他神经保护剂相比不良反应发生率差异无统计学意义(P>0.05);与单用阿替普酶相比,依达拉奉联用阿替普酶可降低颅内出血发生率(P<0.05),而全因死亡率差异无统计学意义(P>0.05)。经济性方面,依达拉奉短期使用不具备成本-效果优势,而现有的远期研究显示其可能具有成本-效果优势。结论依达拉奉治疗AIS具有较好的有效性和安全性,但目前研究证据有限,该结论仍需进一步研究和临床试验予以证实,经济性方面也有待进一步评估。
