Table 1_Trends in rehabilitation needs for neurological disorders in China, 1990–2021: a cross-sectional analysis of the Global Burden of Disease Study 2021.docx

BackgroundNeurological disorders are a leading cause of long-term disability, generating substantial rehabilitation needs. China’s rapid population aging and evolving epidemiological profile underscore the urgency of quantifying these needs.
MethodUsing data from the Global Burden of Disease Study 2021, we assessed rehabilitation needs for 10 neurological disorders in China from 1990 to 2021. Prevalence and years lived with disability (YLDs) were analyzed by age, sex, and cause, benchmarked against global trends. Temporal trends were quantified by estimated annual percentage change (EAPC), and Bayesian age–period–cohort modeling was applied to forecast to 2050.
ResultsFrom 1990 to 2021, China’s age-standardized prevalence and YLDs rates increased significantly, with EAPCs of 0.42 (95% CI 0.38 to 0.45) and 0.40 (95% CI 0.36 to 0.43), both exceeding global averages. The largest absolute burdens in 2021 were from stroke, Alzheimer’s disease, and Parkinson’s disease. Parkinson’s disease (EAPC = 1.85, 95% CI 1.78 to 1.92), multiple sclerosis (1.42, 95% CI 1.36 to 1.48), and motor neuron disease (1.11, 95% CI 1.05 to 1.17) showed the steepest proportional rises. Women bore higher late-life burdens, while men had greater trauma-related disability. Rehabilitation needs were concentrated in older adults, with substantial geographic and service-access inequities reported in prior national surveys. Forecasts to 2050 indicate sustained growth, with neurodegenerative disorders comprising an increasing share of total rehabilitation demand.
ConclusionThe scale and pace of growth in China’s neurological rehabilitation needs reflect demographic aging, improved survival, and persistent service gaps. Meeting this challenge will require decentralizing rehabilitation, integrating disease-specific pathways into universal health coverage, and prioritizing underserved rural and older populations.