Supplementary Material for: Disease burden of Parkinson’s disease in Asia and its 34 countries and territories from 1990 to 2021: findings from the Global Burden of Disease Study 2021

Introduction: The increasing global population and aging have made Parkinson's disease (PD) a significant public health concern. Comprehensive evaluations of PD burden trends in Asian subregions and countries are lacking. This study investigated PD burden in Asia from 1990 to 2021, categorized by age, sex, and region. Methods: Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 were analyzed to assess the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) across five Asian subregions and 34 countries/territories, using join-point regression, decomposition analysis, frontier analysis, and Bayesian models to examine changes, influencing factors, and predict future trends. Results: In 2021, the age-standardized PD incidence and prevalence in Asia were higher than the global average, particularly in East Asia (24.16 and 243.46/100,000, respectively). From 1990 to 2021, the incidence of PD in Asia rose by 198.01%, its prevalence rose by 284.35%, mortality rose by 111.27%, and DALY rose by 144.45%. Males consistently presented a greater PD burden than females did, with a growing sex gap over time. PD burden increased with age, especially among those aged 65 years and older. Population aging was the primary driver of new PD cases, and increasing etiological factors led to more patients. Inequalities in the PD burden have increased between high- and low-income areas, with low-income regions being more affected. By 2036, PD incidence is projected to increase in all subregions except the High-income Asia-Pacific region, with males experiencing a higher rate of increase. Conclusion: The PD burden in Asia has significantly increased over the past three decades, particularly in middle-aged and elderly males, middle- and low-SDI countries, and individuals already suffering from PD. The increasing incidence and aging population necessitate the reallocation of medical resources, improved chronic disease management systems, stronger public health interventions, and sustainable development efforts. Research into etiological factors, pathogenesis, early diagnosis, preventive interventions, and regional management is critical.引言：全球人口增长与老龄化趋势使得帕金森病（Parkinson's Disease, PD）成为不容忽视的重大公共卫生议题。目前学界尚缺乏针对亚洲各次区域及国家的帕金森病疾病负担趋势的全面评估。本研究针对1990年至2021年亚洲地区的帕金森病疾病负担展开系统性分析，按年龄、性别及地理区域进行分类统计。研究方法：本研究对2021年全球疾病、伤害与危险因素负担研究（Global Burden of Diseases, Injuries, and Risk Factors Study, GBD）的公开数据进行分析，旨在评估亚洲5个次区域及34个国家/地区的帕金森病发病率、患病率、死亡率与伤残调整生命年（Disability-Adjusted Life Years, DALYs）；通过连接点回归、分解分析、前沿分析与贝叶斯模型，考察疾病负担的动态变化、潜在影响因素并预测未来发展趋势。研究结果：2021年，亚洲地区帕金森病的年龄标化发病率与患病率均高于全球平均水平，其中东亚地区表现尤为突出（分别为24.16/10万与243.46/10万）。1990年至2021年间，亚洲帕金森病发病率累计上升198.01%，患病率上升284.35%，死亡率上升111.27%，伤残调整生命年上升144.45%。男性群体的帕金森病疾病负担始终高于女性，且性别间的负担差距随时间持续扩大。疾病负担随年龄增长呈显著上升趋势，尤以65岁及以上老年群体为甚。人口老龄化是新增帕金森病病例的核心驱动因素，而致病危险因素的增加进一步推高了患者总规模。高收入与低收入地区间的帕金森病疾病负担不平等程度有所加剧，低收入地区受疾病影响更为严重。预计到2036年，除高收入亚太地区外，亚洲所有次区域的帕金森病发病率均将呈现上升态势，且男性群体的增幅更高。研究结论：过去三十年间，亚洲地区的帕金森病疾病负担已显著加重，尤其集中于中老年男性、中等及低社会人口指数（Socio-demographic Index, SDI）国家与已确诊帕金森病群体。发病率的持续攀升与人口老龄化趋势，要求相关部门重新调配医疗资源、完善慢性病管理体系、强化公共卫生干预举措并推进可持续发展工作。针对帕金森病致病危险因素、发病机制、早期诊断手段、预防干预策略及区域化管理模式的研究，具有至关重要的现实意义。