Table 2_The global, regional, and national patterns of change in the burden of edentulism, 1990–2021: an analysis of the global burden of disease study 2021 and forecast to 2041.docx

BackgroundEdentulism is a critical global health issue. It affects physical health and quality of life, and the associated healthcare costs pose a burden on individuals and society. Therefore, we analyzed the global burden of edentulism from 1990 to 2021 and projected trends from 2021 to 2041.
MethodsThis study used publicly available data from the 2021 Global Burden of Disease, Injuries, and Risk Factors Study (GBD). The paper reports prevalence, incidence, and years lived with disability (YLDs) of edentulism per 100,000 population [with 95% uncertainty intervals (UI)] in 1990 vs. 2021, across all age groups (0–95 + years). It details changing trends from 1990 to 2021 by gender, age, and Socio-demographic Index (SDI). Trends were assessed using joinpoint regression. Nordpred and BAPC models projected incidence from 2021 to 2041.
ResultsGlobally, the age-standardized incidence rate (ASIR) decreased from 328.85 (95% UI: 268.72–396.35) per 100,000 in 1990 to 305.04 (95% UI: 261.19–356.58) in 2021, with an estimated annual percentage change (EAPC) of −0.23% (95% CI: −0.33% to −0.14%), indicating a long-term decline. However, joinpoint regression revealed a recent upward trend from 2015 to 2021. The age group with the highest incidence increased by 5 years; the 75–79 group had the highest rate in 2021. The ASIR for males (284.91, 95% UI: 284.74–285.07) was lower than for females (325.06, 95% UI: 324.90–325.23) in 2021. Middle-range SDI regions tend to have high ASIR. When SDI is between 0.5 and 0.7, ASIR peaks. Incidence increased from 2015 to 2021 in both sexes. Nordpred and BAPC models predict rising incidence and case numbers from 2021 to 2041.
ConclusionsDespite declining age-standardized rates, the absolute global burden of edentulism continues to rise due to population growth and aging, disproportionately affecting low-middle SDI regions, women, and older adults (≥75 years). Without intervention, incidence and burden will escalate.

研究背景：无牙症（Edentulism）是一项重大的全球公共卫生问题，其不仅损害身体健康与生活质量，相关医疗支出还会给个人与社会带来沉重负担。因此，本研究分析了1990年至2021年全球无牙症的疾病负担，并预测了2021年至2041年的变化趋势。
研究方法：本研究采用2021年全球疾病、伤害和风险因素研究（Global Burden of Disease, Injuries, and Risk Factors Study, GBD）的公开数据集。本文报告了1990年与2021年各年龄组（0~95岁及以上）每10万人口中无牙症的患病率、发病率与伤残生存年（years lived with disability, YLDs），并附上95%不确定区间（uncertainty intervals, UI）。本研究详细阐述了1990年至2021年按性别、年龄及社会人口指数（Socio-demographic Index, SDI）划分的变化趋势，通过连接点回归（joinpoint regression）分析趋势变化，并运用Nordpred与BAPC模型预测了2021年至2041年的发病率。
研究结果：全球范围内，年龄标化发病率（age-standardized incidence rate, ASIR）从1990年的每10万人328.85（95% UI：268.72~396.35）下降至2021年的305.04（95% UI：261.19~356.58），估计年度百分比变化（estimated annual percentage change, EAPC）为-0.23%，95%置信区间（confidence interval, CI）为-0.33%~-0.14%，提示长期呈下降趋势。但连接点回归分析显示，2015年至2021年期间发病率出现阶段性上升趋势。发病率最高的年龄组较此前上移了5个年龄段，2021年75~79岁年龄组的发病率位居首位。2021年男性的年龄标化发病率（284.91，95% UI：284.74~285.07）低于女性（325.06，95% UI：324.90~325.23）。社会人口指数中等的地区通常年龄标化发病率较高，当社会人口指数介于0.5至0.7之间时，年龄标化发病率达到峰值。2015年至2021年，男女两性的发病率均有所上升。Nordpred与BAPC模型预测，2021年至2041年，无牙症的发病率与患病人数将持续攀升。
结论：尽管年龄标化发病率呈下降趋势，但受人口增长与人口老龄化影响，全球无牙症的绝对疾病负担仍在持续上升，且对中低社会人口指数地区、女性及75岁及以上老年人群造成不成比例的严重冲击。若不采取针对性干预措施，无牙症的发病率与疾病负担将进一步加剧。