The Escalating Global Burden of motor neuron disease: spatiotemporal trends among older adults, affected factors, and future projections.

OBJECTIVE

Motor Neuron Disease (MND) is an increasing social health issue, in the cases of adults above 50 years of age, which requires the examination of its multidimensional burden, the spatiotemporal patterns, and the factors that contribute to it.

METHODS

We estimated age-standardized prevalence (ASPR), incidence (ASIR), mortality (ASMR), disability-adjusted life years (ASDR), and years lived with disability (ASYLDs) and years of life lost (ASYLLs) in adults aged 50 and older based on Global Burden of Disease (GBD) data 1990-2021. The correlation between Socio-demographic Index (SDI) and disease burden was sought through the analysis of correlation; the relationship between temporal changes and the gave way to joinpoint regression and the Bayesian age-period-cohort (BAPC) models to determine future disease burden.

RESULTS

The number of MND cases and age-standardized rates (ASRs) increased substantially over the period 1990-2021 with YLLs making up over 95 percent of DALYs. The highest burden was 75-84 years, with the males having a skewed burden. There were positive relationships between SDI where high-SDI regions (such as Australasia, North America, Western Europe) had the greatest burdens. The burdens were highest in Finland, Ireland and Sweden; the smallest countries recorded steep increases in Lithuania and Costa Rica. The analysis of joinpoint showed that global ASIR on the increase (1995-2005) then decreased (2019-2021), high-SDI areas recorded consistent growth. BAPC forecasted the increase in the number of cases even after minimal decrease in ASRs by 2040.

INTERPRETATION: The problem of the increasing burden of MND fueled by the aging population and negative prognosis highlights the inequalities between the strata in terms of SDI. The ability to treat increases the burdens in high-income regions. The focus on surveillance, fair prevention, and resources distribution is important. The paper has emphasized the importance of international cooperation to help reduce disparities associated with SDI and maximize interventions.