ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuroepidemiology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1651799
Age-period-cohort analysis and 2036 projections of the burden of ischemic stroke in Finland, Korea, Singapore and China, 1990-2021
Provisionally accepted
- 1China-Japan Union Hospital of Jilin University, Changchun, China
- 2Jilin University School of Nursing, Changchun, China
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Objective: To analyze the temporal changes in ischemic stroke incidence and prevalence and their correlations with age, period, and birth cohort from 1990 to 2021 in Finland, Korea, Singapore and China, and to predict the trends of incidence and number of cases in 2036. Methods: The data from the Global Burden of Disease (GBD) 2021 database were used. The effects of age, period and birth cohort on the incidence of ischemic stroke were sorted out by age-period-cohort (APC) modeling. Bayesian age-period-cohort (BAPC) modeling was used to predict the incidence rates of different sex and age groups in 2036. Results: The global all-age disability-adjusted life year (DALY) rate of ischemic stroke decreased by 34.90% between 1990 and 2021, with the highest disease burden in China, especially in males. Whereas Singapore, South Korea, and Finland were lower than the global average. The APC model showed that the incidence increased significantly with the increase of age. Compared with China, the age of high incidence in Singapore, South Korea and Finland has moved forward. In terms of period effect, there were fluctuations across the countries. Although China is less affected by the cyclical effect, the overall burden is increased. In the cohort effect, the incidence of Singapore, Finland, and Korea showed a "U-shape", while China's prevalence continued to decline. Projections for the next 15 years indicate that the incidence rates in Finland, Korea, and Singapore will remain low, whereas China may continue to increase. By 2036, it could reach nearly 200 per 100,000 people, and the uncertainty is greater, so it needs to focus on prevention and control. Conclusion: The burden of disease for ischemic stroke has been declining in all four countries from 1990 to 2021, but it has been rising in recent years and is expected to continue to rise over the next 15 years.
Keywords: ischemic stroke, Epidemiology, burden of disease, Bayesian age-period-cohort model, Disease Prediction
Received: 07 Jul 2025; Accepted: 14 Oct 2025.
Copyright: © 2025 Zhang, Zhao, Wang, Zhao and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lijing Zhao, zhao_lj@jlu.edu.cn
Zhongxin Xu, xuzhongxin@jlu.edu.cn
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