Years lived with disability (YLDs) for 1160 sequelae of 289 disease and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

Theo Vos, Abraham Flaxman, Mahsen Naghavi, Rafael Lozano, Catherine Michaud, Majid Ezzati, Kenji Shibuya, Joshua Salomon, Safa Abdalla, Victor Aboyans, Jerry Abraham, Ilana Ackerman, Rakesh Aggarwal, Stephanie Ahn, Mohammad Ali, Miriam Alvarado, H Ross Anderson, Laurie Anderson, Kathryn Andrews, Charles AtkinsonLarry Baddour, Adil Bahalim, Suzanne Barker-Collo, Lope Barrero, David Bartels, Maria-Gloria Basanez, Amanda Baxter, Michelle Bell, Emelia Benjamin, D Bennett, Eduardo Bernabe, Kavi Bhalla, Bishal Bhandari, Boris Bikbov, Aref Bin Abdulhak, Gretchen Birbeck, James Black, Hannah Blencowe, Jed Blore, Fiona Blyth, Ian Bolliger, Audrey Bonaventure, Soufiane Boufous, Rupert Bourne, Michel Boussinseq, Tasanee Braithwaite, Carol Brayne, Lisa Bridgett, Simon Brooker, Peter Brooks, Traolach Brugha, Claire Bryan-Hancock, Chiara Bucello, Rachelle Buchbinder, Geoffrey Buckle, Christine Budke, Michael Burch, Peter Burney, Roy Burstein, Bianca Calabria, Benjamin Campbell, Charles Canter, Helene Carabin, Jonathan Carapetis, Loreto Carmona, Claudia Cella, Fiona Charlson, Honglei Chen, Andrew Tai-Ann Cheng, David Chou, Sumeet Chugh, Luc Coffeng, Steven Colan, Samantha Colquhoun, K Ellicott Colson, John Condon, Myles Connor, Leslie Cooper, Matthew Corriere, Monica Cortinovis, Karen Courville de Vaccaro, William Couser, Benjamin Cowie, Michael Criqui, Marita Cross, Kaustubh Dabhadkar, Manu Dahiya, Nabila Dahodwala, James Damsere-Derry, Goodarz Danaei, Adrian Davis, Diego De Leo, Louisa Degenhardt, Robert Dellavalle, Allyne Delossantos, Julie Denenberg, Sarah Derrett, Don Des Jarlais, Samath Dharmarante, Mukesh dhernai, Cesar Diaz-Torne, Helen Dolk, E Ray Dorsey, Tim Driscoll, Herbert Duber, Beth Ebel, Karen Edmond, Alexis Elbaz, Suad Eltahir Ali, Holly Erskine, Patricia Erwin, Patricia Espindola, Stalin Ewoigbokhan, Farshad Farzadfar, Valery Feigin, David Felson, Alize Ferrari, Cleusa Ferri, Eric Fevre, Mariel Finucane, Seth Flaxman, Louise Flood, Kyle Foreman, Mohammad Forouzanfar, Francis Fowkes, Richard Franklin, Marlene Fransen, Michael Freeman, Belinda Gabbe, S Gabriel, Emmanuela Gakidou, Hammad Ganatra, Bianca Garcia, Flavio Gaspari, Richard Gillum, Gerhard Gmel, Richard Gosselin, Rebecca Grainger, Justina Groeger, Francis Guillemin, David Gunnell, Ramyani Gupta, Juanita Haagsma, Holly Hagan, Yara Halasa, W Hall, Diana Haring, Josep Maria Haro, James Harrison, Rasmus Havmoeller, Rodrick Hay, Hideki Higashi, Catherine Hill, Bruno Hoen, Howard Hoffman, Peter Hotez, Damian Hoy, John Huang, Sydney Ibeanusi, Kathryn Jacobsen, Spencer James, Deborah Jarvis, Rashmi Jasrasaria, Sudha Jayaraman, Nicole Johns, Jost Jonas, Ganesan Karthikeyan, Nicholas Kassebaum, Norito Kawakami, Andre Keren, Jon-Paul Khoo, Charles King, Lisa Marie Knowlton, Olive Kobusingye, Adofo Koranteng, Rita Krishnamurthi, Ratilal Lalloo, Laura Laslett, Tim Lathlean, Janet Leasher, Yong Yi Lee, James Leigh, Stephen Lim, Elizabeth Limb, John Kent Lin, Michael Lipnick, Steven Lipshultz, W Liu, Maria Loane, Summer Ohno, Ronan Lyons, Jixiang Ma, Jacqueline Mabweijano, Michael MacIntyre, Reza Malekzadeh, Leslie Mallinger, Sivabalan Manivannan, Wagner Marcenes, Lyn March, David Margolis, G MARKS, Robin Marks, Akira Matsumori, Richard Matzopoulos, Bongani Mayosi, John McAnulty, Mary McDermott, Neil McGill, John McGrath, Maria Elena Medina-Mora, Michele Meltzer, George Menash, Tony Merriman, Ana-Claire Meyer, Valeria Miglioli, Matthew Miller, Ted Miller, Philip Mitchell, Ana Olga Mocumbi, Terrie Moffitt, Ali A Mokdad, Lorenzo Monasta, Marcella Montico, Maziar Moradi-Lakeh, Andrew Moran, Lidia Morawska, Rintaro Mori, Michele Murdoch, Michael Mwaniki, Kovin Naidoo, M Nathan Nair, Luigi Naldi, KM Venkat Narayan, Paul Nelson, Robert Nelson, Michael Nevitt, Charles Newton, Sandra Nolte, Paul Norman, Rosana Norman, Martin O'Donnell, Simon O'Hanlon, Casey Olives, Saad B Omer, Katrina Ortblad, Richard Osborne, Doruk Ozgediz, Andrew Page, Bishnu Pahari, Jeyaraj Durai Pandian, Andrea Panozo Rivero, Scott Patten, Neil Pearce, Rogelio Perez Padilla, Fernando Perez-Ruiz, Norberto Perico, Konrad Pesudovs, David Phillips, Michael Phillips, Kelsey Pierce, Sebastien Pion, Guilherme Polanczyk, Suzanne Polinder, C Arden Pope III, Svetlana Popova, Esteban Porrini, Farshad Pourmalek, Martin Prince, Rachel Pullan, Kapa Ramaiah, Dharani Ranganathan, Homie Razavi, Mathilda Regan, Jurgen Rehm, David B Rein, Guiseppe Remuzzi, Kathryn Richardson, Fredrick Rivara, Thomas Roberts, C ROBINSON, Felipe Rodriguez De Leon, Luca Ronfani, Robin Room, Lisa Rosenfeld, Lesley Rushton, Ralph Sacco, Sukanta Saha, Uchechukwu Sampson, Lidia Sanchez-Riera, Ella Sanman, David Schwebel, James graham Scott, Maria Segui-Gomez, Saeid Shahraz, Donald Shepard, Hwashin Shin, Rupak Shivakoti, David Singh, Gitanjali Singh, Jasvinder Singh, Jessica Singleton, David Sleet, Karen Sliwa, Emma Smith, J L Smith, Nicolas Stapelberg, Andrew Steer, Timothy Steiner, Wilma Stolk, Lars Jacob Stovner, Christopher Sudfeld, Sana Syed, Giorgio Tamburlini, Mohammad Tavakkoli, H Taylor, Jennifer Taylor, William Taylor, Bernadette Thomas, W Murray Thomson, George Thurston, Imad Tleyjeh, Marcello Tonelli, Jeffrey Towbin, Thomas Truelsen, Miltiadis Tsilimbaris, Clotilde Ubeda, Eduardo Undurraga, Marieke van der Werf, Jim van Os, Monica Vavilala, N Venketasubramanian, Mengru Wang, Wenzhi Wang, Kerrianne Watt, David Weatherall, Martin Weinstock, Robert Weintraub, Marc Weisskopf, Myrna Weissman, Richard White, Harvey Whiteford, Steven Wiersma, J Wilkinson, Hywel Williams, Sean Williams, Emma Witt, Frederick Wolfe, Anthony Woolf, Sarah Wulf, Pon-Hsiu Yeh, Anita Zaidi, Zhi-Jie Zheng, David Zonies, Alan Lopez, Christopher Murray

    Research output: Contribution to journalArticle

    Abstract

    Background: Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither effort quantified uncertainty in prevalence or years lived with disability (YLDs).

    Methods: 
    Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were 
    adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis.

    Findings: 
    Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350 000 cases per 1 million people. Prevalence and severity of health loss were weakly correlated (correlation coefficient −0·37). In 2010, there were 777 million YLDs from all causes, up from 583 million in 1990. The main contributors to global YLDs were mental and behavioural disorders, musculoskeletal disorders, and diabetes or endocrine diseases. The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. Age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010. Regional patterns of the leading causes of YLDs were more similar compared with years of life lost due to premature mortality. Neglected tropical diseases, HIV/AIDS, tuberculosis, malaria, and anaemia were important causes of YLDs in sub-Saharan Africa.

    Interpretation: 
    Rates of YLDs per 100 000 people have remained largely constant over time but rise steadily with age. Population growth and ageing have increased YLD numbers and crude rates over the past two decades. Prevalences of the most common causes of YLDs, such as mental and behavioural disorders and musculoskeletal disorders, have not decreased. Health systems will need to address the needs of the rising numbers of individuals with a range of disorders that largely cause disability but not mortality. Quantification of the burden of non-fatal health outcomes will be crucial to understand how well health systems are responding to these challenges. Effective and affordable strategies to deal with this rising burden are an urgent priority for health systems in most parts of the world.
    Original languageEnglish
    Pages (from-to)2163-2196
    Number of pages34
    JournalLancet
    Volume380
    Issue number9859
    DOIs
    Publication statusPublished - 2012

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