Background: Stroke is a pressing public health issue worldwide. This study aimed to forecast the future temporal trends and distribution characteristics of the global stroke burden. Methods and Results: Global data on stroke incidence, prevalence, deaths, and disability‐adjusted life years between 1990 and 2021 were obtained from the GBD (Global Burden of Disease) Study 2021. The temporal trends of stroke burden were estimated using various regression models. Gross domestic product per capita was adopted as a predictor in the model to consider the impact of economic development on stroke burden. Projections of stroke burden up to 2050 were generated using the optimal model selected based on the Akaike information criterion, encompassing global, World Bank income levels, national levels, and sex‐age groups. In 2050, we projected 21.43 million stroke cases, 159.31 million survivors, 12.05 million deaths, and 224.86 million disability‐adjusted life years due to stroke globally. From 2021 to 2050, there was a declining trend in the global age‐adjusted stroke rates, with −7% in incidence, −4% in prevalence, −28% in deaths, and −28% in disability‐adjusted life years. Upper‐middle‐income countries were projected to have the most severe stroke burden, followed by lower‐middle‐income countries, low‐income countries, and high‐income countries. The stroke burden in over half of the 204 countries and territories was expected to be alleviated from 2022 to 2050. Men and older women worldwide bear higher burden. Conclusions: Stroke remains a serious global health challenge, especially in low‐income and middle‐income countries. Targeted implementation of prevention and interventions is imperative across diverse demographic groups.
To investigate the gender differences in neurocognitive functioning in patients with first-episode schizophrenia (FES) in China. A total of 449 Chinese patients with FES (210 males, 239 females) were included in this study. Participants' psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS). Neurocognitive functioning was assessed by 10 neuropsychological tests from a battery. Neurocognitive test scores were converted to scale scores and t-scores using normative data from Chinese populations. Males were younger and less likely to be married, had an earlier age of illness onset and a longer duration of untreated psychosis (DUP), and scored higher on the PANSS negative, general and total scales than females. After controlling for potential confounders, females performed better than males in the verbal learning and memory domain (p=0.016). While most neurocognitive domains were correlated with PANSS negative scores for male patients with FES, for female patients with FES, negative associations were found between scores on the PANSS general subscales and neurocognitive domains. We also performed a case-control comparison with a group of patients with clinically stable schizophrenia (CSS) (n=60) who were matched by age, sex and education years with patients with FES (n=58). After controlling for potential confounders, no significant differences were found between patients with FES and patients with CSS in all neurocognitive domains. Female patients still performed better in the verbal learning and memory domain (t=2.14, p=0.034). No interaction effects of gender and disease were found. Gender was an independent influence factor for the verbal learning and memory domain. Both female patients with first-episode schizophrenia and female patients with clinically stable schizophrenia performed better than male patients.
The aim of this study was to develop a brief version of cognitive assessment test for evaluating the efficacy of treatments targeting cognitive impairments in Chinese schizophrenia patients, to examine its reliability, and establish normative data. Stratified according to age, gender, and educational level, healthy adult subjects were recruited from fifteen institutions in seven administrative regions of China and 723 valid samples were obtained, of which 50 were retested. Generalized Linear Models were conducted to analyze the effects of age, sex, and education. There was no significant difference between genders, while significant effects were demonstrated respectively among age and education on the normative data of C-BCT. The Cronbach α of C-BCT is 0.75, and the test-retest reliability (ICC) ranged from 0.62 to 0.76. Normative data of C-BCT were generated by gender, age and education, and the effects of these demographic factors were analyzed. It revealed good internal consistency and test-retest reliability of C-BCT.
To validate the reliability and validity of the Chinese version of the THINC-it tool in adults with major depressive disorder (MDD). Subjects aged 18 to 65 years (n=117) with MDD were evaluated and compared to age- and sex-matched healthy controls (n=124). Subjects completed the THINC-it, four criteria-related objective cognitive subtests, and the paper version of Perceived Deficits Questionnaire for Depression-5-item (PDQ-5-D). There were significant differences in Spotter [Mean difference (MD) Standard errors (SE)=-0.40 (0.17), P=0.018; 95% Confidence intervals (CI) (-0.73 to -0.07)]; Codebreaker [MD (SE)=-0.39 (0.14), P=0.006; 95% CI(-0.67 to -0.11)]; and the overall performance of four objective tests (including variants of IDN, OBK, DSST, and TMT-B) [MD (SE)=-0.30 (0.12), P=0.013; 95% CI (-0.53 to -0.06]) between the two groups. In the HC group, PDQ-5-D retest reliability was good (ICC = 0.841), and the test-retest reliability of the objective cognitive test was relatively low (ICC ranging from 0.123 to 0.545). In the MDD group: Cronbach's α of PDQ-5-D=0.704; all the THINC-it subtests had good concurrent validity (r ranging from 0.343 to 0.835, all P<0.01). The test-retest sample size was relatively small, the educational level and IQ of the control and MDD groups were not completely matched. The Chinese version of the THINC-it tool exhibits good reliability and validity in adults with MDD. There is a need to incorporate cognitive assessment of adults with MDD broadly. The THINC-it tool is the first tool validated to assess cognition of MDD in a Chinese population.