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Long-term trends in stroke and the impact of population aging in China: Results from the 2021 Global Burden of Disease Study

Chen, X.; Liang, H.; Wei, W.; mutallip, m.; Bao, X.; Yang, S.; Zhang, C.

2026-02-01 public and global health
10.64898/2026.01.29.26345177 medRxiv
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BackgroundStroke is a leading cause of public health burden in China, particularly among the elderly. This study aims to examine long-term trends in stroke incidence and the impact of population aging. MethodsUsing the Global Burden of Disease (GBD) Study 2021, we analyzed the incidence, mortality, and disability-adjusted life years (DALYs) for ischemic stroke (IS), cerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) from 1990 to 2021. We applied the estimated annual percentage change (EAPC) and decomposition analysis to assess trends and the influence of population aging. FindingsFrom 1990 to 2021, the age-standardized incidence rate (ASIR) of IS rose from 110.05 to 135.79, with an EAPC of 0.94. The EAPCs for ICH and SAH were -2.24 and -3.70, respectively. Population aging significantly contributed to the stroke burden, with 800,000 IS-related deaths from 1980 to 2021. In 2021, the proportion of IS deaths due to aging was 279.4% for men and 204.8% for women. ConclusionsStroke incidence and mortality continue to rise, especially among the elderly. Aging exacerbates the stroke burden, highlighting the need for targeted policies to improve the quality of life for the aging population.

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