{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:38:27Z","timestamp":1792795107386,"version":"4.5.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neurological disorders are a leading cause of long-term disability, generating substantial rehabilitation needs. China\u2019s rapid population aging and evolving epidemiological profile underscore the urgency of quantifying these needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Using data from the Global Burden of Disease Study 2021, we assessed rehabilitation needs for 10 neurological disorders in China from 1990 to 2021. Prevalence and years lived with disability (YLDs) were analyzed by age, sex, and cause, benchmarked against global trends. Temporal trends were quantified by estimated annual percentage change (EAPC), and Bayesian age\u2013period\u2013cohort modeling was applied to forecast to 2050.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 1990 to 2021, China\u2019s age-standardized prevalence and YLDs rates increased significantly, with EAPCs of 0.42 (95% CI 0.38 to 0.45) and 0.40 (95% CI 0.36 to 0.43), both exceeding global averages. The largest absolute burdens in 2021 were from stroke, Alzheimer\u2019s disease, and Parkinson\u2019s disease. Parkinson\u2019s disease (EAPC = 1.85, 95% CI 1.78 to 1.92), multiple sclerosis (1.42, 95% CI 1.36 to 1.48), and motor neuron disease (1.11, 95% CI 1.05 to 1.17) showed the steepest proportional rises. Women bore higher late-life burdens, while men had greater trauma-related disability. Rehabilitation needs were concentrated in older adults, with substantial geographic and service-access inequities reported in prior national surveys. Forecasts to 2050 indicate sustained growth, with neurodegenerative disorders comprising an increasing share of total rehabilitation demand.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The scale and pace of growth in China\u2019s neurological rehabilitation needs reflect demographic aging, improved survival, and persistent service gaps. Meeting this challenge will require decentralizing rehabilitation, integrating disease-specific pathways into universal health coverage, and prioritizing underserved rural and older populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1688298","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T04:11:38Z","timestamp":1775707898000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Trends in rehabilitation needs for neurological disorders in China, 1990\u20132021: a cross-sectional analysis of the Global Burden of Disease Study 2021"],"prefix":"10.3389","volume":"13","author":[{"given":"Chengcheng","family":"Zhang","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Shantou University Medical College, Shantou","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqi","family":"Xiu","sequence":"additional","affiliation":[{"name":"School of Public Health, Harbin Medical University, Harbin","place":["Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjuan","family":"Ying","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Shantou University Medical College, Shantou","place":["Guangdong, China"]},{"name":"Shantou University Medical College, Shantou","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifeng","family":"Xiao","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Shantou University Medical College, Shantou","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/S1474-4422(18)30499-X","article-title":"Global, regional, and national burden of neurological disorders, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016.","volume":"18","year":"2019","journal-title":"Lancet Neurol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000495197","article-title":"Global burden of neurological disorders: from Global Burden of Disease estimates to actions.","volume":"52","author":"Feigin","year":"2019","journal-title":"Neuroepidemiology."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2006","DOI":"10.1016\/S0140-6736(20)32340-0","article-title":"Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019.","volume":"396","author":"Cieza","year":"2021","journal-title":"Lancet."},{"key":"B4","doi-asserted-by":"publisher","first-page":"834","DOI":"10.23736\/S1973-9087.17.04746-3","article-title":"The World health organization \u201cRehabilitation 2030: a call for action\u201d.","volume":"53","author":"Gimigliano","year":"2017","journal-title":"Eur J Phys Rehabil Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"167","DOI":"10.2471\/BLT.17.191809","article-title":"Strengthening health systems to provide rehabilitation services.","volume":"95","author":"Krug","year":"2017","journal-title":"Bull World Health Organ."},{"key":"B6","doi-asserted-by":"publisher","first-page":"100692","DOI":"10.1016\/j.medj.2025.100692","article-title":"GBD 2021 China Neurological Disorders et al. Burden of neurological disorders in China and its provinces, 1990-2021: findings from the global burden of disease study 2021.","volume":"6","author":"Zhang","year":"2025","journal-title":"Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"952161","DOI":"10.3389\/fpubh.2022.952161","article-title":"Global, regional, and national burden and attributable risk factors of neurological disorders: the Global Burden of Disease study 1990-2019.","volume":"10","author":"Ding","year":"2022","journal-title":"Front Public Health."},{"key":"B8","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1161\/CIRCULATIONAHA.116.025250","article-title":"Prevalence, incidence, and mortality of stroke in China: results from a nationwide population-based survey of 480 687 adults.","volume":"135","author":"Wang","year":"2017","journal-title":"Circulation."},{"key":"B9","doi-asserted-by":"publisher","first-page":"914245","DOI":"10.3389\/fpsyt.2022.914245","article-title":"Socioeconomic inequality in rehabilitation service utilization for schizophrenia in China: findings from a 7-year nationwide longitudinal study.","volume":"13","author":"Ding","year":"2022","journal-title":"Front Psychiatry."},{"key":"B10","volume-title":"Global Burden of Disease Study 2021 (GBD 2021) Results","year":"2023"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019.","volume":"396","year":"2020","journal-title":"Lancet."},{"key":"B12","doi-asserted-by":"publisher","first-page":"e712","DOI":"10.1016\/S2214-109X(15)00069-8","article-title":"Disability weights for the Global Burden of Disease 2013 study.","volume":"3","author":"Salomon","year":"2015","journal-title":"Lancet Glob Health."},{"key":"B13","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1002\/bimj.201500263","article-title":"Projecting the future burden of cancer: bayesian age-period-cohort analysis with integrated nested laplace approximations.","volume":"59","author":"Riebler","year":"2017","journal-title":"Biom J."},{"key":"B14","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1146\/annurevstatistics-040220-091727","article-title":"Post-processing of MCMC.","volume":"9","author":"South","year":"2021","journal-title":"Annu Rev Stat Appl."},{"key":"B15","first-page":"1","article-title":"Age standardization of death rates: implementation of the year 2000 standard.","volume":"47","author":"Anderson","year":"1998","journal-title":"Natl Vital Stat Rep."},{"key":"B16","doi-asserted-by":"publisher","first-page":"3670","DOI":"10.1002\/sim.3733","article-title":"Estimating average annual per cent change in trend analysis.","volume":"28","author":"Clegg","year":"2009","journal-title":"Stat Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/S1474-4422(24)00038-3","article-title":"Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021.","volume":"23","year":"2024","journal-title":"Lancet Neurol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1016\/S0140-6736(11)61176-8","article-title":"Population ageing and wellbeing: lessons from Japan\u2019s long-term care insurance policy.","volume":"378","author":"Tamiya","year":"2011","journal-title":"Lancet."},{"key":"B19","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1093\/heapol\/czn037","article-title":"Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage.","volume":"24","author":"Kwon","year":"2009","journal-title":"Health Policy Plan."},{"key":"B20","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1136\/svn-2020-000355","article-title":"Chinese stroke association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update on organizational stroke management.","volume":"5","author":"Lou","year":"2020","journal-title":"Stroke Vasc Neurol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/S1474-4422(18)30415-0","article-title":"Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990\u20132016: a systematic analysis.","volume":"18","year":"2019","journal-title":"Lancet Neurol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"04160","DOI":"10.7189\/jogh.13.04160","article-title":"Global, regional, and national burden of neurological disorders in 204 countries and territories worldwide.","volume":"13","author":"Huang","year":"2023","journal-title":"J Glob Health."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1192","DOI":"10.1016\/S0140-6736(19)32136-1","article-title":"10 years of health-care reform in China: progress and gaps in Universal Health Coverage.","volume":"394","author":"Yip","year":"2019","journal-title":"Lancet."},{"key":"B24","doi-asserted-by":"publisher","first-page":"7160","DOI":"10.3390\/ijerph17197319","article-title":"Regional disparities of rehabilitation resources for persons with disabilities in China: data from 2014 to 2019.","volume":"17","author":"Jing","year":"2020","journal-title":"Int J Environ Res Public Health."},{"key":"B25","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s12939-018-0742-z","article-title":"Unequal distribution of health human resource in mainland China: what are the determinants from a comprehensive perspective?","volume":"17","author":"Li","year":"2018","journal-title":"Int J Equity Health."},{"key":"B26","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1093\/geront\/gnx018","article-title":"The german long-term care insurance program: evolution and recent developments.","volume":"58","author":"Nadash","year":"2018","journal-title":"Gerontologist."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1001\/jamaneurol.2019.1604","article-title":"Efficacy of home-based telerehabilitation vs in-clinic therapy for adults after stroke: a randomized clinical trial.","volume":"76","author":"Cramer","year":"2019","journal-title":"JAMA Neurol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1016\/S1474-4422(16)30230-7","article-title":"The epidemiology of Parkinson\u2019s disease: risk factors and prevention.","volume":"15","author":"Ascherio","year":"2016","journal-title":"Lancet Neurol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/S0140-6736(20)30367-6","article-title":"Dementia prevention, intervention, and care: 2020 report of the Lancet commission.","volume":"396","author":"Livingston","year":"2020","journal-title":"Lancet."},{"key":"B30","doi-asserted-by":"publisher","first-page":"2016","DOI":"10.1016\/S0140-6736(13)60221-4","article-title":"Epidemiology of Alzheimer\u2019s disease and other forms of dementia in China, 1990-2010: a systematic review and analysis.","volume":"381","author":"Chan","year":"2013","journal-title":"Lancet."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.1016\/S0140-6736(19)30427-1","article-title":"Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.","volume":"394","author":"Zhou","year":"2019","journal-title":"Lancet."},{"key":"B32","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1016\/S0140-6736(18)31712-4","article-title":"Maternal mortality ratios in 2852 Chinese counties, 1996\u20132015, and achievement of millennium development goal 5 in China: a subnational analysis of the global burden of disease study 2016.","volume":"393","author":"Liang","year":"2019","journal-title":"Lancet"},{"key":"B33","doi-asserted-by":"publisher","first-page":"CD007146","DOI":"10.1002\/14651858.CD007146.pub3","article-title":"Interventions for preventing falls in older people living in the community.","volume":"2012","author":"Gillespie","year":"2012","journal-title":"Cochrane Database Syst Rev."},{"key":"B34","doi-asserted-by":"publisher","first-page":"S201","DOI":"10.1016\/j.apmr.2013.10.010","article-title":"Systematic review of return to work after mild traumatic brain injury: results of the international collaboration on mild traumatic brain injury prognosis.","volume":"95","author":"Cancelliere","year":"2014","journal-title":"Arch Phys Med Rehabil."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1326","DOI":"10.1056\/NEJMsa1204629","article-title":"Monetary costs of dementia in the United States.","volume":"368","author":"Hurd","year":"2013","journal-title":"N Engl J Med."},{"key":"B36","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/S0140-6736(05)17868-4","article-title":"Early supported discharge services for stroke patients: a meta-analysis of individual patients\u2019 data.","volume":"365","author":"Langhorne","year":"2005","journal-title":"Lancet."},{"key":"B37","doi-asserted-by":"publisher","first-page":"e5004","DOI":"10.1136\/bmj.e5004","article-title":"Physiotherapy intervention in Parkinson\u2019s disease: systematic review and meta-analysis.","volume":"345","author":"Tomlinson","year":"2012","journal-title":"BMJ."},{"key":"B38","doi-asserted-by":"publisher","first-page":"CD006036","DOI":"10.1002\/14651858.CD006036.pub2","article-title":"Multidisciplinary rehabilitation for adults with multiple sclerosis.","volume":"2","author":"Khan","year":"2007","journal-title":"Cochrane Database Syst Rev."},{"key":"B39","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1016\/S1474-4422(05)70326-4","article-title":"Effects of non-invasive ventilation on survival and quality of life in motor neuron disease: a randomised controlled trial.","volume":"5","author":"Bourke","year":"2006","journal-title":"Lancet Neurol."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1688298\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T04:11:42Z","timestamp":1775707902000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1688298\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,9]]},"references-count":39,"alternative-id":["10.3389\/fmed.2026.1688298"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1688298","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,9]]},"article-number":"1688298"}}