Analysis of rehabilitation needs in patients with dementia in Russia

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Background. Dementia is one of the leading causes of disability among older adults that requires significant rehabilitation services. In Russia, the population aging is expected to increase the number of people with dementia and associated functional limitations. However, rehabilitation needs for this condition have not been quantitatively assessed. Objective: To estimate the magnitude and trends in rehabilitation need of people with Alzheimer's disease and other dementias in Russia. Material and methods. A secondary analysis was conducted using aggregated data from the Global Burden of Disease (GBD) program 2023 and the World Health Organization (WHO) Rehabilitation Need Estimator for the years 1990–2021; the latter is a joint project of the WHO and the Institute for Health Metrics and Evaluation (IHME). Crude and age-standardized indicators of the need for rehabilitation were analyzed, including prevalence, years lived with disability (YLD) per 100,000 population, and disability-adjusted life years (DALY) per 100,000 population. Then, the dynamics of these indicators and age–sex structure for Russia were assessed and compared with those of the WHO European Region for 2019. Results. Age-standardized prevalence of rehabilitation need declined from 693.5 cases per 100,000 in 1990 to 673.4 cases per 100,000 in 2021 (–2.9%). The age-standardized YLD rate decreased from 154.7 to 147.1 per 100,000 (–4.9%). According to GBD 2023 data, the crude DALY rate increased from 384.8 in 1990 to 631.0 in 2019 per 100,000, indicating a growth of the absolute burden (+64.0%). Female YLD (159.4) was 1.33 times higher than male YLD (119.6 per 100,000). Notably, the YLD in the 95+ age group was found to be 19 times higher than in the 65–69 age group, thus reflecting a sharp age gradient. Crude rates of DALY, YLD, mortality, and prevalence in Russia were 24–34% lower than the average for the WHO European Region. Conclusion. Although age-standardized rates have stabilized, the absolute need for rehabilitation in Russia is increasing and will continue to grow due to population aging. Lower rates compared with Europe probably reflect higher premature mortality and underdiagnosis of dementia rather than favorable conditions. Thus, integrating rehabilitation into dementia care pathways is an urgent priority in the healthcare system.