Bayesian age‐period‐cohort analysis and trend prediction of epilepsy disease burden in China, 1990–2021

OBJECTIVE: This study analyzes the trends, age-period-cohort effects, and influencing factors of epilepsy burden in China from 1990 to 2021, and predicts future burden to support prevention strategies. METHODS: Data were sourced from the Global Burden of Disease Study (GBD) 2021 study. Joinpoint regression analyzed trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs). The BAPC (Bayesian Age-Period-Cohort) model evaluated age, period, and cohort effects, and an ARIMA (Autoregressive Integrated Moving Average) model projected burden to 2036. RESULTS: In 2021, epilepsy cases reached 3.086 million (a 41.67% increase since 1990), while DALYs fell to 1.375 million person-years (a 35.60% decrease). Age-standardized incidence and prevalence increased (average annual percent change [AAPC] = 0.78% and 0.42%, respectively), whereas mortality and DALY rates declined (AAPC = -2.65% and -1.79%). After 2019, incidence and prevalence rose sharply, accompanied by a short-term increase in DALY rates indicating a risk of rebound. Age-specific burden shifted from a unimodal (0-25 years) to a bimodal distribution (0-14 and 30-34 years), with the highest burden now among working-age adults. The DALY rate decreased slowest in youths (20-24 years) and fastest in middle-aged groups (45-55 years). Projections indicate continued declines in mortality but stable yet fluctuating incidence through 2036. CONCLUSION: Despite improved mortality and DALY rates, epilepsy incidence and prevalence have increased, and although the overall DALY rate has declined, a recent uptick since 2019 signals the need for continued vigilance and targeted intervention. The shifting burden toward working-age populations underscores the need for differentiated prevention strategies focusing on young adults and the elderly, emphasizing early intervention and long-term management.