Long-Term Trends in the Global Burden of Age-Related Macular Degeneration: Sex Differences, Aging Effects, and Future Projections in Middle-Aged and Older Adults.
Level 4 - case-series / case-control
Cross-sectional and ecological modeling analysis of secondary population-level data
PubMed 41433217 · doi:10.1159/000550175
What was done
Using data from the Global Burden of Disease (GBD) Study 2021, the authors evaluated the global, regional, and national prevalence and disability-adjusted life years (DALYs) of age-related macular degeneration (AMD) in adults aged ≥45 years across sex and Socio-Demographic Index (SDI) groups. They applied an age-period-cohort model to assess the effects of aging, time period, and birth cohort, conducted frontier analysis to benchmark burden reduction, and used autoregressive integrated moving average (ARIMA) modeling to project age-standardized DALY rates (ASDR) and prevalence rates from 2022 to 2036.
What was found
Between 1990 and 2021, absolute AMD cases and DALYs nearly doubled worldwide. In 2021, prevalence and DALY rates rose exponentially with age, with females maintaining consistently higher rates across all age brackets. While age-period-cohort modeling showed declining risk across successive birth cohorts, low-SDI regions bore the highest age-standardized rates. ARIMA projections estimated the global ASDR will rise to 6.80 (95% CI: 5.82-7.78) by 2036, with female ASDR reaching 7.46 (95% CI: 6.29-8.63).
Why it matters
This study identifies disproportionate AMD burdens in low-resource settings and among older women, providing long-term projections to guide public health planning, screening allocation, and vision-preservation strategies through 2036.
Limits
The study relies on modeled secondary data from GBD 2021, which inherently depends on the variable quality and availability of primary epidemiological records, particularly in low-SDI countries. Individual clinical subtypes (e.g., neovascular vs. atrophic AMD), access to ophthalmic therapies, and specific risk factor data were not reported in the abstract. ARIMA projections assume historical trend continuity and cannot account for unforeseen therapeutic breakthroughs.
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