Global trends and projections of rehabilitation needs in chronic obstructive pulmonary disease, 1990-2050: an analysis using WHO rehabilitation need estimates.

Chronic obstructive pulmonary disease (COPD) is a major contributor to disability worldwide. Rehabilitation plays an important role in improving functional outcomes, yet global patterns of potential population-level rehabilitation needs among people with COPD remain insufficiently described.

We used the WHO Rehabilitation Need Estimates to estimate potential rehabilitation needs and years lived with disability (YLDs) among people with COPD across 195 countries from 1990 to 2021, with projections to 2050. Temporal trends, decomposition of drivers, associations with the socio-demographic index (SDI), and inequality indices were assessed.

In 2021, potential rehabilitation needs related to COPD reached 123.5 million (95% UI 105.5-142.2), and YLDs reached 14.9 million (11.9-17.9). From 1990 to 2021, both measures increased substantially, whereas the age-standardized prevalence rate (ASPR) remained stable and the age-standardized YLD rate (ASYR) increased slightly. The largest burdens were observed in the South-East Asia and Western Pacific Regions, with the fastest growth in the African and Eastern Mediterranean Regions. China, India, and the United States had the largest absolute numbers. By 2050, potential rehabilitation needs and YLDs are projected to reach 150.2 million and 18.6 million, respectively. Increases were mainly driven by population growth and population aging. Women had higher absolute numbers of potential rehabilitation needs and YLDs, whereas men had higher ASPRs at older ages. YLDs were disproportionately concentrated in lower-SDI countries, with persistent inequalities.

Potential rehabilitation needs among people with COPD have increased substantially and are projected to continue rising through 2050, primarily driven by demographic changes and persistent socioeconomic inequalities. These findings highlight the importance of strengthening COPD prevention and improving rehabilitation planning, particularly for aging populations and lower-SDI settings.
Chronic respiratory disease
Mental Health
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Policy
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Authors

Qiu Qiu, Lan Lan, Hou Hou, Huang Huang, Huang Huang, Xia Xia
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