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| Age-period-cohort analysis of incidence and mortality of stroke in China from 1994 to 2023 |
| LI Jingqi, LI Chenxi, DONG Liping
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| Beijing Daxing District People's Hospital, Beijing 102600, China |
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Abstract Objective To analyze the age, period and cohort effects on the incidence and mortality of stroke in China from 1994 to 2023, so as to provide the evidence for optimizing stroke prevention and control strategies. Methods Data on crude incidence, age-standardized incidence, crude mortality and age-standardized mortality of stroke in China during 1994-2023 were extracted from the Global Burden of Disease 2023 database. The temporal trends of the above four indicators were analyzed. The age-period-cohort model was adopted to explore the age, period and birth cohort effects on crude incidence and crude mortality of stroke. Results The overall crude incidence of stroke in China increased from 177.45/105 in 1994 to 295.44/105 in 2023. The age-standardized incidence, crude mortality and age-standardized mortality decreased from 258.07/105, 170.18/105 and 275.16/105 in 1994 to 192.19/105, 143.65/105 and 93.26/105 in 2023, respectively. From 1994 to 2023, the crude incidence and crude mortality of stroke rose with advancing age with a marked acceleration after 50 years old, which increased from 221.98/105 and 193.23/105 in the 50-<55 age group to 2 771.07/105 and 957.90/105 in the 90-<95 age group. Both the incidence risk and mortality risk of stroke presented downward trends over time; the RR values decreased from 1.044 (95%CI: 1.032-1.056) and 1.580 (95%CI: 1.507-1.656) during 1994-1998 to 0.839 (95%CI: 0.823-0.856) and 0.548 (95%CI: 0.515-0.582) during 2019-2023. Additionally, the stroke incidence and mortality risks declined with the delay of birth year. The RR values dropped from 1.923 (95%CI: 1.800-2.056) and 7.453 (95%CI: 6.476-8.577) in the 1902-1906 birth cohort to 0.603 (95%CI: 0.527-0.690) and 0.042 (95%CI: 0.005-0.345) in the 2012-2016 birth cohort. Conclusions The overall disease burden of stroke in China declined from 1994 to 2023. Crude incidence and crude mortality of stroke generally increased with age, while stroke incidence and mortality risks showed 8 overall decreasing trends along with the passage of time and the renewal of birth cohorts.
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Received: 25 November 2025
Revised: 11 April 2026
Published: 27 May 2026
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