Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019

Alarcos Cieza; Kate Causey; Kaloyan Kamenov; Sarah Wulf Hanson; Somnath Chatterji; Theo Vos

doi:10.1016/S0140-6736(20)32340-0

Table
Global prevalence and years of life lived with disability for health conditions in need of rehabilitation, all-age counts, and age-standardised rates for 2019, percentage change since 1990, and average disability weight for 2019
Prevalence
Years of life lived with disability
Average disability weight
All age (millions)
Age-standardised rate (per 1000)
All age (millions)
Age-standardised rate (per 1000)
2019 Percentage change^* 2019 Percentage change^* 2019 Percentage change^* 2019 Percentage change^* 2019
Overall total 2412·0 (2338·0 to 2501·0) 63% (61 to 64)^† 298·0 (289·0 to 309·0) –5·6% (−6·1 to −5·1)^† 310·0 (235·0 to 392·0) 69% (67 to 72)^† 38·0 (29·0 to 49·0) −5% (−6 to −3·9)^† 0·13 (0·10 to 0·16)

Musculoskeletal disorders
Musculoskeletal disorders (total) 1714·0 (1632·0 to 1800·0) 62% (60 to 64)^† 210·0 (200·0 to 221·0) −8·8% (−10 to −8·2)^† 149·0 (108·0 to 199·0) 59% (55 to 64)^† 18·0 (13·0 to 24·0) −11% (−13 to −10)^† 0·08 (0·06 to 0·11)
Low back pain 568·0 (505·0 to 641·0) 47% (44 to 51)^† 70·0 (62·0 to 79·0) −16% (−17 to −16)^† 64·0 (45·0 to 85·0) 47% (43 to 51)^† 7·8 (5·5 to 10·0) −16% (−17 to −16)^† 0·11 (0·08 to 0·15)
Neck pain 223·0 (179·0 to 281·0) 79% (70 to 87)^† 27·0 (22·0 to 34·0) −0·45 % (−2·6 to 1·7) 22·0 (15·0 to 32·0) 78% (69 to 87)^† 2·7 (1·8 to 3·8) −0·31% (−2·5 to 1·8) 0·10 (0·07 to 0·14)
Fractures 436·0 (411·0 to 465·0) 69% (67 to 71)^† 54·0 (51·0 to 57·0) −6·9% (−7·8 to −6·0)^† 26·0 (18·0 to 36·0) 66% (63 to 68)^† 3·2 (2·2 to 4·4) −8·3% (9·5 to −7·2)^† 0·06 (0·04 to 0·08)
Other injuries 305·0 (282·0 to 336·0) 43% (40 to 46)^† 38·0 (35·0 to 41·0) −17% (−18 to −15)^† 11·0 (7·5 to 15·0) 25% (19 to 31)^† 1·3 (0·9 to 1·8) −24% (−27 to −21)^† 0·03 (0·02 to 0·05)
Osteoarthritis 344·0 (275·0 to 414·0) 114% (112 to 117)^† 41·0 (33·0 to 50·0) 3·1 % (1·8 to 4·2)^† 19·0 (10·0 to 38·0) 115% (112 to 117)^† 2·3 (1·2 to 4·5) 3·3% (2 to 4·6)^† 0·05 (0·03 to 0·1)
Amputation 176·0 (164·0 to 190·0) 52% (50 to 55)^† 22·0 (20·0 to 23·0) −13% (−14 to −12)^† 5·5 (3·8 to 7·7) 36% (29 to 44)^† 0·7 (0·5to 1·0) −23% (−27 to −18)^† 0·03 (0·02 to 0·04)
Rheumatoid arthritis 13·0 (12·0 to 15·0) 106% (104 to 109)^† 1·6 (1·5 to 1·8) 8·1% (7·5 to 8·6)^† 2·4 (1·7 to 3·3) 105% (102 to 108)^† 0·3 (0·2 to 0·4) 8·3% (7·3 to 9·3)^† 0·18 (0·13 to 0·24)

Neurological disorders
Neurological disorders (total) 255·0 (242·0 to 268·0) 106% (103 to 110)^† 32·0 (31·0 to 34·0) 10% (8·4 to 12)^† 51·0 (37·0 to 65·0) 104% (100 to 109)^† 6·4 (4·7 to 8·2) 11% (8·5 to 13)^† 0·20 (0·15 to 0·25)
Cerebral palsy 50·0 (44·0 to 57·0) 159% (138 to 183)^† 6·6 (5·8 to 7·6) 94% (78 to 111)^† 11·0 (7·4 to 15·0) 155% (134 to 178)^† 1·4 (1·0 to 1·9) 91% (76 to 108)^† 0·21 (0·15 to 0·28)
Stroke 86·0 (79·0 to 94·0) 85% (82 to 88)^† 11·0 (10·0 to 12·0) −6·1% (−7·3 to −4·9)^† 18·0 (13·0 to 23·0) 89% (85 to 93)^† 2·2 (1·6 to 2·8) −4·7% (−6·1 to −3·3)^† 0·21 (0·15 to 0·26)
Traumatic brain injury 49·0 (47·0 to 51·0) 80% (78 to 82)^† 6·0 (5·7 to 6·3) −0·01% (−1·1 to 1·2) 7·1 (5·0 to 10·0) 79% (77 to 82)^† 0·9 (0·6 to 1·2) 0·16% (−1 to 1·3) 0·14 (0·1 to 0·2)
Alzheimer's disease and dementia 52·0 (44·0 to 59·0) 161% (156 to 166)^† 6·8 (5·9 to 7·8) 5·7% (4·3 to 6·9)^† 7·4 (5·2 to 10·0) 165% (159 to 171)^† 1·0 (0·7 to 1·3) 5·5% (4 to 6·8)^† 0·14 (0·11 to 0·18)
Spinal cord injury 21·0 (19·0 to 24·0) 82% (74 to 87)^† 2·5 (2·3 to 2·9) 5·8 % (2·7 to 10)^† 6·2 (4·5 to 8·2) 65% (56 to 72)^† 0·8 (0·6 to 1·0) −1·6% (−5·6 to 3·3) 0·30 (0·22 to 0·38)
Parkinson's disease 3·9 (3·3 to 4·7) 156% (150 to 161)^† 0·5 (0·4 to 0·6) 16% (13 to 18)^† 1·2 (0·8 to 1·6) 155% (149 to 161)^† 0·2 (0·1 to 0·2) 16% (13 to 19)^† 0·30 (0·21 to 0·39)
Multiple sclerosis 1·4 (1·2 to 1·5) 72% (66 to 77)^† 0·2 (0·1 to 0·2) −6·1% (−8·7 to −3·8)^† 0·5 (0·3 to 0·6) 71% (65 to 77)^† 0·1 (0·04 to 0·07) −5·8% (−8·6 to −2·9)^† 0·33 (0·24 to 0·42)
Motor neuron disease 0·2 (0·2 to 0·3) 69% (62 to 76)^† 0·03 (0·02 to 0·03) 1·9% (0·61 to 3·4)^† 0·1 (0·0 to 0·1) 69% (62 to 76)^† 0·01 (0 to 0·01) 1·9% (0·57 to 3·3)^† 0·25 (0·17 to 0·32)
Guillain-Barré syndrome 0·1 (0·1 to 0·1) 67% (57 to 77)^† 0·01 (0·01 to 0·02) 6·6 % (3·6 to 10)^† 0·03 (0·02 to 0·04) 67% (57 to 77)^† 0 (0 to 0·01) 6·5% (3·6 to 9·5)^† 0·30 (0·20 to 0·41)

Sensory impairments
Sensory impairments (total) 677·0 (631·0 to 723·0) 77% (74 to 81)^† 84·0 (79 to 90) −4·5% (−5 to −4)^† 45·0 (31·0 to 62·0) 70% (65 to 74)^† 5·7 (3·9 to 7·7) −9·4% (−11 to −7·9)^† 0·07 (0·05 to 0·09)
Hearing loss 403·0 (357·0 to 449·0) 79% (74 to 84)^† 51·0 (45·0 to 56·0) −5·4% (−6·2 to −4·8)^† 24·0 (16·0 to 33·0) 69% (61 to 76)^† 3·0 (2·0 to 4·2) −7·3% (−8·3 to −6·3)^† 0·06 (0·04 to 0·08)
Vision loss 329·0 (302·0 to 358·0) 80% (77 to 83)^† 41·0 (38·0 to 44·0) −3·8% (−4·5 to −3·1)^† 21·0 (15·0 to 30·0) 71% (68 to 74)^† 2·7 (1·9 to 3·7) −12% (−14 to −9·5)^† 0·06 (0·05 to 0·09)

Mental disorders
Mental disorders (total) 187·0 (147·0 to 229·0) 40% (36 to 47)^† 24·0 (19 to 30) 0·52% (−2·1 to 4·2) 29·0 (22·0 to 37·0) 53% (49 to 58)^† 3·7 (2·8 to 4·7) 1·7% (0·06 to 3·5)^† 0·16 (0·12 to 0·20)
Developmental intellectual disability 137·0 (97·0 to 177·0) 37% (32 to 46)^† 18·0 (13·0 to 23·0) 1·2% (−2·5 to 7·1) 10·0 (6·1 to 14·0) 44% (37 to 54)^† 1·3 (0·8 to 1·9) 6·5% (1·3 to 13)^† 0·07 (0·05 to 0·1)
Schizophrenia 24·0 (20·0 to 27·0) 66% (63 to 69)^† 2·9 (2·5 to 3·3) −0·88% (−1·7 to −0·13)^† 15·0 (11·0 to 19·0) 65% (62 to 69)^† 1·8 (1·3 to 2·3) −0·57% (−1·6 to 0·38) 0·64 (0·49 to 0·76)
Autism spectrum disorders 28·0 (24·0 to 34·0) 39% (39 to 40)^† 3·7 (3·1 to 4·4) −0·93% (−1·3 to −0·61)^† 4·3 (2·8 to 6·2) 39% (38 to 40)^† 0·6 (0·4 to 0·8) −0·76% (−1·4 to −0·16)^† 0·15 (0·11 to 0·21)

Chronic respiratory diseases
Chronic respiratory diseases (total) 118·0 (107·0 to 130·0) 89% (85 to 93)^† 15·0 (13·0 to 16·0) −6% (−7·7 to −4·1)^† 20·0 (17·0 to 22·0) 89% (85 to 94)^† 2·5 (2·1 to 2·8) −4·8% (−6·6 to −3)^† 0·17 (0·14 to 0·19)
Chronic obstructive pulmonary disease 118·0 (107·0 to 130·0) 89% (85 to 93)^† 15·0 (13·0 to 16·0) −6% (−7·7 to −4·1)^† 20·0 (17·0 to 22·0) 89% (85 to 94)^† 2·5 (2·1 to 2·8) −4·8% (−6·6 to −3)^† 0·17 (0·14 to 0·19)

Cardiovascular diseases
Cardiovascular diseases (total) 37·0 (30·0 to 44·0) 106% (99 to 113)^† 4·6 (3·9 to 5·6) −7·2% (−10 to −4)^† 4·2 (2·7 to 6) 106% (99 to 114)^† 0·5 (0·4 to 0·8) −6·9% (−10 to −3·7)^† 0·11 (0·08 to 0·16)
Heart failure 35·0 (29·0 to 43·0) 107% (99 to 115)^† 4·5 (3·7 to 5·4) −6·9% (−10 to −3·5)^† 4·1 (2·6 to 5·8) 107% (99 to 115)^† 0·5 (0·3 to 0·7) 6·7% (−10 to −3·3)^† 0·11 (0·08 to 0·16)
Acute myocardial infarction 1·3 (1·1 to 1·5) 82% (80 to 84)^† 0·2 (0·1 to 0·2) −15% (−16 to −14)^† 0·1 (0·1 to 0·2) 83% (79 to 86)^† 0·01 (0·01 to 0·02) −14% (−16 to −13)^† 0·09 (0·06 to 0·12)

Neoplasms
Neoplasms (total) 18·0 (17·0 to 19·0) 118% (104 to 132)^† 2·2 (2·0 to 2·3) 4·7% (−2·2 to 12) 1·9 (1·4 to 2·6) 129% (114 to 144)^† 0·2 (0·2 to 0·3) 15% (7·5 to 22)^† 0·11 (0·08 to 0·14)

^*Percentage change from 1990 to 2019.
^†Statistically significant.

		Prevalence				Years of life lived with disability				Average disability weight
		All age (millions)		Age-standardised rate (per 1000)		All age (millions)		Age-standardised rate (per 1000)
		2019	Percentage change^*	2019	Percentage change^*	2019	Percentage change^*	2019	Percentage change^*	2019
Overall total		2412·0 (2338·0 to 2501·0)	63% (61 to 64)^†	298·0 (289·0 to 309·0)	–5·6% (−6·1 to −5·1)^†	310·0 (235·0 to 392·0)	69% (67 to 72)^†	38·0 (29·0 to 49·0)	−5% (−6 to −3·9)^†	0·13 (0·10 to 0·16)

Musculoskeletal disorders
	Musculoskeletal disorders (total)	1714·0 (1632·0 to 1800·0)	62% (60 to 64)^†	210·0 (200·0 to 221·0)	−8·8% (−10 to −8·2)^†	149·0 (108·0 to 199·0)	59% (55 to 64)^†	18·0 (13·0 to 24·0)	−11% (−13 to −10)^†	0·08 (0·06 to 0·11)
	Low back pain	568·0 (505·0 to 641·0)	47% (44 to 51)^†	70·0 (62·0 to 79·0)	−16% (−17 to −16)^†	64·0 (45·0 to 85·0)	47% (43 to 51)^†	7·8 (5·5 to 10·0)	−16% (−17 to −16)^†	0·11 (0·08 to 0·15)
	Neck pain	223·0 (179·0 to 281·0)	79% (70 to 87)^†	27·0 (22·0 to 34·0)	−0·45 % (−2·6 to 1·7)	22·0 (15·0 to 32·0)	78% (69 to 87)^†	2·7 (1·8 to 3·8)	−0·31% (−2·5 to 1·8)	0·10 (0·07 to 0·14)
	Fractures	436·0 (411·0 to 465·0)	69% (67 to 71)^†	54·0 (51·0 to 57·0)	−6·9% (−7·8 to −6·0)^†	26·0 (18·0 to 36·0)	66% (63 to 68)^†	3·2 (2·2 to 4·4)	−8·3% (9·5 to −7·2)^†	0·06 (0·04 to 0·08)
	Other injuries	305·0 (282·0 to 336·0)	43% (40 to 46)^†	38·0 (35·0 to 41·0)	−17% (−18 to −15)^†	11·0 (7·5 to 15·0)	25% (19 to 31)^†	1·3 (0·9 to 1·8)	−24% (−27 to −21)^†	0·03 (0·02 to 0·05)
	Osteoarthritis	344·0 (275·0 to 414·0)	114% (112 to 117)^†	41·0 (33·0 to 50·0)	3·1 % (1·8 to 4·2)^†	19·0 (10·0 to 38·0)	115% (112 to 117)^†	2·3 (1·2 to 4·5)	3·3% (2 to 4·6)^†	0·05 (0·03 to 0·1)
	Amputation	176·0 (164·0 to 190·0)	52% (50 to 55)^†	22·0 (20·0 to 23·0)	−13% (−14 to −12)^†	5·5 (3·8 to 7·7)	36% (29 to 44)^†	0·7 (0·5to 1·0)	−23% (−27 to −18)^†	0·03 (0·02 to 0·04)
	Rheumatoid arthritis	13·0 (12·0 to 15·0)	106% (104 to 109)^†	1·6 (1·5 to 1·8)	8·1% (7·5 to 8·6)^†	2·4 (1·7 to 3·3)	105% (102 to 108)^†	0·3 (0·2 to 0·4)	8·3% (7·3 to 9·3)^†	0·18 (0·13 to 0·24)

Neurological disorders
	Neurological disorders (total)	255·0 (242·0 to 268·0)	106% (103 to 110)^†	32·0 (31·0 to 34·0)	10% (8·4 to 12)^†	51·0 (37·0 to 65·0)	104% (100 to 109)^†	6·4 (4·7 to 8·2)	11% (8·5 to 13)^†	0·20 (0·15 to 0·25)
	Cerebral palsy	50·0 (44·0 to 57·0)	159% (138 to 183)^†	6·6 (5·8 to 7·6)	94% (78 to 111)^†	11·0 (7·4 to 15·0)	155% (134 to 178)^†	1·4 (1·0 to 1·9)	91% (76 to 108)^†	0·21 (0·15 to 0·28)
	Stroke	86·0 (79·0 to 94·0)	85% (82 to 88)^†	11·0 (10·0 to 12·0)	−6·1% (−7·3 to −4·9)^†	18·0 (13·0 to 23·0)	89% (85 to 93)^†	2·2 (1·6 to 2·8)	−4·7% (−6·1 to −3·3)^†	0·21 (0·15 to 0·26)
	Traumatic brain injury	49·0 (47·0 to 51·0)	80% (78 to 82)^†	6·0 (5·7 to 6·3)	−0·01% (−1·1 to 1·2)	7·1 (5·0 to 10·0)	79% (77 to 82)^†	0·9 (0·6 to 1·2)	0·16% (−1 to 1·3)	0·14 (0·1 to 0·2)
	Alzheimer's disease and dementia	52·0 (44·0 to 59·0)	161% (156 to 166)^†	6·8 (5·9 to 7·8)	5·7% (4·3 to 6·9)^†	7·4 (5·2 to 10·0)	165% (159 to 171)^†	1·0 (0·7 to 1·3)	5·5% (4 to 6·8)^†	0·14 (0·11 to 0·18)
	Spinal cord injury	21·0 (19·0 to 24·0)	82% (74 to 87)^†	2·5 (2·3 to 2·9)	5·8 % (2·7 to 10)^†	6·2 (4·5 to 8·2)	65% (56 to 72)^†	0·8 (0·6 to 1·0)	−1·6% (−5·6 to 3·3)	0·30 (0·22 to 0·38)
	Parkinson's disease	3·9 (3·3 to 4·7)	156% (150 to 161)^†	0·5 (0·4 to 0·6)	16% (13 to 18)^†	1·2 (0·8 to 1·6)	155% (149 to 161)^†	0·2 (0·1 to 0·2)	16% (13 to 19)^†	0·30 (0·21 to 0·39)
	Multiple sclerosis	1·4 (1·2 to 1·5)	72% (66 to 77)^†	0·2 (0·1 to 0·2)	−6·1% (−8·7 to −3·8)^†	0·5 (0·3 to 0·6)	71% (65 to 77)^†	0·1 (0·04 to 0·07)	−5·8% (−8·6 to −2·9)^†	0·33 (0·24 to 0·42)
	Motor neuron disease	0·2 (0·2 to 0·3)	69% (62 to 76)^†	0·03 (0·02 to 0·03)	1·9% (0·61 to 3·4)^†	0·1 (0·0 to 0·1)	69% (62 to 76)^†	0·01 (0 to 0·01)	1·9% (0·57 to 3·3)^†	0·25 (0·17 to 0·32)
	Guillain-Barré syndrome	0·1 (0·1 to 0·1)	67% (57 to 77)^†	0·01 (0·01 to 0·02)	6·6 % (3·6 to 10)^†	0·03 (0·02 to 0·04)	67% (57 to 77)^†	0 (0 to 0·01)	6·5% (3·6 to 9·5)^†	0·30 (0·20 to 0·41)

Sensory impairments
	Sensory impairments (total)	677·0 (631·0 to 723·0)	77% (74 to 81)^†	84·0 (79 to 90)	−4·5% (−5 to −4)^†	45·0 (31·0 to 62·0)	70% (65 to 74)^†	5·7 (3·9 to 7·7)	−9·4% (−11 to −7·9)^†	0·07 (0·05 to 0·09)
	Hearing loss	403·0 (357·0 to 449·0)	79% (74 to 84)^†	51·0 (45·0 to 56·0)	−5·4% (−6·2 to −4·8)^†	24·0 (16·0 to 33·0)	69% (61 to 76)^†	3·0 (2·0 to 4·2)	−7·3% (−8·3 to −6·3)^†	0·06 (0·04 to 0·08)
	Vision loss	329·0 (302·0 to 358·0)	80% (77 to 83)^†	41·0 (38·0 to 44·0)	−3·8% (−4·5 to −3·1)^†	21·0 (15·0 to 30·0)	71% (68 to 74)^†	2·7 (1·9 to 3·7)	−12% (−14 to −9·5)^†	0·06 (0·05 to 0·09)

Mental disorders
	Mental disorders (total)	187·0 (147·0 to 229·0)	40% (36 to 47)^†	24·0 (19 to 30)	0·52% (−2·1 to 4·2)	29·0 (22·0 to 37·0)	53% (49 to 58)^†	3·7 (2·8 to 4·7)	1·7% (0·06 to 3·5)^†	0·16 (0·12 to 0·20)
	Developmental intellectual disability	137·0 (97·0 to 177·0)	37% (32 to 46)^†	18·0 (13·0 to 23·0)	1·2% (−2·5 to 7·1)	10·0 (6·1 to 14·0)	44% (37 to 54)^†	1·3 (0·8 to 1·9)	6·5% (1·3 to 13)^†	0·07 (0·05 to 0·1)
	Schizophrenia	24·0 (20·0 to 27·0)	66% (63 to 69)^†	2·9 (2·5 to 3·3)	−0·88% (−1·7 to −0·13)^†	15·0 (11·0 to 19·0)	65% (62 to 69)^†	1·8 (1·3 to 2·3)	−0·57% (−1·6 to 0·38)	0·64 (0·49 to 0·76)
	Autism spectrum disorders	28·0 (24·0 to 34·0)	39% (39 to 40)^†	3·7 (3·1 to 4·4)	−0·93% (−1·3 to −0·61)^†	4·3 (2·8 to 6·2)	39% (38 to 40)^†	0·6 (0·4 to 0·8)	−0·76% (−1·4 to −0·16)^†	0·15 (0·11 to 0·21)

Chronic respiratory diseases
	Chronic respiratory diseases (total)	118·0 (107·0 to 130·0)	89% (85 to 93)^†	15·0 (13·0 to 16·0)	−6% (−7·7 to −4·1)^†	20·0 (17·0 to 22·0)	89% (85 to 94)^†	2·5 (2·1 to 2·8)	−4·8% (−6·6 to −3)^†	0·17 (0·14 to 0·19)
	Chronic obstructive pulmonary disease	118·0 (107·0 to 130·0)	89% (85 to 93)^†	15·0 (13·0 to 16·0)	−6% (−7·7 to −4·1)^†	20·0 (17·0 to 22·0)	89% (85 to 94)^†	2·5 (2·1 to 2·8)	−4·8% (−6·6 to −3)^†	0·17 (0·14 to 0·19)

Cardiovascular diseases
	Cardiovascular diseases (total)	37·0 (30·0 to 44·0)	106% (99 to 113)^†	4·6 (3·9 to 5·6)	−7·2% (−10 to −4)^†	4·2 (2·7 to 6)	106% (99 to 114)^†	0·5 (0·4 to 0·8)	−6·9% (−10 to −3·7)^†	0·11 (0·08 to 0·16)
	Heart failure	35·0 (29·0 to 43·0)	107% (99 to 115)^†	4·5 (3·7 to 5·4)	−6·9% (−10 to −3·5)^†	4·1 (2·6 to 5·8)	107% (99 to 115)^†	0·5 (0·3 to 0·7)	6·7% (−10 to −3·3)^†	0·11 (0·08 to 0·16)
	Acute myocardial infarction	1·3 (1·1 to 1·5)	82% (80 to 84)^†	0·2 (0·1 to 0·2)	−15% (−16 to −14)^†	0·1 (0·1 to 0·2)	83% (79 to 86)^†	0·01 (0·01 to 0·02)	−14% (−16 to −13)^†	0·09 (0·06 to 0·12)

Neoplasms
	Neoplasms (total)	18·0 (17·0 to 19·0)	118% (104 to 132)^†	2·2 (2·0 to 2·3)	4·7% (−2·2 to 12)	1·9 (1·4 to 2·6)	129% (114 to 144)^†	0·2 (0·2 to 0·3)	15% (7·5 to 22)^†	0·11 (0·08 to 0·14)