{
  "abstract": "China’s stroke burden is increasingly shaped by survival with disability, population ageing, and demand for rehabilitation and long-term support. Yet the extent to which stroke disability burden has shifted towards older-old and oldest-old adults, and how this burden relates to community and elder-care service capacity, remains insufficiently quantified. We conducted a population-based secondary analysis of Global Burden of Disease Study 2023 estimates for China from 1990 to 2023, focusing on ischaemic stroke and intracerebral haemorrhage. We examined disability-adjusted life years (DALYs), years lived with disability (YLDs), YLD share of DALYs, age-specific patterns among adults aged 50 years or older, estimated annual percentage changes (EAPCs), and three-factor decomposition of absolute DALY changes. We also linked 2023 stroke YLDs with national community health and elder-care service indicators as descriptive capacity proxies. From 1990 to 2023, the YLD share of DALYs increased from 10.5% to 22.3% for ischaemic stroke and from 1.8% to 3.3% for intracerebral haemorrhage. The crude all-age ischaemic stroke YLD rate increased by 2.75% per year (95% CI 2.68 to 2.82), while the crude all-age intracerebral haemorrhage DALY rate declined but its YLD rate and YLD share increased. Crude all-age rates were interpreted as population-level burden indicators influenced by population age structure, alongside age-stratified and decomposition analyses. Among adults aged 50 years or older, disability burden shifted towards older-old and oldest-old groups, particularly for ischaemic stroke. In 2023, combined all-age YLDs from ischaemic stroke and intracerebral haemorrhage were approximately 4.77 million, corresponding descriptively to 128.2 YLDs per community health service centre/station and 16.7 YLDs per community health bed. Stroke in China is increasingly a survivorship and disability challenge. The burden-to-capacity proxy indicators provide planning context but do not directly measure rehabilitation access, adequacy, quality, or unmet need.",
  "abstract_shown": true,
  "affiliations": [
    "Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China",
    "Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yumin Zhou"
    },
    {
      "affs": [
        1
      ],
      "name": "Wenke Fan"
    },
    {
      "name": "Dandan Lv"
    },
    {
      "name": "Qian Li"
    },
    {
      "name": "Yu Cao"
    },
    {
      "name": "Hao Tian"
    },
    {
      "name": "Weiwei Guo"
    },
    {
      "name": "Xia Bi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/155trwsxzz8pm.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0361758",
  "fulltext_url": null,
  "id": "155trwsxzz8pm",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0361758",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2728|Acute Ischemic Stroke Management"
    ],
    [
      "plos",
      "/Biology and life sciences/Developmental biology/Organism development/Aging"
    ],
    [
      "plos",
      "/Biology and life sciences/Physiology/Physiological processes/Aging"
    ],
    [
      "plos",
      "/Medicine and health sciences/Clinical medicine/Signs and symptoms/Hemorrhage"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Cerebrovascular diseases/Stroke"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Cerebrovascular diseases/Stroke/Hemorrhagic stroke"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Cerebrovascular diseases/Stroke/Ischemic stroke"
    ],
    [
      "plos",
      "/Medicine and health sciences/Neurology/Cerebrovascular diseases/Stroke"
    ],
    [
      "plos",
      "/Medicine and health sciences/Neurology/Cerebrovascular diseases/Stroke/Hemorrhagic stroke"
    ],
    [
      "plos",
      "/Medicine and health sciences/Neurology/Cerebrovascular diseases/Stroke/Ischemic stroke"
    ],
    [
      "plos",
      "/Medicine and health sciences/Public and occupational health"
    ],
    [
      "plos",
      "/Medicine and health sciences/Public and occupational health/Global health"
    ],
    [
      "plos",
      "/Medicine and health sciences/Vascular medicine/Hemorrhage"
    ],
    [
      "plos",
      "/Medicine and health sciences/Vascular medicine/Stroke"
    ],
    [
      "plos",
      "/Medicine and health sciences/Vascular medicine/Stroke/Hemorrhagic stroke"
    ],
    [
      "plos",
      "/Medicine and health sciences/Vascular medicine/Stroke/Ischemic stroke"
    ],
    [
      "plos",
      "/People and places/Geographical locations/Asia/China"
    ]
  ],
  "openalex": "W7225433930",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-06",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/155trwsxzz8pm.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:20:24Z",
      "native_id": "10.1371/journal.pone.0361758",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0361758"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:public and occupational health",
      "subfield": "epidemiology-public-health"
    },
    {
      "field": "medicine",
      "origin": "plos:neurology",
      "subfield": "neurology"
    }
  ],
  "title": "Stroke disability burden and rehabilitation service-capacity proxies in China, 1990–2023: A population-based analysis using GBD 2023 and national service statistics",
  "title_text": "Stroke disability burden and rehabilitation service-capacity proxies in China, 1990–2023: A population-based analysis using GBD 2023 and national service statistics",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:20:48Z",
  "url": "https://research.draconitic.com/paper/155trwsxzz8pm",
  "venue": "PLOS One",
  "versions": []
}