Global, Regional, and National Burden of Autism Spectrum Disorder: Trends and Decomposition Analysis From 1990 to 2021, and Projections for 2045.

This study tracked autism rates worldwide from 1990 to 2021 and predicted future trends to 2045. Autism cases increased from 42 million to 62 million globally, affecting boys more than girls. Middle-income countries saw the biggest increases. Japan, South Korea, and Singapore had the highest autism rates in 2021. The study predicts autism cases will reach 72 million by 2045, but rates may start declining after 2029 due to aging populations.

This comprehensive global analysis using the Global Burden of Disease 2021 database examined autism spectrum disorder trends from 1990-2021 across 21 regions and projected burdens to 2045. Prevalent cases increased from 41.9 million to 61.8 million, with males disproportionately affected. Age-standardized prevalence rates rose from 773.25 to 788.34 per 100,000. Middle socio-demographic index regions showed largest increases, while high-income regions had minimal growth.

Japan, South Korea, and Singapore demonstrated highest 2021 prevalence rates. Decomposition analysis revealed population growth as the primary driver of case increases, with aging populations causing rate declines. Projections estimate 71.8 million cases by 2045, with prevalence rates peaking in 2029 then declining.

Findings support urgent need for enhanced autism services, particularly in middle-income countries and high-growth regions. Healthcare systems should prepare for continued burden increases through 2029, with particular attention to male populations. Early intervention programs and equitable resource distribution are essential for managing projected case increases.

Study relies on Global Burden of Disease database estimates which may have diagnostic and reporting variations across regions and time periods. Projections are model-based and subject to uncertainty. The abstract does not specify methodological details or potential confounding factors that could influence burden estimates.

Autism Spectrum Disorder (ASD) has rising global prevalence and lifelong impacts. We quantified its 1990-2021 burden using Estimated Annual Percent Change (EAPC) trends, decomposition analysis, and the Nordpred model to project burdens to 2045. This study analyzed the global, regional, and national ASD burden from 1990 to 2021 using the Global Burden of Disease (GBD) 2021 database, assessing prevalent cases, Disability-Adjusted Life Years (DALYs), Age-Standardized Prevalence Rate (ASPR), and Age-Standardized Disability-Adjusted Life Years Rate (ASDR). It used EAPC to analyze trends, decomposition analysis to examine contributors, and the Nordpred model for predictions to 2045.

From 1990 to 2021, prevalent cases rose from 41,929,995.80 to 61,823,539.64, males more affected. ASPR increased from 773.25 to 788.34/100,000, ASDR from 144.51 to 147.56/100,000. The number of DALYs increased by 3.68 million (95 % Uncertainty Interval 3.20-4.10 million) from 1990 to 2021. Middle Socio-demographic Index (SDI) regions saw the largest increases, High SDI regions minimal growth.

Among 21 GBD regions, high-income Asia Pacific grew fastest, Oceania declined. Nationally, Japan, South Korea, and Singapore had the highest 2021 ASPR/ASDR, Bangladesh, Brazil, and Nepal the lowest. Decomposition analysis showed population growth drove prevalent cases and DALYs increases, aging caused declines. Predictive models estimate 71,782,946 cases by 2045, DALYs peaking at 13,365,467 years.

ASPR and ASDR expected to peak in 2029 (792.16/100,000) and 2034 (148.55/100,000), then decline. The rising ASD burden requires immediate action, particularly in middle SDI regions and high-income Asia Pacific, where growth is speeding up. Early intervention and equitable resource distribution for high-risk groups like males and fast-growing populations are essential to cut projected case and DALY increases by 2045.