Pruritus in Europe's Aging Populations: Regional and National Patterns, 1990-2023, and Forecasts to 2050: A Systematic Analysis for the Global Burden of Disease Study 2023

Pruritus is a common and distressing symptom among older adults, yet long-term patterns and regional differences across Europe remain insufficiently characterized. As European populations age rapidly, understanding how the burden of pruritus has evolved and may change is essential for clinical and public health planning.

Using Global Burden of Disease (GBD) 2023 estimates, we quantified incidence, prevalence, and disability-adjusted life years (DALYs) of pruritus among adults aged over 60 years in Central, Eastern, and Western Europe from 1990 to 2023. Age-standardized rates and case numbers were extracted for 5-year age groups by sex and country. Temporal trends were evaluated using estimated annual percentage change (EAPC) and Joinpoint regression. Future burden to 2050 was projected with Bayesian age-period-cohort models using Integrated Nested Laplace Approximation. All estimates included 95% uncertainty intervals.

From 1990 to 2023, age-standardized incidence, prevalence, and DALY rates increased significantly across all three European regions. In 2023, Central Europe exhibited the highest rates, whereas Western Europe had the largest absolute numbers of affected individuals. Females consistently showed higher rates and earlier peak ages than males. Age-specific curves demonstrated an inverted-U shape, and country rankings were generally aligned with long-term EAPC patterns. Projections suggest continued growth in incident and prevalent cases and DALYs through 2050, especially in Western Europe, with persistent sex- and age-related disparities.

The burden of pruritus among older adults in Europe has risen steadily over the past three decades and is projected to increase further. Integrating routine itch assessment, optimized skin care, medication review, and strengthened referral pathways into primary, geriatric, and long-term care services is urgent to mitigate preventable disability in aging populations.