Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019

Autor: Emma Nichols, Jaimie D Steinmetz, Stein Emil Vollset, Kai Fukutaki, Julian Chalek, Foad Abd-Allah, Amir Abdoli, Ahmed Abualhasan, Eman Abu-Gharbieh, Tayyaba Tayyaba Akram, Hanadi Al Hamad, Fares Alahdab, Fahad Mashhour Alanezi, Vahid Alipour, Sami Almustanyir, Hubert Amu, Iman Ansari, Jalal Arabloo, Tahira Ashraf, Thomas Astell-Burt, Getinet Ayano, Jose L Ayuso-Mateos, Atif Amin Baig, Anthony Barnett, Amadou Barrow, Bernhard T Baune, Yannick Béjot, Woldesellassie M Mequanint Bezabhe, Yihienew Mequanint Bezabih, Akshaya Srikanth Bhagavathula, Sonu Bhaskar, Krittika Bhattacharyya, Ali Bijani, Atanu Biswas, Srinivasa Rao Bolla, Archith Boloor, Carol Brayne, Hermann Brenner, Katrin Burkart, Richard A Burns, Luis Alberto Cámera, Chao Cao, Felix Carvalho, Luis F S Castro-de-Araujo, Ferrán Catalá-López, Ester Cerin, Prachi P Chavan, Nicolas Cherbuin, Dinh-Toi Chu, Vera Marisa Costa, Rosa A S Couto, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Vanessa De la Cruz-Góngora, Deepak Dhamnetiya, Diana Dias da Silva, Daniel Diaz, Abdel Douiri, David Edvardsson, Michael Ekholuenetale, Iman El Sayed, Shaimaa I El-Jaafary, Khalil Eskandari, Sharareh Eskandarieh, Saman Esmaeilnejad, Jawad Fares, Andre Faro, Umar Farooque, Valery L Feigin, Xiaoqi Feng, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Pietro Ferrara, Irina Filip, Howard Fillit, Florian Fischer, Shilpa Gaidhane, Lucia Galluzzo, Ahmad Ghashghaee, Nermin Ghith, Alessandro Gialluisi, Syed Amir Gilani, Ionela-Roxana Glavan, Elena V Gnedovskaya, Mahaveer Golechha, Rajeev Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Mohammad Rifat Haider, Brian J Hall, Samer Hamidi, Asif Hanif, Graeme J Hankey, Shafiul Haque, Risky Kusuma Hartono, Ahmed I Hasaballah, M Tasdik Hasan, Amr Hassan, Simon I Hay, Khezar Hayat, Mohamed I Hegazy, Golnaz Heidari, Reza Heidari-Soureshjani, Claudiu Herteliu, Mowafa Househ, Rabia Hussain, Bing-Fang Hwang, Licia Iacoviello, Ivo Iavicoli, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Seyed Sina Naghibi Irvani, Hiroyasu Iso, Masao Iwagami, Roxana Jabbarinejad, Louis Jacob, Vardhmaan Jain, Sathish Kumar Jayapal, Ranil Jayawardena, Ravi Prakash Jha, Jost B Jonas, Nitin Joseph, Rizwan Kalani, Amit Kandel, Himal Kandel, André Karch, Ayele Semachew Kasa, Gizat M Kassie, Pedram Keshavarz, Moien AB Khan, Mahalaqua Nazli Khatib, Tawfik Ahmed Muthafer Khoja, Jagdish Khubchandani, Min Seo Kim, Yun Jin Kim, Adnan Kisa, Sezer Kisa, Mika Kivimäki, Walter J Koroshetz, Ai Koyanagi, G Anil Kumar, Manasi Kumar, Hassan Mehmood Lak, Matilde Leonardi, Bingyu Li, Stephen S Lim, Xuefeng Liu, Yuewei Liu, Giancarlo Logroscino, Stefan Lorkowski, Giancarlo Lucchetti, Ricardo Lutzky Saute, Francesca Giulia Magnani, Ahmad Azam Malik, João Massano, Man Mohan Mehndiratta, Ritesh G Menezes, Atte Meretoja, Bahram Mohajer, Norlinah Mohamed Ibrahim, Yousef Mohammad, Arif Mohammed, Ali H Mokdad, Stefania Mondello, Mohammad Ali Ali Moni, Md Moniruzzaman, Tilahun Belete Mossie, Gabriele Nagel, Muhammad Naveed, Vinod C Nayak, Sandhya Neupane Kandel, Trang Huyen Nguyen, Bogdan Oancea, Nikita Otstavnov, Stanislav S Otstavnov, Mayowa O Owolabi, Songhomitra Panda-Jonas, Fatemeh Pashazadeh Kan, Maja Pasovic, Urvish K Patel, Mona Pathak, Mario F P Peres, Arokiasamy Perianayagam, Carrie B Peterson, Michael R Phillips, Marina Pinheiro, Michael A Piradov, Constance Dimity Pond, Michele H Potashman, Faheem Hyder Pottoo, Sergio I Prada, Amir Radfar, Alberto Raggi, Fakher Rahim, Mosiur Rahman, Pradhum Ram, Priyanga Ranasinghe, David Laith Rawaf, Salman Rawaf, Nima Rezaei, Aziz Rezapour, Stephen R Robinson, Michele Romoli, Gholamreza Roshandel, Ramesh Sahathevan, Amirhossein Sahebkar, Mohammad Ali Sahraian, Brijesh Sathian, Davide Sattin, Monika Sawhney, Mete Saylan, Silvia Schiavolin, Allen Seylani, Feng Sha, Masood Ali Shaikh, KS Shaji, Mohammed Shannawaz, Jeevan K Shetty, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Diego Augusto Santos Silva, João Pedro Silva, Renata Silva, Jasvinder A Singh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Amanda E Smith, Sergey Soshnikov, Emma Elizabeth Spurlock, Dan J Stein, Jing Sun, Rafael Tabarés-Seisdedos, Bhaskar Thakur, Binod Timalsina, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Gebiyaw Wudie Tsegaye, Sahel Valadan Tahbaz, Pascual R Valdez, Narayanaswamy Venketasubramanian, Vasily Vlassov, Giang Thu Vu, Linh Gia Vu, Yuan-Pang Wang, Anders Wimo, Andrea Sylvia Winkler, Lalit Yadav, Seyed Hossein Yahyazadeh Jabbari, Kazumasa Yamagishi, Lin Yang, Yuichiro Yano, Naohiro Yonemoto, Chuanhua Yu, Ismaeel Yunusa, Siddhesh Zadey, Mikhail Sergeevich Zastrozhin, Anasthasia Zastrozhina, Zhi-Jiang Zhang, Christopher J L Murray, Theo Vos
Přispěvatelé: Nichols, E., Steinmetz, J. D., Vollset, S. E., Fukutaki, K., Chalek, J., Abd-Allah, F., Abdoli, A., Abualhasan, A., Abu-Gharbieh, E., Akram, T. T., Al Hamad, H., Alahdab, F., Alanezi, F. M., Alipour, V., Almustanyir, S., Amu, H., Ansari, I., Arabloo, J., Ashraf, T., Astell-Burt, T., Ayano, G., Ayuso-Mateos, J. L., Baig, A. A., Barnett, A., Barrow, A., Baune, B. T., Bejot, Y., Bezabhe, W. M. M., Bezabih, Y. M., Bhagavathula, A. S., Bhaskar, S., Bhattacharyya, K., Bijani, A., Biswas, A., Bolla, S. R., Boloor, A., Brayne, C., Brenner, H., Burkart, K., Burns, R. A., Camera, L. A., Cao, C., Carvalho, F., Castro-de-Araujo, L. F. S., Catala-Lopez, F., Cerin, E., Chavan, P. P., Cherbuin, N., Chu, D. -T., Costa, V. M., Couto, R. A. S., Dadras, O., Dai, X., Dandona, L., Dandona, R., De la Cruz-Gongora, V., Dhamnetiya, D., Dias da Silva, D., Diaz, D., Douiri, A., Edvardsson, D., Ekholuenetale, M., El Sayed, I., El-Jaafary, S. I., Eskandari, K., Eskandarieh, S., Esmaeilnejad, S., Fares, J., Faro, A., Farooque, U., Feigin, V. L., Feng, X., Fereshtehnejad, S. -M., Fernandes, E., Ferrara, P., Filip, I., Fillit, H., Fischer, F., Gaidhane, S., Galluzzo, L., Ghashghaee, A., Ghith, N., Gialluisi, A., Gilani, S. A., Glavan, I. -R., Gnedovskaya, E. V., Golechha, M., Gupta, R., Gupta, V. B., Gupta, V. K., Haider, M. R., Hall, B. J., Hamidi, S., Hanif, A., Hankey, G. J., Haque, S., Hartono, R. K., Hasaballah, A. I., Hasan, M. T., Hassan, A., Hay, S. I., Hayat, K., Hegazy, M. I., Heidari, G., Heidari-Soureshjani, R., Herteliu, C., Househ, M., Hussain, R., Hwang, B. -F., Iacoviello, L., Iavicoli, I., Ilesanmi, O. S., Ilic, I. M., Ilic, M. D., Irvani, S. S. N., Iso, H., Iwagami, M., Jabbarinejad, R., Jacob, L., Jain, V., Jayapal, S. K., Jayawardena, R., Jha, R. P., Jonas, J. B., Joseph, N., Kalani, R., Kandel, A., Kandel, H., Karch, A., Kasa, A. S., Kassie, G. M., Keshavarz, P., Khan, M. A., Khatib, M. N., Khoja, T. A. M., Khubchandani, J., Kim, M. S., Kim, Y. J., Kisa, A., Kisa, S., Kivimaki, M., Koroshetz, W. J., Koyanagi, A., Kumar, G. A., Kumar, M., Lak, H. M., Leonardi, M., Li, B., Lim, S. S., Liu, X., Liu, Y., Logroscino, G., Lorkowski, S., Lucchetti, G., Lutzky Saute, R., Magnani, F. G., Malik, A. A., Massano, J., Mehndiratta, M. M., Menezes, R. G., Meretoja, A., Mohajer, B., Mohamed Ibrahim, N., Mohammad, Y., Mohammed, A., Mokdad, A. H., Mondello, S., Moni, M. A. A., Moniruzzaman, M., Mossie, T. B., Nagel, G., Naveed, M., Nayak, V. C., Neupane Kandel, S., Nguyen, T. H., Oancea, B., Otstavnov, N., Otstavnov, S. S., Owolabi, M. O., Panda-Jonas, S., Pashazadeh Kan, F., Pasovic, M., Patel, U. K., Pathak, M., Peres, M. F. P., Perianayagam, A., Peterson, C. B., Phillips, M. R., Pinheiro, M., Piradov, M. A., Pond, C. D., Potashman, M. H., Pottoo, F. H., Prada, S. I., Radfar, A., Raggi, A., Rahim, F., Rahman, M., Ram, P., Ranasinghe, P., Rawaf, D. L., Rawaf, S., Rezaei, N., Rezapour, A., Robinson, S. R., Romoli, M., Roshandel, G., Sahathevan, R., Sahebkar, A., Sahraian, M. A., Sathian, B., Sattin, D., Sawhney, M., Saylan, M., Schiavolin, S., Seylani, A., Sha, F., Shaikh, M. A., Shaji, K. S., Shannawaz, M., Shetty, J. K., Shigematsu, M., Shin, J. I., Shiri, R., Silva, D. A. S., Silva, J. P., Silva, R., Singh, J. A., Skryabin, V. Y., Skryabina, A. A., Smith, A. E., Soshnikov, S., Spurlock, E. E., Stein, D. J., Sun, J., Tabares-Seisdedos, R., Thakur, B., Timalsina, B., Tovani-Palone, M. R., Tran, B. X., Tsegaye, G. W., Valadan Tahbaz, S., Valdez, P. R., Venketasubramanian, N., Vlassov, V., Vu, G. T., Vu, L. G., Wang, Y. -P., Wimo, A., Winkler, A. S., Yadav, L., Yahyazadeh Jabbari, S. H., Yamagishi, K., Yang, L., Yano, Y., Yonemoto, N., Yu, C., Yunusa, I., Zadey, S., Zastrozhin, M. S., Zastrozhina, A., Zhang, Z. -J., Murray, C. J. L., Vos, T., Department of Public Health, Clinicum, Helsinki University Hospital Area, Bill & Melinda Gates Foundation, University of Porto (Portugal), Medical Research Council (Reino Unido), Fundação para a Ciência e Tecnologia (Portugal), King College London, University College London Hospitals NHS Foundation Trust, NIHR - Oxford Biomedical Research Centre (Reino Unido), Novo Nordisk Foundation, National Health and Medical Research Council (Australia), Jazan University (Arabia Saudí), Romanian National Authority for Scientific Research and Innovation, Xiamen University Malaysia (Malasia), Wellcome Trust, Fogarty International Center (Estados Unidos), Federal Ministry of Education & Research (Alemania), Ministero della Salute (Italia), Coordenação de Aperfeicoamento de Pessoal de Nível Superior (Brasil), Nichols, E, D Steinmetz, J, Emil Vollset, S, Fukutaki, K, Chalek, J, Abd-Allah, F, Abdoli, A, Abualhasan, A, Abu-Gharbieh, E, Tayyaba Akram, T, Al Hamad, H, Alahdab, F, Mashhour Alanezi, F, Alipour, V, Almustanyir, S, Amu, H, Ansari, I, Arabloo, J, Ashraf, T, Astell-Burt, T, Ayano, G, L Ayuso-Mateos, J, Amin Baig, A, Barnett, A, Barrow, A, T Baune, B, Béjot, Y, M Mequanint Bezabhe, W, Mequanint Bezabih, Y, Srikanth Bhagavathula, A, Bhaskar, S, Bhattacharyya, K, Bijani, A, Biswas, A, Rao Bolla, S, Boloor, A, Brayne, C, Brenner, H, Burkart, K, A Burns, R, Alberto Cámera, L, Cao, C, Carvalho, F, S Castro-de-Araujo, L, Catalá-López, F, Cerin, E, P Chavan, P, Cherbuin, N, Chu, D, Marisa Costa, V, S Couto, R, Dadras, O, Dai, X, Dandona, L, Dandona, R, De la Cruz-Góngora, V, Dhamnetiya, D, Dias da Silva, D, Diaz, D, Douiri, A, Edvardsson, D, Ekholuenetale, M, El Sayed, I, I El-Jaafary, S, Eskandari, K, Eskandarieh, S, Esmaeilnejad, S, Fares, J, Faro, A, Farooque, U, L Feigin, V, Feng, X, Fereshtehnejad, S, Fernandes, E, Ferrara, P, Filip, I, Fillit, H, Fischer, F, Gaidhane, S, Galluzzo, L, Ghashghaee, A, Ghith, N, Gialluisi, A, Amir Gilani, S, Glăvan, I, V Gnedovskaya, E, Golechha, M, Gupta, R, Bala Gupta, V, Kumar Gupta, V, Rifat Haider, M, J Hall, B, Hamidi, S, Hanif, A, J Hankey, G, Haque, S, Kusuma Hartono, R, I Hasaballah, A, Tasdik Hasan, M, Hassan, A, I Hay, S, Hayat, K, I Hegazy, M, Heidari, G, Heidari-Soureshjani, R, Herteliu, C, Househ, M, Hussain, R, Hwang, B, Iacoviello, L, Iavicoli, I, Stephen Ilesanmi, O, M Ilic, I, D Ilic, M, Sina Naghibi Irvani, S, Iso, H, Iwagami, M, Jabbarinejad, R, Jacob, L, Jain, V, Kumar Jayapal, S, Jayawardena, R, Prakash Jha, R, B Jonas, J, Joseph, N, Kalani, R, Kandel, A, Kandel, H, Karch, A, Semachew Kasa, A, M Kassie, G, Keshavarz, P, B Khan, M, Nazli Khatib, M, Ahmed Muthafer Khoja, T, Khubchandani, J, Seo Kim, M, Jin Kim, Y, Kisa, A, Kisa, S, Kivimäki, M, J Koroshetz, W, Koyanagi, A, Anil Kumar, G, Kumar, M, Mehmood Lak, H, Leonardi, M, Li, B, S Lim, S, Liu, X, Liu, Y, Logroscino, G, Lorkowski, S, Lucchetti, G, Lutzky Saute, R, Giulia Magnani, F, Azam Malik, A, Massano, J, Mohan Mehndiratta, M, G Menezes, R, Meretoja, A, Mohajer, B, Mohamed Ibrahim, N, Mohammad, Y, Mohammed, A, H Mokdad, A, Mondello, S, Ali Moni, M, Moniruzzaman, M, Belete Mossie, T, Nagel, G, Naveed, M, C Nayak, V, Neupane Kandel, S, Huyen Nguyen, T, Oancea, B, Otstavnov, N, S Otstavnov, S, O Owolabi, M, Panda-Jonas, S, Pashazadeh Kan, F, Pasovic, M, K Patel, U, Pathak, M, P Peres, M, Perianayagam, A, B Peterson, C, R Phillips, M, Pinheiro, M, A Piradov, M, Dimity Pond, C, H Potashman, M, Hyder Pottoo, F, I Prada, S, Radfar, A, Raggi, A, Rahim, F, Rahman, M, Ram, P, Ranasinghe, P, Laith Rawaf, D, Rawaf, S, Rezaei, N, Rezapour, A, R Robinson, S, Romoli, M, Roshandel, G, Sahathevan, R, Sahebkar, A, Ali Sahraian, M, Sathian, B, Sattin, D, Sawhney, M, Saylan, M, Schiavolin, S, Seylani, A, Sha, F, Ali Shaikh, M, S Shaji, K, Shannawaz, M, K Shetty, J, Shigematsu, M, Il Shin, J, Shiri, R, Augusto Santos Silva, D, Pedro Silva, J, Silva, R, A Singh, J, Yurievich Skryabin, V, Aleksandrovna Skryabina, A, E Smith, A, Soshnikov, S, Elizabeth Spurlock, E, J Stein, D, Sun, J, Tabarés-Seisdedos, R, Thakur, B, Timalsina, B, Roberto Tovani-Palone, M, Xuan Tran, B, Wudie Tsegaye, G, Valadan Tahbaz, S, R Valdez, P, Venketasubramanian, N, Vlassov, V, Thu Vu, G, Gia Vu, L, Wang, Y, Wimo, A, Sylvia Winkler, A, Yadav, L, Hossein Yahyazadeh Jabbari, S, Yamagishi, K, Yang, L, Yano, Y, Yonemoto, N, Yu, C, Yunusa, I, Zadey, S, Sergeevich Zastrozhin, M, Zastrozhina, A, Zhang, Z, L Murray, C, Vos, T
Rok vydání: 2021
Předmět:
Zdroj: The Lancet Public Health
LANCET PUBLIC HEALTH
r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
Consejo Superior de Investigaciones Científicas (CSIC)
The Lancet Public Health, Vol 7, Iss 2, Pp e105-e125 (2022)
GBD 2019 Dementia Forecasting Collaborators 2022, ' Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050 : an analysis for the Global Burden of Disease Study 2019 ', The Lancet Public Health, vol. 7, no. 2, pp. e105-e125 . https://doi.org/10.1016/S2468-2667(21)00249-8
ISSN: 2468-2667
DOI: 10.1016/S2468-2667(21)00249-8
Popis: Background: Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. Methods: We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. Findings: We estimated that the number of people with dementia would increase from 57·4 (95% uncertainty interval 50·4-65·1) million cases globally in 2019 to 152·8 (130·8-175·9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0·1% [-7·5 to 10·8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1·69 [1·64-1·73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1·67 [1·52-1·85]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41-67]) and western Europe (74% [58-90]), and the largest in north Africa and the Middle East (367% [329-403]) and eastern sub-Saharan Africa (357% [323-395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. Interpretation: Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. F Carvalho and E F Fernandes acknowledge support from the University of Porto (UID/MULTI/04378/2019 and UID/QUI/50006/2019 with funding from FCT/MCTES through national funds). L F S Castro-de-Araujo acknowledges support from the Medical Research Council (London; grant number MC_PC_MR/T03355X/1). V M Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória (DL57/2016/CP1334/CT0006). A Douiri acknowledges support from the NIHR Applied Research Collaboration (ARC) South London at King’s College Hospital NHS Foundation Trust and the Royal College of Physicians, as well as the support from the NIHR Biomedical Research Centre based at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. N Ghith acknowledges her salary as a postdoc is covered by a grant to her research group provided by Novo Nordisk Foundation. V K Gupta and V B Gupta acknowledge funding support from National Health and Medical Research Council (NHMRC), Australia. S Haque acknowledges support from Jazan University, Saudi Arabia, for providing access to the Saudi Digital Library for this study. C Herteliu is partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation (CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084). Y J Kim was supported by the Research Management Centre, Xiamen University, Malaysia (No. XMUMRF/2020-C6/ITCM/0004). M Kivimäki was supported by the MRC (S011676) and the Wellcome Trust (221854/Z/20/Z). M Kumar acknowledges support from Fogarty International Center (K43 TW010716-04). S Lorkowski acknowledges institutional support from the Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig (Germany; German Federal Ministry of Education and Research, grant agreement number 01EA1808A). S Mondello was supported by the Italian Ministry of Health (GR-2013-02354960). A Raggi acknowledges support from a grant from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C. Besta, Linea – Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). D A S Silva acknowledges support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brasil (CAPES; Finance Code 001 / CAPES-PRINT). J P Silva acknowledges support from the Applied Molecular Biosciences Unit (UCIBIO; grant number UIDB/04378/2020), supported through Portuguese national funds via FCT/MCTES. Sí
Databáze: OpenAIRE