Disability burden linked to alcohol-related cirrhosis and heart failure projected to rise sharply by 2050

(Barcelona, Spain, Saturday, October 17 2026) The disability burden associated with alcohol-related cirrhosis complicated by heart failure is projected to rise substantially by 2050 across Central Europe, Eastern Europe and the United States (US), according to new research due to be presented at UEG Week 2026.¹

Researchers analysed Global Burden of Disease data from Central Europe, Eastern Europe, Western Europe and the US between 1990 and 2023, examining years lived with disability (YLD) – a measure of time spent living with ill health or disability – by age and sex. They also modelled how the burden could change through to 2050.

The study found that the burden has already increased considerably across all four regions since 1990, with particularly pronounced increases among older adults and men. By 2050, further rises of around 50–67% are projected in the US, Central Europe and Eastern Europe, while Western Europe is projected to see a 19% decline.

Alcohol-related liver disease remains a major public health challenge. The WHO European Region has the highest level of alcohol consumption globally, and alcohol is causally linked to more than 200 diseases and health conditions, including liver cirrhosis and cardiovascular disease.² Scientists are increasingly exploring the interrelationship between the heart and liver along shared disease trajectories, often referred to as the ‘heart-liver axis’. In Europe, alcohol is also the most common cause of death from liver disease.³

Between 1990 and 2023, Western Europe consistently had the highest YLD rate, increasing by 28.6%. However, the steepest increases occurred in Central and Eastern Europe, where rates rose by 82.9% and 74.7%, respectively. The US recorded a 38.5% increase.

The burden was substantially greater among older adults. Across all four regions, people aged 70 and over experienced YLD rates 10 to 16 times higher than those aged 15–49 years.

Marked differences were also observed between men and women. Men experienced a consistently greater burden than women across all four regions, with male-to-female YLD ratios ranging from 1.86 in Eastern Europe to 3.27 in Central Europe.

“Our findings show that the disability burden associated with alcohol-related cirrhosis complicated by heart failure has increased substantially over the past three decades, but the pattern is far from uniform,” said study author Dr Ashesh Das. “Older adults and men are particularly affected, and the marked differences between regions show why a one-size-fits-all approach to prevention and healthcare planning is unlikely to be enough.”

Looking ahead, modelling conducted by the researchers projected that by 2050, the YLD burden could increase by 65.4% in the US, 49.6% in Central Europe and 66.6% in Eastern Europe compared with 2023. By contrast, Western Europe is projected to experience a 19.0% decline.

Older adults in the US are projected to experience a particularly pronounced increase, with the YLD rate among those aged 70 and over predicted to reach 1.893 per 100,000 by 2050 – 73.7% higher than in 2023.

Dr Das said, “The projections suggest that without effective prevention and appropriate healthcare planning, the burden could continue to grow substantially in several regions over the coming decades. With populations ageing, health systems need to consider the combined demands that cirrhosis and heart failure can place on hepatology, cardiology and wider care services.”

The researchers emphasise the importance of strategies to reduce alcohol-related harm. WHO identifies measures including alcohol taxation and restrictions on alcohol availability and marketing as important approaches to reducing alcohol-related harm.³ 

Dr Das concluded, “These projections underline the importance of strengthening strategies to reduce alcohol-related harm, particularly as populations age. The contrasting trajectory projected for Western Europe also highlights the need to understand what may be driving differences between regions, and whether lessons can be applied elsewhere.”