The Global Burden of Disease (GBD) Study conducted a systematic analysis revealing that disorders affecting the nervous system are the leading cause of ill health globally. This analysis showed that neurologic conditions affected a staggering 43.1% of the world’s population in 2021, surpassing cardiovascular diseases (excluding stroke). This data, presented by Jaimie Steinmetz, PhD, MSc, from the Institute for Health Metrics and Evaluation at the University of Washington, along with co-authors, highlighted the immense impact of neurological disorders on a global scale. Thirty-seven conditions related to the nervous system were responsible for 443 million disability-adjusted life-years (DALYs) and 11.1 million deaths in the year 2021.
The analysis encompassed data from 1990 to 2021, showcasing an 18.2% increase in global DALYs from 1990. However, there was a reduction in age-standardized rates of DALYs and rates of death per 100,000 people by 27% and 33.6%, respectively. The study identified the top ten conditions contributing to age-standardized DALYs worldwide, including stroke, neonatal encephalopathy, migraine, Alzheimer’s disease, diabetic neuropathy, meningitis, epilepsy, neurologic complications due to preterm birth, autism spectrum disorder, and nervous system cancer.
Expanding the Scope
Previous GBD studies had analyzed the burden of 15 neurological conditions in 2015 and 2016 but had not included neurodevelopmental disorders or certain cases of congenital, neonatal, and infectious conditions that cause nervous system damage. The omission of these crucial aspects was acknowledged by the researchers. Collectively, neurodevelopmental and pediatric conditions accounted for 18.2% of the total neurologic burden globally in 2021, amounting to 80.3 million DALYs.
Steinmetz emphasized the importance of prevention by targeting modifiable risk factors since many neurological conditions lack cures. The study highlighted several risk factors, with high systolic blood pressure showing the largest burden attribution to stroke. Interventions should focus on addressing risk factors that significantly contribute to the disease burden. Assessing a wide range of risk factors across various neurological conditions can aid in developing effective intervention programs.
Implications and Future Directions
The GBD study team estimated mortality, prevalence, years lived with disability, years of life lost, and DALYs by age and sex in over 200 countries and territories from 1990 to 2021. They included morbidity and deaths directly linked to neurologic conditions that cause damage to the nervous system. The analysis also isolated health loss from conditions where nervous system morbidity was a consequence but not the primary feature, such as congenital conditions, neonatal issues, infectious diseases, and diabetic neuropathy. This meticulous approach ensured the inclusion of cases where nervous system damage occurred.
Call for Further Research
Wolfgang Grisold, MD, president of the World Federation of Neurology, highlighted the need for more attention to be given to neuromuscular diseases, the impacts of cancer on the nervous system, and neuropathic pain in future iterations of the GBD study. As the burden of neurological conditions continues to grow, it is essential to expand research efforts to encompass various aspects of neurology. The comparative analysis of conditions with episodic versus progressive effects remains a challenge, given the diverse impact on individuals.
The global burden of neurological disorders presents a significant challenge to public health worldwide. The findings from the GBD Study underscore the pressing need for comprehensive strategies to prevent and manage neurological conditions effectively. By prioritizing research, intervention programs, and early detection, we can strive towards alleviating the burden of these complex disorders on individuals and societies globally.
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