Neurological diseases are now the leading cause of illness and disability.

stroke, Alzheimer's disease (AD) and other neurological diseases are now the leading cause of health loss and disability worldwide, affecting almost half of the world's population, a new comprehensive analysis finds. Shown.

In 2021, neurological diseases will account for 443 million healthy years of life lost to illness, disability, and premature death (a measurement known as disability-adjusted life years (DALYs)), making neurological diseases the world's leading It is the largest cause of the disease burden. of cardiovascular disease.

The report pointed out that in 2021, approximately 3.4 billion people, or 43% of the world's population, suffered from neurological diseases.

“Nervous system diseases are the world's largest contributor to the overall burden of disease, with infections increasing by 59% worldwide since 1990, so effective, culturally acceptable and affordable prevention is essential. We need to address neurological diseases through treatment, rehabilitation, and long-term care strategies,” lead author Dr. Jamie Steinmetz of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle said in a news release.

The findings of the 2021 Global Disease, Injury and Risk Factors Survey (GBD) have important health service and policy implications and show that global neurological health losses are under-recognized and rising. The authors pointed out that the “distribution of the disease'' and the unequal distribution of the population, both geographically and socio-economically, serve as evidence of an uneven distribution.

The research is Published online March 14, 2024 Lancet Neurology.

top 10

The top 10 causes of neurological health loss in 2021 are stroke, neonatal encephalopathy; MigraineAD and other dementias; diabetic neuropathy, meningitis, epilepsyneurological complications of preterm birth; autism spectrum disordernervous system cancer, etc.

The neurological impact of COVID-19 ranked 20th out of 37 unique symptoms assessed.

In 2021, there were more than 23 million cases of COVID-19 infections worldwide with long-term cognitive symptoms and symptoms. Guillain-Barre syndromeaccounting for 57% of all infectious neurological disease cases and contributing to the loss of 2.48 million years of healthy life expectancy, the study found.

The most common neurological disorder was the catatonic type headache Diabetic neuropathy is the fastest growing of all neurological conditions.

“The number of people living with diabetic neuropathy has more than tripled globally since 1990, rising to 206 million in 2021. ,” co-senior author Liane Ong, Ph.D., from IHME, said in a release.

The data showed that there were significant differences in the burden of neurological diseases between world regions and national income levels, with more than 80% of deaths and health losses due to neurological diseases occurring in low- and middle-income countries. .

The regions with the highest burden of neurological disease were central and western sub-Saharan Africa, while the high-income Asia-Pacific region and Australia had the lowest burden.

“This is partly due to the high prevalence of diseases affecting newborns and children under 5, particularly birth-related complications and infections,” said Tarun Dua, MD, co-senior author of the World Health Organization. , neurological health loss disproportionately affects many of the poorest countries.” (WHO) Department of Brain Health, in a release.

“While improved infant survival rates are increasing long-term disability, limited access to treatment and rehabilitation services is contributing to significantly higher mortality rates in these countries.” Dua said.

Prioritize prevention

The analysis also provides estimates of the proportion of neurological conditions that could be prevented by eliminating known risk factors such as stroke, dementia, multiple sclerosis, and Parkinson's disease. encephalitismeningitis, and Intellectual disability.

This study shows that by improving 18 risk factors over the lifespan, most importantly high systolic blood pressure, 84% of the world's DALYs could be prevented from stroke. Controlling lead exposure could reduce cases of intellectual disability by 63%, and lowering high fasting plasma glucose levels to normal levels could reduce dementia by about 15%.

“Many neurological diseases have no cure and access to health care is often limited, so controlling this global health crisis requires a combination of modifiable risk factors and potentially avoidable risks. “It is essential to understand the burden of certain neurological diseases,” co-author Dr. Katrin Seeher, an expert in mental health and brain health at WHO, said in the release.

It is important to note that conditions of the nervous system include not only non-communicable diseases and injuries, but also infectious and vector-borne diseases and injuries, and that “lifelong prevention and treatment require different We need a strategy,” Steinmetz said.

“Our findings will help policy makers more comprehensively understand the impact of neurological conditions on both adults and children, inform more targeted interventions in countries, and support ongoing efforts around the world. We hope that it will serve as a guide for awareness-raising and advocacy efforts,” Steinmetz added.

The study builds on previous findings and expands the number of neurological conditions studied from 15 to 37, Wolfgang Grisold, president of the World Society of Neurology in London, UK, said in an accompanying editorial. said.

“This important new GBD report highlights that the burden of neurological symptoms is greater than previously thought,” wrote Grisold, who was not involved in the study. “The next iteration will require more attention to neuromuscular disease, the impact of cancer on the nervous system, and neuropathic pain. Disability caused by symptoms that occur temporarily versus disability that is persistent and progressive. It remains difficult to compare disorders that cause disease; their effects on individuals vary widely.”

This research was funded by the Bill and Melinda Gates Foundation. Full disclosure can be found in the original article.