TY - JOUR
T1 - Global, regional, and national burden of disorders affecting the nervous system, 1990–2021
T2 - a systematic analysis for the Global Burden of Disease Study 2021
AU - GBD 2021 Nervous System Disorders Collaborators
AU - Steinmetz, Jaimie D.
AU - Seeher, Katrin Maria
AU - Schiess, Nicoline
AU - Nichols, Emma
AU - Cao, Bochen
AU - Servili, Chiara
AU - Cavallera, Vanessa
AU - Cousin, Ewerton
AU - Hagins, Hailey
AU - Moberg, Madeline E.
AU - Mehlman, Max L.
AU - Abate, Yohannes Habtegiorgis
AU - Abbas, Jaffar
AU - Abbasi, Madineh Akram
AU - Abbasian, Mohammadreza
AU - Abbastabar, Hedayat
AU - Abdelmasseh, Michael
AU - Abdollahi, Mohammad
AU - Abdollahi, Mozhan
AU - Abdollahifar, Mohammad Amin
AU - Abd-Rabu, Rami
AU - Abdulah, Deldar Morad
AU - Abdullahi, Auwal
AU - Abedi, Aidin
AU - Abedi, Vida
AU - Abeldaño Zuñiga, Roberto Ariel
AU - Abidi, Hassan
AU - Abiodun, Olumide
AU - Aboagye, Richard Gyan
AU - Abolhassani, Hassan
AU - Aboyans, Victor
AU - Abrha, Woldu Aberhe
AU - Abualhasan, Ahmed
AU - Abu-Gharbieh, Eman
AU - Aburuz, Salahdein
AU - Adamu, Lawan Hassan
AU - Addo, Isaac Yeboah
AU - Adebayo, Oladimeji M.
AU - Adekanmbi, Victor
AU - Adekiya, Tayo Alex
AU - Adikusuma, Wirawan
AU - Adnani, Qorinah Estiningtyas Sakilah
AU - Adra, Saryia
AU - Afework, Tsion
AU - Afolabi, Aanuoluwapo Adeyimika
AU - Afraz, Ali
AU - Afzal, Saira
AU - Aghamiri, Shahin
AU - Agodi, Antonella
AU - Ferreira, Nuno
N1 - Publisher Copyright:
© 2024 World Health Organization
PY - 2024/4
Y1 - 2024/4
N2 - Background: Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. Methods: We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. Findings: Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. Interpretation: As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. Funding: Bill & Melinda Gates Foundation.
AB - Background: Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. Methods: We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. Findings: Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. Interpretation: As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. Funding: Bill & Melinda Gates Foundation.
UR - http://www.scopus.com/inward/record.url?scp=85187999548&partnerID=8YFLogxK
U2 - 10.1016/S1474-4422(24)00038-3
DO - 10.1016/S1474-4422(24)00038-3
M3 - Article
C2 - 38493795
AN - SCOPUS:85187999548
SN - 1474-4422
VL - 23
SP - 344
EP - 381
JO - The Lancet Neurology
JF - The Lancet Neurology
IS - 4
ER -