Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
Lancet neurology, Vol.23(4), pp.344-381
01/04/2024
: 38493795
1
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.
- Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
- Jaimie D. Steinmetz - University of WashingtonKatrin Maria Seeher - Department of Mental Health and Substance Use, WHO, Geneva, SwitzerlandNicoline Schiess - Johns Hopkins UniversityEmma Nichols - University of WashingtonBochen Cao - Centre international de recherche sur le cancerChiara Servili - University of WashingtonVanessa Cavallera - Istituti di Ricovero e Cura a Carattere ScientificoEwerton Cousin - University of WashingtonHailey Hagins - University of WashingtonMadeline E. Moberg - University of WashingtonMax L. Mehlman - University of WashingtonYohannes Habtegiorgis Abate - University of WashingtonJaffar Abbas - University of WashingtonMadineh Akram Abbasi - University of WashingtonMohammadreza Abbasian - University of WashingtonHedayat Abbastabar - University of WashingtonMichael Abdelmasseh - University of WashingtonMohammad Abdollahi - Shiraz University of Medical SciencesMozhan Abdollahi - University of WashingtonMohammad Amin Abdollahifar - University of SaskatchewanRami Abd-Rabu - University of WashingtonDeldar Morad Abdulah - University of WashingtonAuwal Abdullahi - University of WashingtonAidin Abedi - University of WashingtonVida Abedi - University of WashingtonRoberto Ariel Abeldaño Zuñiga - National Research Council of Mexico, Mexico City, MexicoHassan Abidi - University of WashingtonOlumide Abiodun - University of WashingtonRichard Gyan Aboagye - University of WashingtonHassan Abolhassani - University of WashingtonVictor Aboyans - Institut d’Epidémiologie et de Neurologie TropicaleWoldu Aberhe Abrha - University of WashingtonAhmed Abualhasan - University of WashingtonEman Abu-Gharbieh - University of WashingtonSalahdein Aburuz - University of WashingtonLawan Hassan Adamu - University of WashingtonIsaac Yeboah Addo - University of WashingtonOladimeji M. Adebayo - University of WashingtonVictor Adekanmbi - University of WashingtonTayo Alex Adekiya - University of WashingtonWirawan Adikusuma - University of WashingtonQorinah Estiningtyas Sakilah Adnani - University of WashingtonSaryia Adra - University of WashingtonTsion Afework - University of WashingtonAanuoluwapo Adeyimika Afolabi - University of WashingtonAli Afraz - University of WashingtonSaira Afzal - University of WashingtonShahin Aghamiri - University of WashingtonAntonella Agodi - University of WashingtonWilliams Agyemang-Duah - University of WashingtonBright Opoku Ahinkorah - University of WashingtonAqeel Ahmad - University of WashingtonDanish Ahmad - University of WashingtonSajjad Ahmad - University of WashingtonAmir Mahmoud Ahmadzade - University of WashingtonAli Ahmed - University of WashingtonAyman Ahmed - University of WashingtonHaroon Ahmed - University of WashingtonJivan Qasim Ahmed - University of WashingtonLuai A. Ahmed - University of WashingtonMuktar Beshir Ahmed - University of WashingtonSyed Anees Ahmed - University of WashingtonMarjan Ajami - University of WashingtonBudi Aji - University of WashingtonOlufemi Ajumobi - University of WashingtonSeyed Esma il Akade - Ahvaz Jundishapur University of Medical SciencesMorteza Akbari - University of WashingtonHossein Akbarialiabad - University of WashingtonShiva Akhlaghi - University of WashingtonKarolina Akinosoglou - University of WashingtonRufus Olusola Akinyemi - University of WashingtonMaxwell Akonde - University of WashingtonSyed Mahfuz Al Hasan - University of WashingtonFares Alahdab - University of WashingtonTareq Mohammed Ali Al-Ahdal - University of WashingtonRasmieh Mustafa Al-Amer - University of WashingtonMohammed Albashtawy - University of WashingtonMohammad T. AlBataineh - University of WashingtonKhalifah A. Aldawsari - University of WashingtonHediyeh Alemi - University of WashingtonSharifullah Alemi - University of WashingtonAbdelazeem M. Algammal - University of WashingtonAdel Ali Saeed Al-Gheethi - Cooperative Research Centre for Contamination Assessment and Remediation of the EnvironmentFadwa Alhalaiqa Naji Alhalaiqa - Psychological Sciences Association, Amman, JordanRobert Kaba Alhassan - University of WashingtonAbid Ali - University of WashingtonEndale Alemayehu Ali - University of WashingtonLiaqat Ali - University of WashingtonMohammed Usman Ali - University of WashingtonMusa Mohammed Ali - University of WashingtonRafat Ali - University of WashingtonShahid Ali - University of WashingtonSyed Shujait Shujait Ali - University of SwatZahid Ali - University of WashingtonSheikh Mohammad Alif - University of WashingtonYousef Alimohamadi - University of WashingtonAhmednur Adem Aliyi - University of WashingtonMohamad Aljofan - University of WashingtonSyed Mohamed Aljunid - University of WashingtonSuvarna Alladi - University of WashingtonGBD 2021 Nervous System Disorders CollaboratorsKhoka Hamiduzzaman - Southern Cross University
- Lancet neurology, Vol.23(4), pp.344-381
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- Ministero della Salute (http://data.elsevier.com/vocabulary/SciValFunders/501100003196) OPP 1152504 / Bill and Melinda Gates Foundation (http://data.elsevier.com/vocabulary/SciValFunders/100000865) Medical Research Council (http://data.elsevier.com/vocabulary/SciValFunders/501100000265) Bill and Melinda Gates Foundation (http://data.elsevier.com/vocabulary/SciValFunders/100000865) 21K01093 / Japan Society for the Promotion of Science (http://data.elsevier.com/vocabulary/SciValFunders/501100001691) Institute for Maternal and Child Health Istituto di Ricovero e Cura a Carattere Scientifico Burlo Garofolo Japan Society for the Promotion of Science (http://data.elsevier.com/vocabulary/SciValFunders/501100001691) MR/S011676/1 / Medical Research Council (http://data.elsevier.com/vocabulary/SciValFunders/501100000265) International Agency for Research on Cancer Research and Training Programme 34/2017 / Ministero della Salute (http://data.elsevier.com/vocabulary/SciValFunders/501100003196)
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