Journal article
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
04/01/2024
DOI: 10.1016/S1474-4422(24)00038-3
PMCID: PMC10949203
PMID: 38493795
Abstract
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.
Details
- Title: Subtitle
- Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021
- Creators
- Jaimie D. Steinmetz - University of WashingtonKatrin Maria Seeher - World Health OrganizationNicoline Schiess - Johns Hopkins MedicineEmma Nichols - Institute for Health Metrics and EvaluationBochen Cao - Centre international de recherche sur le cancerChiara Servili - University of WashingtonVanessa Cavallera - Istituti di Ricovero e Cura a Carattere ScientificoEwerton Cousin - Institute for Health Metrics and EvaluationHailey Hagins - Institute for Health Metrics and EvaluationMadeline E. Moberg - University of WashingtonMax L. Mehlman - Institute for Health Metrics and EvaluationYohannes Habtegiorgis Abate - Institute for Health Metrics and EvaluationJaffar Abbas - Institute for Health Metrics and EvaluationMadineh Akram Abbasi - Institute for Health Metrics and EvaluationMohammadreza Abbasian - Institute for Health Metrics and EvaluationHedayat Abbastabar - Institute for Health Metrics and EvaluationMichael Abdelmasseh - Institute for Health Metrics and EvaluationMohammad Abdollahi - Laboratoire d'Informatique, du Traitement de l'Information et des SystèmesMozhan Abdollahi - Institute for Health Metrics and EvaluationMohammad-Amin Abdollahifar - University of SaskatchewanRami Abd-Rabu - University of WashingtonDeldar Morad Abdulah - Institute for Health Metrics and EvaluationAuwal Abdullahi - Institute for Health Metrics and EvaluationAidin Abedi - University of WashingtonVida Abedi - University of WashingtonRoberto Ariel Abeldano Zuniga - Univ Sierra Sur, Postgrad Dept, Miahuatlan De Porfirio D, MexicoHassan Abidi - University of WashingtonOlumide Abiodun - Institute for Health Metrics and EvaluationRichard Gyan Aboagye - Institute for Health Metrics and EvaluationHassan Abolhassani - Institute for Health Metrics and EvaluationVictor Aboyans - Institut d’Epidémiologie et de Neurologie TropicaleWoldu Aberhe Abrha - Aksum UniversityAhmed Abualhasan - University of WashingtonEman Abu-Gharbieh - University of WashingtonSalahdein Aburuz - University of WashingtonLawan Hassan Adamu - Institute for Health Metrics and EvaluationIsaac Yeboah Addo - Institute for Health Metrics and EvaluationOladimeji M. Adebayo - Institute for Health Metrics and EvaluationVictor Adekanmbi - Institute for Health Metrics and EvaluationTayo Alex Adekiya - Institute for Health Metrics and EvaluationWirawan Adikusuma - Institute for Health Metrics and EvaluationQorinah Estiningtyas Sakilah Adnani - Institute for Health Metrics and EvaluationSaryia Adra - University of WashingtonTsion Afework - Institute for Health Metrics and EvaluationAanuoluwapo Adeyimika Afolabi - University of WashingtonAli Afraz - Institute for Health Metrics and EvaluationSaira Afzal - Institute for Health Metrics and EvaluationShahin Aghamiri - Institute for Health Metrics and EvaluationAntonella Agodi - Institute for Health Metrics and EvaluationWilliams Agyemang-Duah - Institute for Health Metrics and EvaluationBright Opoku Ahinkorah - University of WashingtonAqeel Ahmad - University of WashingtonDanish Ahmad - Institute for Health Metrics and EvaluationSajjad Ahmad - Institute for Health Metrics and EvaluationAmir Mahmoud Ahmadzade - Institute for Health Metrics and EvaluationAli Ahmed - Institute for Health Metrics and EvaluationAyman Ahmed - Institute for Health Metrics and EvaluationHaroon Ahmed - University of WashingtonJivan Qasim Ahmed - Institute for Health Metrics and EvaluationLuai A. Ahmed - University of WashingtonMuktar Beshir Ahmed - Institute for Health Metrics and EvaluationSyed Anees Ahmed - East Carolina UniversityMarjan Ajami - Institute for Health Metrics and EvaluationBudi Aji - Institute for Health Metrics and EvaluationOlufemi Ajumobi - Institute for Health Metrics and EvaluationSeyed Esma'il Akade - Ahvaz Jundishapur University of Medical SciencesMorteza Akbari - Institute for Health Metrics and EvaluationHossein Akbarialiabad - Institute for Health Metrics and EvaluationShiva Akhlaghi - University of WashingtonKarolina Akinosoglou - Institute for Health Metrics and EvaluationRufus Olusola Akinyemi - Institute for Health Metrics and EvaluationMaxwell Akonde - Institute for Health Metrics and EvaluationSyed Mahfuz Al Hasan - Institute for Health Metrics and EvaluationFares Alahdab - University of WashingtonTareq Mohammed Ali Al-Ahdal - Institute for Health Metrics and EvaluationRasmieh Mustafa Al-Amer - University of WashingtonMohammed Albashtawy - Institute for Health Metrics and EvaluationMohammad T. AlBataineh - Institute for Health Metrics and EvaluationKhalifah A. Aldawsari - Institute for Health Metrics and EvaluationHediyeh Alemi - Institute for Health Metrics and EvaluationSharifullah Alemi - Institute for Health Metrics and EvaluationAbdelazeem M. Algammal - Institute for Health Metrics and EvaluationAdel Ali Saeed Al-Gheethi - University of Newcastle AustraliaFadwa Alhalaiqa Naji Alhalaiqa - Qatar UniversityRobert Kaba Alhassan - Institute for Health Metrics and EvaluationAbid Ali - Institute for Health Metrics and EvaluationEndale Alemayehu Ali - Institute for Health Metrics and EvaluationLiaqat Ali - Institute for Health Metrics and EvaluationMohammed Usman Ali - University of WashingtonMusa Mohammed Ali - Institute for Health Metrics and EvaluationRafat Ali - University of WashingtonShahid Ali - Institute for Health Metrics and EvaluationSyed Shujait Shujait Ali - Institute for Health Metrics and EvaluationZahid Ali - Institute for Health Metrics and EvaluationSheikh Mohammad Alif - Institute for Health Metrics and EvaluationYousef Alimohamadi - Institute for Health Metrics and EvaluationAhmednur Adem Aliyi - Institute for Health Metrics and EvaluationMohamad Aljofan - Institute for Health Metrics and EvaluationSyed Mohamed Aljunid - University of WashingtonSuvarna Alladi - Institute for Health Metrics and EvaluationGBD 2021 Nervous System Disorders CollaboratorsDavid C Schwebel (Contributor) - Research Administration
- Resource Type
- Journal article
- Publication Details
- Lancet neurology, Vol.23(4), pp.344-381
- DOI
- 10.1016/S1474-4422(24)00038-3
- PMID
- 38493795
- PMCID
- PMC10949203
- NLM abbreviation
- Lancet Neurol
- ISSN
- 1474-4422
- eISSN
- 1474-4465
- Publisher
- Elsevier
- Number of pages
- 38
- Grant note
- 21K01093 / Grants-in-Aid for Scientific Research; Ministry of Education, Culture, Sports, Science and Technology, Japan (MEXT); Japan Society for the Promotion of Science; Grants-in-Aid for Scientific Research (KAKENHI) Bill & Melinda Gates Foundation; Bill & Melinda Gates Foundation Grand Challenges Explorations Initiative; CGIAR
- Language
- English
- Date published
- 04/01/2024
- Academic Unit
- Research Administration
- Record Identifier
- 9984949178802771
Metrics
6 Record Views