Journal article
Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016
Lancet neurology, Vol.18(5), pp.459-480
05/01/2019
DOI: 10.1016/S1474-4422(18)30499-X
PMCID: PMC6459001
PMID: 30879893
Abstract
Background Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders.
Methods We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach.
Findings Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247-308]) and second leading cause of deaths (9.0 million [8.8-9.4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34-44] and DALYs by 15% [9-21]) whereas their age-standardised rates decreased (deaths by 28% [26-30] and DALYs by 27% [24-31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42.2% [38.6-46.1]), migraine (16.3% [11.7-20.8]), Alzheimer's and other dementias (10.4% [9.0-124]), and meningitis (7.9% [6.6-10.4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1.12 [1.05-1.20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0.7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88.8% (86.5-90.9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22.3% [11.8-35.1] of DALYs are risk attributable) and idiopathic epilepsy (14.1% [10.8-17.5] of DALYs are risk attributable).
Interpretation Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies. Copyright (C) The Author(s). Published by Elsevier Ltd.
Details
- Title: Subtitle
- Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016
- Creators
- Valery L. Feigin - Auckland University of TechnologyEmma Nichols - Auckland University of TechnologyTahiya Alam - University of WashingtonMarlena S. Bannick - University of WashingtonEttore Beghi - Auckland University of TechnologyNatacha Blake - Auckland University of TechnologyWilliam J. Culpepper - Auckland University of TechnologyE. Ray Dorsey - Institute for Health Metrics and EvaluationAlexis Elbaz - Auckland University of TechnologyRichard G. Ellenbogen - Auckland University of TechnologyJames L. Fisher - Auckland University of TechnologyChristina Fitzmaurice - Institute for Health Metrics and EvaluationGiorgia Giussani - Auckland University of TechnologyLinda Glennie - Auckland University of TechnologySpencer L. James - University of WashingtonCatherine Owens Johnson - University of WashingtonNicholas J. Kassebaum - Institute for Health Metrics and EvaluationGiancarlo Logroscino - Auckland University of TechnologyBenoit Marin - Auckland University of TechnologyW. Cliff Mountjoy-Venning - University of WashingtonMinh Nguyen - Institute for Health Metrics and EvaluationRichard Ofori-Asenso - Auckland University of TechnologyAnoop P. Patel - Auckland University of TechnologyMarco Piccininni - Auckland University of TechnologyGregory A. Roth - Institute for Health Metrics and EvaluationTimothy J. Steiner - Institute for Health Metrics and EvaluationLars Jacob Stovner - Auckland University of TechnologyCassandra E. I. Szoeke - The University of MelbourneAlice Theadom - Auckland University of TechnologyStein Emil Vollset - University of WashingtonMitchell Taylor Wallin - Institute for Health Metrics and EvaluationClaire Wright - Auckland University of TechnologyJoseph Raymond Zunt - Auckland University of TechnologyNooshin Abbasi - Institute for Health Metrics and EvaluationFoad Abd-Allah - Institute for Health Metrics and EvaluationAhmed Abdelalim - University of WashingtonIbrahim Abdollahpour - Institute for Health Metrics and EvaluationVictor Aboyans - University of WashingtonHaftom Niguse Abraha - Auckland University of TechnologyDilaram Acharya - Institute for Health Metrics and EvaluationAbdu A. Adamu - Institute for Health Metrics and EvaluationOladimeji M. Adebayo - Auckland University of TechnologyAbiodun Moshood Adeoye - Auckland University of TechnologyJose C. Adsuar - Institute for Health Metrics and EvaluationMohsen Afarideh - Institute for Health Metrics and EvaluationSutapa Agrawal - Institute for Health Metrics and EvaluationAlireza Ahmadi - Institute for Health Metrics and EvaluationMuktar Beshir Ahmed - Institute for Health Metrics and EvaluationAmani Nidhal Aichour - Institute for Health Metrics and EvaluationIbtihel Aichour - Institute for Health Metrics and EvaluationMiloud Taki Eddine Aichour - Institute for Health Metrics and EvaluationRufus Olusola Akinyemi - Auckland University of TechnologyNadia Akseer - Institute for Health Metrics and EvaluationAyman Al-Eyadhy - Auckland University of TechnologyRustam Al Shahi Salman - University of EdinburghFares Alahdab - Auckland University of TechnologyKefyalew Addis Alene - Institute for Health Metrics and EvaluationSyed Mohamed Aljunid - Auckland University of TechnologyKhalid Altirkawi - Auckland University of TechnologyNelson Alvis-Guzman - Auckland University of TechnologyNahla Hamed Anber - Auckland University of TechnologyCarl Abelardo T. Antonio - Auckland University of TechnologyJalal Arabloo - Auckland University of TechnologyOlatunde Aremu - Institute for Health Metrics and EvaluationJohan Arnlov - Institute for Health Metrics and EvaluationHamid Asayesh - Institute for Health Metrics and EvaluationRana Jawad Asghar - University of WashingtonHagos Tasew Atalay - Auckland University of TechnologyAshish Awasthi - Institute for Health Metrics and EvaluationBeatriz Paulina Ayala Quintanilla - La Trobe UniversityTambe B. Ayuk - Inst Med Res & Med Plant Studies, Ctr Food & Nutr Res, Yaounde, CameroonAlaa Badawi - Auckland University of TechnologyMaciej Banach - Auckland University of TechnologyJoseph Adel Mattar Banoub - Auckland University of TechnologyMiguel A. Barboza - Auckland University of TechnologySuzanne Lyn Barker-Collo - Institute for Health Metrics and EvaluationTill Winfried Barnighausen - Auckland University of TechnologyBernhard T. Baune - Auckland University of TechnologyNeeraj Bedi - Institute for Health Metrics and EvaluationMasoud Behzadifar - University of WashingtonMeysam Behzadifar - Auckland University of TechnologyYannick Bejot - Auckland University of TechnologyBayu Begashaw Bekele - Auckland University of TechnologyAbate Bekele Belachew - Auckland University of TechnologyDerrick A. Bennett - Institute for Health Metrics and EvaluationIsabela M. Bensenor - Institute for Health Metrics and EvaluationAdugnaw Berhane - Institute for Health Metrics and EvaluationMircea Beuran - Institute for Health Metrics and EvaluationKrittika Bhattacharyya - Auckland University of TechnologyZulfiqar A. Bhutta - Auckland University of TechnologyBelete Biadgo - Auckland University of TechnologyAli Bijani - Auckland University of TechnologyNigus Bililign - Auckland University of TechnologyMuhammad Shahdaat Bin Sayeed - Auckland University of TechnologyChristopher Kynrint Blazes - Auckland University of TechnologyCarol Brayne - Auckland University of TechnologyZahid A. Butt - Auckland University of TechnologyIsmael R. Campos-Nonato - Institute for Health Metrics and EvaluationCarlos Cantu-Brito - Auckland University of TechnologyMate Car - Auckland University of TechnologyGBD 2016 Neurology CollaboratorsDavid C Schwebel (Contributor) - Research Administration
- Resource Type
- Journal article
- Publication Details
- Lancet neurology, Vol.18(5), pp.459-480
- DOI
- 10.1016/S1474-4422(18)30499-X
- PMID
- 30879893
- PMCID
- PMC6459001
- NLM abbreviation
- Lancet Neurol
- ISSN
- 1474-4422
- eISSN
- 1474-4465
- Publisher
- Elsevier
- Number of pages
- 22
- Grant note
- NW London NIHR Collaboration for Leadership in Applied Health Research and Care Cancer Society of New Zealand Australian Government Swedish Heart and Lung Foundation; Swedish Heart-Lung Foundation Sistema Nacional de Investigacion (Panama) 01EA1411A / German Federal Ministry of Education and Research (nutriCARD) FT3 140100085 / Australian Research Council Health Research Council; Health Research Council of New Zealand University of Auckland 81773552 / National Natural Science Foundation of China; National Natural Science Foundation of China (NSFC)
- Language
- English
- Date published
- 05/01/2019
- Academic Unit
- Research Administration
- Record Identifier
- 9984949453502771
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