Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
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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. FUNDING: Bill & Melinda Gates Foundation.
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The record
- Venue
- The Lancet Neurology
- Topic
- Long-Term Effects of COVID-19
- Field
- Medicine
- Canadian institutions
- —
- Funders
- Daiichi Sankyo EuropeNational Institute on Deafness and Other Communication DisordersNational Institute of Mental HealthNational Heart, Lung, and Blood InstituteJeffrey Cheah School of Medicine and Health Sciences, Monash University MalaysiaFaculty of Medicine and Health, University of SydneyInstituto de Salud Carlos IIIRussian Academy of SciencesMedical Research CouncilResearch Institute, Nationwide Children's HospitalDuke Global Health Institute, Duke UniversityDirectorate for Biological SciencesBabcock UniversityUniversity of Veterinary and Animal SciencesAdigrat UniversityKing Faisal UniversityUniversité de Versailles Saint-Quentin-en-YvelinesKfW EntwicklungsbankUniversity of NicosiaAlfaisal UniversityWestern Sydney UniversityBerlin Institute of HealthMahatma Gandhi UniversityUniversidade Federal de SergipeUniversitas Syiah KualaUniversitas MataramJahrom University of Medical SciencesUniversity of NizwaAja University of Medical SciencesRazi Vaccine and Serum Research InstituteLorestan University of Medical SciencesGonabad University of Medical SciencesSt. Olavs Hospital Universitetssykehuset i TrondheimUniversitas HasanuddinMasarykova UniverzitaUniversity of ThessalyHawassa UniversityKarl-Franzens-Universität GrazUniversity of Social Welfare and Rehabilitation SciencesGeorge Institute for Global HealthUniversity of PeradeniyaCentral University of KeralaGuru Angad Dev Veterinary and Animal Sciences UniversityDire Dawa UniversityFondazione I.R.C.C.S. Istituto Neurologico Carlo BestaNanjing UniversityNational Nutrition and Food Technology Research InstituteTokyo Medical and Dental UniversityAddis Ababa UniversityIlam UniversityTartu ÜlikoolEuropean Academy of NeurologyUniversity of TabrizEuropean Stroke OrganisationShaqra UniversityUniversity of the PhilippinesChina Medical UniversityUrmia UniversityTarbiat Modares UniversityYasuj University of Medical SciencesTrakya ÜniversitesiNazarbayev UniversityWuhan UniversityAfrican Population and Health Research CenterTechnische Universität BerlinUniversity of JohannesburgUniversity of TsukubaSyddansk UniversitetUniversity of ZanjanUniversità degli Studi dell'AquilaManagement and Science UniversityOulun YliopistoZanjan University of Medical SciencesUniversity of GondarUnited Arab Emirates UniversityBahir Dar UniversityGolestan University of Medical SciencesUniversitatea de Medicină şi Farmacie "Carol Davila" BucureştiShahid Beheshti University of Medical SciencesBaqiyatallah University of Medical SciencesUniversitat de BarcelonaGöteborgs UniversitetUniversidade de CoimbraInternational Trachoma InitiativeUniversity of JordanKerman Neuroscience Research Center, Kerman University of Medical SciencesGuilan University of Medical SciencesTamilnadu State Council For Science And TechnologyDeakin UniversityUniversity of Electronic Science and Technology of ChinaUniversitetet i OsloNationwide Children's HospitalUniversidad de Costa RicaDeutsches Zentrum für Neurodegenerative ErkrankungenKeele UniversityLeids Universitair Medisch CentrumJazan UniversityGriffith UniversityAhvaz Jundishapur University of Medical SciencesMazandaran University of Medical SciencesShahrekord UniversityHamadan University of Medical SciencesJenderal Soedirman UniversityPrince Sattam bin Abdulaziz UniversityThomas Jefferson UniversityAbdul Wali Khan University MardanAlborz University of Medical SciencesUniversity of PeshawarYarmouk UniversityUniversity of Technology SydneySouth Eastern Sydney Local Health DistrictTehran University of Medical Sciences and Health ServicesTabriz University of Medical SciencesShiraz University of Medical SciencesAjman UniversityUniversidad Autónoma MetropolitanaUniversity of WollongongKing Abdulaziz UniversityKarolinska InstitutetJordan University of Science and TechnologyEuropean and Developing Countries Clinical Trials PartnershipUniversiti MalayaSabzevar University of Medical SciencesIsfahan University of Medical SciencesShandong UniversityIlam University of Medical SciencesUniversidade de São PauloQueen's UniversityPirogov Russian National Research Medical UniversityUniwersytet ŁódzkiUniversity of Florida HealthBaker Heart and Diabetes InstituteDelhi Technological UniversityUniversité de BordeauxDongguk UniversityUniversità di CataniaUniversidad ICESIUniversità di BolognaAsia UniversityTaibah UniversityNational and Kapodistrian University of AthensParacelsus Medizinische PrivatuniversitätUniversity of CanberraCancer Institute NSWCairo UniversitySchool of Medicine, Indiana UniversityUniversity of OttawaKing Faisal Specialist Hospital and Research CentreImperial College LondonPublic Health EnglandUniversity of Central PunjabJames Cook UniversityUniversity of PatrasUniversiti Sains MalaysiaUniversity of South AustraliaUniversity of New South WalesKermanshah University of Medical SciencesRMIT UniversityCleveland ClinicUniversiteit LeidenSunnybrook Research InstituteInstitut National de la Santé et de la Recherche MédicaleUniversity of PennsylvaniaTsinghua UniversityDeutsche ForschungsgemeinschaftAmity UniversityJohns Hopkins UniversityUniversity of WarwickSouthern Cross UniversityBauman Moscow State Technical UniversityPublic Health Foundation of IndiaChung Shan Medical UniversityWestfälische Wilhelms-Universität MünsterIndian Council of Medical ResearchUniversity of PretoriaBundesministerium für GesundheitSouth African Medical Research CouncilKing Abdullah University of Science and TechnologyCapital Medical UniversityStudent Research Committee, Tabriz University of Medical SciencesLa Trobe UniversityDilla UniversityAustralian Catholic UniversityQueensland Brain InstituteSydney Medical SchoolNewcastle UniversityUniversity of OxfordShiraz UniversityUniversity of SouthamptonCOMSATS Institute of Information TechnologyUniversity of QueenslandNational Institute for Health and Care ResearchUniversity of ColomboUniversidade Federal do Rio Grande do SulArabian Gulf UniversityArak University of Medical SciencesNeyshabur University of Medical SciencesShanghai Jiao Tong UniversityKasturba Medical College, ManipalJamia Millia IslamiaNorthwell HealthLawson Health Research InstituteKarpagam Academy of Higher EducationUniversity of KufaAhmadu Bello UniversityKU LeuvenUniversità Cattolica del Sacro CuoreIslamic Azad University, ShahrekordUniversité Mohammed VI PolytechniqueUniversidad de AntioquiaMusculoskeletal Research Center, Washington University in St. LouisHamad Medical CorporationXiamen UniversityChildren's Hospital of PhiladelphiaKrishna Institute Of Medical Sciences Deemed To Be UniversityUniversità degli Studi di SienaShahrekord University of Medical SciencesImam Abdulrahman Bin Faisal UniversityAugusta UniversityUniversity College LondonUniversiti Kebangsaan MalaysiaUniversity at BuffaloCoventry UniversityLondon School of Economics and Political ScienceAcademy of Military Medical SciencesMadda Walabu UniversityKerman University of Medical SciencesTrường Đại học Duy TânWellcome TrustUniversitas Ahmad DahlanIslamic Azad UniversityUniversity of EssexDezful University of Medical SciencesHögskolan DalarnaSheffield Hallam UniversityGastrointestinal and Liver Diseases Research CenterVanderbilt UniversityInstitut für Arbeitsmarkt- und BerufsforschungNew Mexico State UniversityUniversidad de ColimaKurdistan University Of Medical SciencesBrody School of MedicineNational Science FoundationHouston Methodist Research InstituteIran University of Medical SciencesNankai UniversityUniversiteit UtrechtUniversité de LimogesFlinders UniversityNorges Teknisk-Naturvitenskapelige UniversitetMekelle UniversityCooperative Research Centre for Contamination Assessment and Remediation of the EnvironmentUniversité de BourgogneQazvin University of Medical SciencesUniversity of South CarolinaUniversity of GlasgowNational Institute of Mental Health and NeurosciencesTaipei Medical UniversityUniversity College CorkLoma Linda UniversityHarvard Business SchoolUniversidad Peruana Cayetano HerediaMinistero della SaluteUniversitas AirlanggaHouston Methodist HospitalNational Institutes of HealthWollega UniversityNational University of SingaporeKuwait UniversityCentre International de Recherche sur le CancerUniversity of Health and Allied SciencesUniversidade de LisboaNanjing University of Science and TechnologyOttawa Hospital Research InstituteAmgenUniversity of WaterlooSalahaddin University-ErbilNorwegian Institute of Public HealthRafsanjan University of Medical SciencesUnited Nations Population FundAuckland University of Technology, New ZealandNew York University ShanghaiUniversity of ConnecticutUniversität BaselEast Carolina UniversityUniverzita Karlova v PrazeUniversidade da Beira InteriorUniversitas PadjadjaranMashhad University of Medical SciencesMassachusetts General HospitalInternational Centre for Diarrhoeal Disease Research, BangladeshSt. Baldrick's FoundationKhalifa University of Science, Technology and ResearchMonash UniversityVanderbilt University Medical CenterWashington University in St. LouisMacquarie UniversityArizona State UniversityFlorida Department of HealthAmerican Stroke AssociationQatar UniversityAsian Institute of Medicine, Science and TechnologyJimma UniversityZahedan University of Medical SciencesWarwick Medical SchoolDeutsches KrebsforschungszentrumHarvard UniversityCase Western Reserve UniversityUniversity of South FloridaLoughborough UniversityAlexander von Humboldt-StiftungUniversità degli Studi di MilanoUrmia University of Medical SciencesHáskólinn í ReykjavíkPfizerFederation University AustraliaBill and Melinda Gates FoundationAarhus UniversitetMedizinische Universität GrazGAVI AllianceUniversidad de ConcepciónHaramaya UniversityDivision of Mathematical SciencesAksum UniversityConquer Cancer FoundationUniversidad Nacional de ColombiaInstitute for Advanced Studies in Basic SciencesNorthwestern University
- Keywords
- Burden of diseaseDiseaseMedicineEnvironmental healthPathology
- Has abstract in OpenAlex
- yes