Global, regional, and national burden of neurological disorders during 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015
Authors: Valery L Feigin, Amanuel Alemu Abajobir, Kalkidan Hassen Abate, Foad Abd-Allah, Abdishakur M Abdulle, Semaw Ferede Abera, Gebre Yitayih Abyu, Muktar Beshir Ahmed, Amani Nidhal Aichour, Ibtihel Aichour, Miloud Taki Eddine Aichour, Rufus Olusola Akinyemi, Samer Alabed, Rajaa Al-Raddadi, Nelson Alvis-Guzman, Azmeraw T. Amare, Hossein Ansari, Palwasha Anwari, Johan Ärnlöv, Hamid Asayesh, Solomon Weldegebreal Asgedom, Tesfay Mehari Atey, Leticia Avila-Burgos, Euripide Frinel, G. Arthur Avokpaho, Mahmood Reza Azarpazhooh, Aleksandra Barac, Miguel Barboza, Suzanne L Barker-Collo, Till Bärnighausen, Neeraj Bedi, Ettore Beghi, Derrick A Bennett, Isabela M Bensenor, Adugnaw Berhane, Balem Demtsu Betsu, Soumyadeep Bhaumik, Sait Mentes Birlik, Stan Biryukov, Dube Jara Boneya, Lemma Negesa Bulto Bulto, Hélène Carabin, Daniel Casey, Carlos A. Castañeda-Orjuela, Ferrán Catalá-López, Honglei Chen, Abdulaal A Chitheer, Rajiv Chowdhury, Hanne Christensen, Lalit Dandona, Rakhi Dandona, Gabrielle A de Veber, Samath D Dharmaratne, Huyen Phuc Do, Klara Dokova, E Ray Dorsey, Richard G Ellenbogen, Sharareh Eskandarieh, Maryam S Farvid, Seyed-Mohammad Fereshtehnejad, Florian Fischer, Kyle J Foreman, Johanna M Geleijnse, Richard F Gillum, Giorgia Giussani, Ellen M Goldberg, Philimon N Gona, Alessandra Carvalho Goulart, Harish Chander Gugnani, Rahul Gupta, Vladimir Hachinski, Rajeev Gupta, Randah Ribhi Hamadeh, Mitiku Hambisa, Graeme J Hankey, Habtamu Abera Hareri, Rasmus Havmoeller, Simon I Hay, Pouria Heydarpour, Peter J Hotez, Mihajlo (Michael) B Jakovljevic, Mehdi Javanbakht, Panniyammakal Jeemon, Jost B Jonas, Yogeshwar Kalkonde, Amit Kandel, André Karch, Amir Kasaeian, Anshul Kastor, Peter Njenga Keiyoro, Yousef Saleh Khader, Ibrahim A Khalil, Ejaz Ahmad Khan, Young-Ho Khang, Abdullah Tawfih, Abdullah Khoja, Jagdish Khubchandani, Chanda Kulkarni, Daniel Kim, Yun Jin Kim, Mika Kivimaki, Yoshihiro Kokubo, Soewarta Kosen, Michael Kravchenko, Rita Vanmala Krishnamurthi, Barthelemy Kuate Defo, G Anil Kumar, Rashmi Kumar, Hmwe H Kyu, Anders Larsson, Pablo M Lavados, Yongmei Li, Xiaofeng Liang, Misgan Legesse Liben, Warren D Lo, Giancarlo Logroscino, Paulo A Lotufo, Clement T Loy, Mark T Mackay, Hassan Magdy Abd El Razek, Mohammed Magdy Abd El Razek, Azeem Majeed, Reza Malekzadeh, Treh Manhertz, Lorenzo G Mantovani, João Massano, Mohsen Mazidi, Colm McAlinden, Suresh Mehata, Man Mohan Mehndiratta, Ziad A Memish, Walter Mendoza, Mubarek Abera Mengistie, George A Mensah, Atte Meretoja, Haftay Berhane Mezgebe, Ted R Miller, Shiva Raj Mishra, Norlinah Mohamed Ibrahim, Alireza Mohammadi, Kedir Endris Mohammed, Shafiu Mohammed, Ali H Mokdad, Maziar Moradi-Lakeh, Ilais Moreno Velasquez, Kamarul Imran Musa, Mohsen Naghavi, Josephine Wanjiku Ngunjiri, Cuong Tat Nguyen, Grant Nguyen, Quyen Le Nguyen, Trang Huyen Nguyen, Emma Nichols, Dina Nur Anggraini Ningrum, Vuong Minh Nong, Bo Norrving, Jean Jacques N Noubiap, Felix Akpojene Ogbo, Mayowa O Owolabi, Jeyaraj D. Pandian, Priyakumari Ganesh Parmar, David M Pereira, Max Petzold, Michael Robert Phillips, Michael A Piradov, Richie G. Poulton, Farshad Pourmalek, Mostafa Qorbani, Anwar Rafay, Mahfuzar Rahman, Mohammad HifzUr Rahman, Rajesh Kumar Rai, Sasa Rajsic, Annemarei Ranta, Salman Rawaf, Andre M.N. Renzaho, Mohammad Sadegh Rezai, Gregory A Roth, Gholamreza Roshandel, Enrico Rubagotti, Perminder Sachdev, Saeid Safiri, Ramesh Sahathevan, Mohammad Ali Sahraian, Abdallah M. Samy, Paula Santalucia, Itamar S Santos, Benn Sartorius, Maheswar Satpathy, Monika Sawhney, Mete I Saylan, Sadaf G Sepanlou, Masood Ali Shaikh, Raad Shakir, Morteza Shamsizadeh, Kevin N Sheth, Mika Shigematsu, Haitham Shoman, Diego Augusto Santos Silva, Mari Smith, Eugene Sobngwi, Luciano A Sposato, Jeffrey D Stanaway, Dan J Stein, Timothy J Steiner, Lars Jacob Stovner, Rizwan Suliankatchi Abdulkader, Cassandra EI Szoeke, Rafael Tabarés-Seisdedos, David Tanne, Alice M Theadom, Amanda G Thrift, David L Tirschwell, Roman Topor-Madry, Bach Xuan Tran, Thomas Truelsen, Kald Beshir Tuem, Kingsley Nnanna Ukwaja, Olalekan A Uthman, Yuri Y Varakin, Tommi Vasankari, Narayanaswamy Venketasubramanian, Vasiliy Victorovich Vlassov, Fiseha Wadilo, Tolassa Wakayo, Mitchell T Wallin, Elisabete Weiderpass, Ronny Westerman, Tissa Wijeratne, Charles Shey Wiysonge, Minyahil Alebachew Woldu, Charles D A Wolfe, Denis Xavier, Gelin Xu, Yuichiro Yano, Hassen Hamid Yimam, Naohiro Yonemoto, Chuanhua Yu, Zoubida Zaidi, Maysaa El Sayed Zaki, Joseph R Zunt, Christopher J L Murray, Theo Vos
Journal: The Lancet Neurology (2017)

Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level.We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer's disease and other dementias, Parkinson's disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, medication overuse headache, brain and nervous system cancers, and a residual category of other neurological disorders. We also analysed results based on the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility, to identify patterns associated with development and how countries fare against expected outcomes relative to their level of development.Neurological disorders ranked as the leading cause group of DALYs in 2015 (250·7 [95% uncertainty interval (UI) 229·1 to 274·7] million, comprising 10·2% of global DALYs) and the second-leading cause group of deaths (9·4 [9·1 to 9·7] million], comprising 16·8% of global deaths). The most prevalent neurological disorders were tension-type headache (1505·9 [UI 1337·3 to 1681·6 million cases]), migraine (958·8 [872·1 to 1055·6] million), medication overuse headache (58·5 [50·8 to 67·4 million]), and Alzheimer's disease and other dementias (46·0 [40·2 to 52·7 million]). Between 1990 and 2015, the number of deaths from neurological disorders increased by 36·7%, and the number of DALYs by 7·4%. These increases occurred despite decreases in age-standardised rates of death and DALYs of 26·1% and 29·7%, respectively; stroke and communicable neurological disorders were responsible for most of these decreases. Communicable neurological disorders were the largest cause of DALYs in countries with low SDI. Stroke rates were highest at middle levels of SDI and lowest at the highest SDI. Most of the changes in DALY rates of neurological disorders with development were driven by changes in YLLs.Neurological disorders are an important cause of disability and death worldwide. Globally, the burden of neurological disorders has increased substantially over the past 25 years because of expanding population numbers and ageing, despite substantial decreases in mortality rates from stroke and communicable neurological disorders. The number of patients who will need care by clinicians with expertise in neurological conditions will continue to grow in coming decades. Policy makers and health-care providers should be aware of these trends to provide adequate services.Bill & Melinda Gates Foundation.