Burden of Neurological Disorders Across the US From 1990-2017: A Global Burden of Disease Study
Author
Feigin, Valery LVos, Theo
Alahdab, Fares
Amit, Arianna Maever L
Bärnighausen, Till Winfried
Beghi, Ettore
Beheshti, Mahya
Chavan, Prachi P
Criqui, Michael H
Desai, Rupak
Dhamminda Dharmaratne, Samath
Dorsey, E Ray
Wilder Eagan, Arielle
Elgendy, Islam Y
Filip, Irina
Giampaoli, Simona
Giussani, Giorgia
Hafezi-Nejad, Nima
Hole, Michael K
Ikeda, Takayoshi
Owens Johnson, Catherine
Kalani, Rizwan
Khatab, Khaled
Khubchandani, Jagdish
Kim, Daniel
Koroshetz, Walter J
Krishnamoorthy, Vijay
Krishnamurthi, Rita V
Liu, Xuefeng
Lo, Warren David
Logroscino, Giancarlo
Mensah, George A
Miller, Ted R
Mohammed, Salahuddin
Mokdad, Ali H
Moradi-Lakeh, Maziar
Morrison, Shane Douglas
Shivamurthy, Veeresh Kumar N
Naghavi, Mohsen
Nichols, Emma
Norrving, Bo
Odell, Christopher M
Pupillo, Elisabetta
Radfar, Amir
Roth, Gregory A
Shafieesabet, Azadeh
Sheikh, Aziz
Sheikhbahaei, Sara
Shin, Jae Il
Singh, Jasvinder A
Steiner, Timothy J
Stovner, Lars Jacob
Wallin, Mitchell Taylor
Weiss, Jordan
Wu, Chenkai
Zunt, Joseph Raymond
Adelson, Jaimie D
Murray, Christopher J L
Date
2020-11-02Journal
JAMA NeurologyPublisher
American Medical AssociationType
Article
Metadata
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Importance: Accurate and up-to-date estimates on incidence, prevalence, mortality, and disability-adjusted life-years (burden) of neurological disorders are the backbone of evidence-based health care planning and resource allocation for these disorders. It appears that no such estimates have been reported at the state level for the US. Objective: To present burden estimates of major neurological disorders in the US states by age and sex from 1990 to 2017. Design, Setting, and Participants: This is a systematic analysis of the Global Burden of Disease (GBD) 2017 study. Data on incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) of major neurological disorders were derived from the GBD 2017 study of the 48 contiguous US states, Alaska, and Hawaii. Fourteen major neurological disorders were analyzed: Stroke, Alzheimer disease and other dementias, Parkinson disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, traumatic brain injury, spinal cord injuries, brain and other nervous system cancers, meningitis, encephalitis, and tetanus. Exposures: Any of the 14 listed neurological diseases. Main Outcome and Measure: Absolute numbers in detail by age and sex and age-standardized rates (with 95% uncertainty intervals) were calculated. Results: The 3 most burdensome neurological disorders in the US in terms of absolute number of DALYs were stroke (3.58 [95% uncertainty interval [UI], 3.25-3.92] million DALYs), Alzheimer disease and other dementias (2.55 [95% UI, 2.43-2.68] million DALYs), and migraine (2.40 [95% UI, 1.53-3.44] million DALYs). The burden of almost all neurological disorders (in terms of absolute number of incident, prevalent, and fatal cases, as well as DALYs) increased from 1990 to 2017, largely because of the aging of the population. Exceptions for this trend included traumatic brain injury incidence (-29.1% [95% UI,-32.4% to-25.8%]); spinal cord injury prevalence (-38.5% [95% UI,-43.1% to-34.0%]); meningitis prevalence (-44.8% [95% UI,-47.3% to-42.3%]), deaths (-64.4% [95% UI,-67.7% to-50.3%]), and DALYs (-66.9% [95% UI,-70.1% to-55.9%]); and encephalitis DALYs (-25.8% [95% UI,-30.7% to-5.8%]). The different metrics of age-standardized rates varied between the US states from a 1.2-fold difference for tension-type headache to 7.5-fold for tetanus; southeastern states and Arkansas had a relatively higher burden for stroke, while northern states had a relatively higher burden of multiple sclerosis and eastern states had higher rates of Parkinson disease, idiopathic epilepsy, migraine and tension-type headache, and meningitis, encephalitis, and tetanus. Conclusions and Relevance: There is a large and increasing burden of noncommunicable neurological disorders in the US, with up to a 5-fold variation in the burden of and trends in particular neurological disorders across the US states. The information reported in this article can be used by health care professionals and policy makers at the national and state levels to advance their health care planning and resource allocation to prevent and reduce the burden of neurological disorders.Identifier to cite or link to this item
http://hdl.handle.net/10713/14193ae974a485f413a2113503eed53cd6c53
10.1001/jamaneurol.2020.4152
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