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    Burden of Neurological Disorders Across the US From 1990-2017: A Global Burden of Disease Study

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    Author
    Feigin, Valery L
    Vos, 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
    Show allShow less

    Date
    2020-11-02
    Journal
    JAMA Neurology
    Publisher
    American Medical Association
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://jamanetwork.com/journals/jamaneurology/fullarticle/2772579
    Abstract
    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.
    Keyword
    Global Burden of Disease
    Nervous System Diseases
    United States
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/14193
    ae974a485f413a2113503eed53cd6c53
    10.1001/jamaneurol.2020.4152
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