New GBD Data Shed Light on National Burden of Neurological Disorders

The number of people in the United States with neurological disorders is large and increasing, and the burden of neurological disease varies highly by geographic location, according to findings from a new Global Burden of Disease (GBD) Study.

The GBD 2017 US Neurological Disorders Collaborators arrived at their conclusion after performing a systematic analysis of the GBD 2017 study. Specifically, they assessed neurological disorders data pertaining to prevalence, incidence, mortality, and disability-adjusted life-years (DALYs) from all 50 US states. They took into account 14 key neurological disorders, including Alzheimer disease and other dementias, brain and other nervous system cancers, encephalitis, epilepsy, meningitis, migraine, motor neuron disease, multiple sclerosis, Parkinson disease, spinal cord injuries, stroke, tension-type headache, tetanus, and traumatic brain injury.

The results of the analysis indicated that stroke, Alzheimer disease and other dementias, and migraine were the most burdensome neurological disorders in the United States, based on the absolute number of DALYs (3.58, 2.55, and 2.40, respectively). Other key findings included:

• From 1990 to 2016, the burden associated with nearly all neurological disorders increased primarily due to the aging population, with exceptions being the incidence of traumatic brain injury (−29.1%); the prevalence of spinal cord injury (−38.5%); the prevalence, deaths, and DALYs associated with meningitis (−44.8%, −64.4%, and −66.9%, respectively); and DALYs associated with encephalitis (−25.8%).
• Age-standardized rates across US states ranged from a 1.2-fold difference with tension-type headache to a 7.5-fold difference with tetanus.
• The burden of stroke was relatively higher in Arkansas and southeastern US states.
• The burden of multiple sclerosis was relatively higher in northern US states.
• The burden of Parkinson disease, migraine and tension-type headache, idiopathic epilepsy, encephalitis, meningitis, and tetanus was higher in eastern US states.

“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 authors concluded.

“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,” they added.

—Christina Vogt

Reference:
GBD 2017 US Neurological Disorders Collaborators. Burden of neurological disorders across the US from 1990-2017: a Global Burden of Disease study. JAMA Neurol. Published online November 2, 2020. doi:10.1001/jamaneurol.2020.4152