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Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

2024-04Journal article Open access
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dc.contributor.authorGBD 2021 Nervous System Disorders Collaborators
dc.contributor.authorSteinmetz, Jaimie D.
dc.contributor.authorSeeher, Katrin Maria
dc.contributor.authorSchiess, Nicoline
dc.contributor.authorNichols, Emma
dc.contributor.authorCao, Bochen
dc.contributor.authorServili, Chiara
dc.contributor.authorCavallera, Vanessa
dc.contributor.authorCousin, Ewerton
dc.contributor.authorHagins, Hailey
dc.contributor.authorMoberg, Madeline E.
dc.contributor.authorMehlman, Max L.
dc.contributor.authorAbate, Yohannes Habtegiorgis
dc.contributor.authorAbbas, Jaffar
dc.contributor.authorAbbasi, Madineh Akram
dc.contributor.authorAbbasian, Mohammadreza
dc.contributor.authorAbbastabar, Hedayat
dc.contributor.authorAbdelmasseh, Michael
dc.contributor.authorAbdollahi, Mohammad
dc.contributor.authorAbdollahi, Mozhan
dc.contributor.authorAbdollahifar, Mohammad Amin
dc.contributor.authorAbd-Rabu, Rami
dc.contributor.authorAbdulah, Deldar Morad
dc.contributor.authorAbdullahi, Auwal
dc.contributor.authorAbedi, Aidin
dc.contributor.authorAbedi, Vida
dc.contributor.authorAbeldaño Zuñiga, Roberto Ariel
dc.contributor.authorAbidi, Hassan
dc.contributor.authorAbiodun, Olumide
dc.contributor.authorAboagye, Richard Gyan
dc.contributor.authorAbolhassani, Hassan
dc.contributor.authorAboyans, Victor
dc.contributor.authorAbrha, Woldu Aberhe
dc.contributor.authorAbualhasan, Ahmed
dc.contributor.authorAbu-Gharbieh, Eman
dc.contributor.authorAburuz, Salahdein
dc.contributor.authorAdamu, Lawan Hassan
dc.contributor.authorAddo, Isaac Yeboah
dc.contributor.authorAdebayo, Oladimeji M.
dc.contributor.authorAdekanmbi, Victor
dc.contributor.authorAdekiya, Tayo Alex
dc.contributor.authorAdikusuma, Wirawan
dc.contributor.authorAdnani, Qorinah Estiningtyas Sakilah
dc.contributor.authorAdra, Saryia
dc.contributor.authorAfework, Tsion
dc.contributor.authorAfolabi, Aanuoluwapo Adeyimika
dc.contributor.authorAfraz, Ali
dc.contributor.authorAfzal, Saira
dc.contributor.authorAghamiri, Shahin
dc.contributor.authorAgodi, Antonella
dc.contributor.authorBettencourt, Paulo J. G.
dc.date.accessioned2024-05-22T12:54:38Z
dc.date.available2024-05-22T12:54:38Z
dc.date.issued2024-04
dc.description.abstractBackground: 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.1016/S1474-4422(24)00038-3pt_PT
dc.identifier.eid85187999548
dc.identifier.issn1474-4422
dc.identifier.pmcPMC10949203
dc.identifier.pmid38493795
dc.identifier.urihttp://hdl.handle.net/10400.14/45221
dc.identifier.wos001270049900001
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.titleGlobal, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage381pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage344pt_PT
oaire.citation.titleThe Lancet Neurologypt_PT
oaire.citation.volume23pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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