NISAN - the National Institute for Stroke and Applied Neurosciences

Permanent link for this collection

https://hdl.handle.net/10292/10244

Institute Director: Professor Valery Feigin

Deputy Director: Associate Professor Alice Theadom

The National Institute for Stroke and Applied Neurosciences (NISAN) conducts epidemiological studies and clinical trials to improve health and outcomes in people with major neurological disorders. Current research programmes focus on:

Stroke
Traumatic brain injury
Neuromuscular disorders

Research with this aim is unique in New Zealand and NISAN is a hub for information sharing and developing a cohesive network between existing research and clinical groups with interests in:

Neuroepidemiology
Public health
Neurorehabilitation
Neuropsychology
Biostatistics

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Now showing 1 - 6 of 6

Differing Definitions of First-Ever Stroke Influence Incidence Estimates More Than Trends: A Study Using Linked Administrative Data
(S. Karger AG, 2023-09-26) Youens, David; Katzenellenbogen, Judith; Srinivasa Ragavan, Rathina; Sodhi-Berry, Nita; Carson, Jennie; Zemedikun, Dawit; Thrift, Amanda G; Feigin, Valery; Nedkoff, Lee
Introduction Researchers apply varying definitions when measuring stroke incidence using administrative data. We aimed to investigate the sensitivity of incidence estimates to varying definitions of stroke and lookback periods, and to provide updated incidence rates and trends for Western Australia (WA). Methods We used linked state-wide hospital and death data from 1985-2017 to identify incident strokes from 2005-2017. A standard definition was applied which included strokes coded as the principal hospital diagnosis or the underlying cause of death, with a 10-year lookback used to clear prevalent cases. Alternative definitions were compared against the standard definition by percentage difference in case numbers. Age-standardised incidence rates were calculated, and age- and sex-adjusted Poisson regression models used to estimate incidence trends. Results The standard definition with a 10-year lookback period captured 31,274 incident strokes. Capture increased by 19.3% when including secondary diagnoses, 4.1% when including nontraumatic subdural and extradural haemorrhage, and 8.1% when including associated causes of death. Excluding death records reduced capture by 11.1%. A 20-year lookback reduced over-ascertainment by 2.0% and a 1-year lookback increased capture by 13.3%. Incidence declined 0.6% annually (95% confidence interval -0.9, -0.3). Annual reductions were similar for most definitions except when death records were excluded (-0.1%, CI -0.4, 0.2) and with the shortest lookback periods (greatest annual reduction). Conclusion Stroke incidence has declined in WA. Differing methods of identifying stroke influence estimates of incidence to a greater extent than estimates of trends. Reductions in stroke incidence over time are primarily driven by declines in hospitalised stroke.
Ethnic Differences in Stroke Outcomes in Aotearoa New Zealand: A National Linkage Study
(SAGE Publications, 2023-03-05) Denison, Hayley; Corbin, Marine; Douwes, Jeroen; Thompson, Stephanie; Harwood, Matire; Davis, Alan; Fink, John N; Barber, P Alan; Gommans, John; Cadilhac, Dominique; Levack, William; McNaughton, Harry; Kim, Joosup; Feigin, VL; Abernethy, Virginia; Girvan, Jackie; Wilson, Andrew; Ranta, Annemarei
BACKGROUND: Ethnic differences in post-stroke outcomes have been largely attributed to biological and socioeconomic characteristics resulting in differential risk factor profiles and stroke sub-types, but evidence is mixed. AIMS: This study assessed ethnic differences in stroke outcome and service access in New Zealand (NZ) and explored underlying causes in addition to traditional risk factors. METHODS: This national cohort study used routinely collected health and social data to compare post-stroke outcomes between NZ Europeans, Māori, Pacific Peoples, and Asians, adjusting for differences in baseline characteristics, socioeconomic deprivation, and stroke characteristics. First and principal stroke public hospital admissions during November 2017-October 2018 were included (N=6,879). Post-stroke unfavourable outcome was defined as being dead, change in residence, or unemployed if working pre-stroke. RESULTS: In total, 5,394 NZ Europeans, 762 Māori, 369 Pacific Peoples and 354 Asians experienced a stroke during the study period. Median age was 65 years for Māori and Pacific Peoples, and 71 and 79 years for Asians and NZ Europeans, respectively. Compared with NZ Europeans, Māori were more likely to have an unfavourable outcome at all three time-points (OR=1.6 (95%CI=1.3-1.9); 1.4 (1.2-1.7); 1.4 (1.2-1.7), respectively). Māori also had increased odds of death at all time-points (1.7 (1.3-2.1); 1.5 (1.2-1.9); 1.7 (1.3-2.1)) and unemployment at twelve months (2.5 (1.2-5.2). There was evidence of differences in post-stroke secondary prevention medication by ethnicity. CONCLUSIONS: We found ethnic disparities in care and outcomes following stroke, independent of traditional risk factors raising concern for potential unconscious bias and institutional racism in stroke services.
Global Age-Sex-Specific Mortality, Life Expectancy, and Population Estimates in 204 Countries and Territories and 811 Subnational Locations, 1950–2021, and the Impact of the COVID-19 Pandemic: A Comprehensive Demographic Analysis for the Global Burden
(Elsevier BV, 2024) Schumacher, Austin E; Kyu, Hmwe Hmwe; Aali, Amirali; Abbafati, Cristiana; Abbas, Jaffar; Abbasgholizadeh, Rouzbeh; Abbasi, Madineh Akram; Abbasian, Mohammadreza; Abd ElHafeez, Samar; Abdelmasseh, Michael; Abd-Elsalam, Sherief; Abdelwahab, Ahmed; Abdollahi, Mohammad; Abdoun, Meriem; Abdullahi, Auwal; Abdurehman, Ame Mehadi; Abebe, Mesfin; Abedi, Aidin; Abedi, Armita; Abegaz, Tadesse M; Abeldaño Zuñiga, Roberto Ariel; Abhilash, ES; Abiodun, Olugbenga Olusola; Aboagye, Richard Gyan; Abolhassani, Hassan; Abouzid, Mohamed; Abreu, Lucas Guimarães; Abrha, Woldu Aberhe; Abrigo, Michael RM; Abtahi, Dariush; Abu Rumeileh, Samir; Abu-Rmeileh, Niveen ME; Aburuz, Salahdein; Abu-Zaid, Ahmed; Acuna, Juan Manuel; Adair, Tim; Addo, Isaac Yeboah; Adebayo, Oladimeji M; Adegboye, Oyelola A; Adekanmbi, Victor; Aden, Bashir; Adepoju, Abiola Victor; Adetunji, Charles Oluwaseun; Adeyeoluwa, Temitayo Esther; Adeyomoye, Olorunsola Israel; Adha, Rishan; Adibi, Amin; Adikusuma, Wirawan; Adnani, Qorinah Estiningtyas Sakilah; Adra, Saryia; Afework, Abel; Afolabi, Aanuoluwapo Adeyimika; Afraz, Ali; Afyouni, Shadi; Afzal, Saira; Agasthi, Pradyumna; Aghamiri, Shahin; Agodi, Antonella; Agyemang-Duah, Williams; Ahinkorah, Bright Opoku; Ahmad, Aqeel; Ahmad, Danish; Ahmad, Firdos; Ahmad, Muayyad M; Ahmad, Tauseef; Ahmadi, Keivan; Ahmadzade, Amir Mahmoud; Ahmadzade, Mohadese; Ahmed, Ayman; Ahmed, Haroon; Ahmed, Luai A; Ahmed, Muktar Beshir; Ahmed, Syed Anees; Ajami, Marjan; Aji, Budi; Ajumobi, Olufemi; Akalu, Gizachew Taddesse; Akara, Essona Matatom; Akinosoglou, Karolina; Akkala, Sreelatha; Akyirem, Samuel; Al Hamad, Hanadi; Al Hasan, Syed Mahfuz; Al Homsi, Ammar; Al Qadire, Mohammad; Ala, Moein; Aladelusi, Timothy Olukunle; AL-Ahdal, Tareq Mohammed Ali; Alalalmeh, Samer O; Al-Aly, Ziyad; Alam, Khurshid; Alam, Manjurul; Alam, Zufishan; Al-amer, Rasmieh Mustafa; Alanezi, Fahad Mashhour; Alanzi, Turki M; Albashtawy, Mohammed; AlBataineh, Mohammad T; Aldridge, Robert W; Alemi, Sharifullah; Al-Eyadhy, Ayman; Al-Gheethi, Adel Ali Saeed; Alhabib, Khalid F; Alhalaiqa, Fadwa Alhalaiqa Naji; Al-Hanawi, Mohammed Khaled; Ali, Abid; Ali, Akhtar; Ali, Beriwan Abdulqadir; Ali, Hassam; Ali, Mohammed Usman; Ali, Rafat; Ali, Syed Shujait Shujait; Ali, Zahid; Alian Samakkhah, Shohreh; Alicandro, Gianfranco; Alif, Sheikh Mohammad; Aligol, Mohammad; Alimi, Rasoul; Aliyi, Ahmednur Adem; Al-Jumaily, Adel; Aljunid, Syed Mohamed; Almahmeed, Wael; Al-Marwani, Sabah; Al-Maweri, Sadeq Ali Ali; Almazan, Joseph Uy; Al-Mekhlafi, Hesham M; Almidani, Omar; Alomari, Mahmoud A; Alonso, Nivaldo; Alqahtani, Jaber S; Alqutaibi, Ahmed Yaseen; Al-Sabah, Salman Khalifah; Altaf, Awais; Al-Tawfiq, Jaffar A; Altirkawi, Khalid A; Alvi, Farrukh Jawad; Alwafi, Hassan; Al-Worafi, Yaser Mohammed; Aly, Hany; Alzoubi, Karem H; Amare, Azmeraw T; Ameyaw, Edward Kwabena; Amhare, Abebe Feyissa; Amin, Tarek Tawfik; Amindarolzarbi, Alireza; Aminian Dehkordi, Javad; Amiri, Sohrab; Amu, Hubert; Amugsi, Dickson A; Amzat, Jimoh; Ancuceanu, Robert; Anderlini, Deanna; Andrade, Pedro Prata; Andrei, Catalina Liliana; Andrei, Tudorel; Angappan, Dhanalakshmi; Anil, Abhishek; Anjum, Afifa; Antony, Catherine M; Antriyandarti, Ernoiz; Anuoluwa, Iyadunni Adesola; Anwar, Sumadi Lukman; Anyasodor, Anayochukwu Edward; Appiah, Seth Christopher Yaw; Aqeel, Muhammad; Arabloo, Jalal; Arabzadeh Bahri, Razman; Arab-Zozani, Morteza; Arafat, Mosab; Araújo, Ana Margarida; Aravkin, Aleksandr Y; Aremu, Abdulfatai; Ariffin, Hany; Aripov, Timur; Armocida, Benedetta; Arooj, Mahwish; Artamonov, Anton A; Artanti, Kurnia Dwi; Arulappan, Judie; Aruleba, Idowu Thomas; Aruleba, Raphael Taiwo; Arumugam, Ashokan; Asaad, Malke; Asgary, Saeed; Ashemo, Mubarek Yesse; Ashraf, Muhammad; Asika, Marvellous O; Athari, Seyyed Shamsadin; Atout, Maha Moh'd Wahbi; Atreya, Alok; Attia, Sameh; Aujayeb, Avinash; Avan, Abolfazl; Awotidebe, Adedapo Wasiu; Ayala Quintanilla, Beatriz Paulina; Ayanore, Martin Amogre; Ayele, Getnet Melaku; Ayuso-Mateos, Jose L; Ayyoubzadeh, Seyed Mohammad; Azadnajafabad, Sina; Azhar, Gulrez Shah; Aziz, Shahkaar; Azzam, Ahmed Y; Babashahi, Mina; Babu, Abraham Samuel; Badar, Muhammad; Badawi, Alaa; Badiye, Ashish D; Baghdadi, Soroush; Bagheri, Nasser; Bagherieh, Sara; Bah, Sulaiman; Bahadorikhalili, Saeed; Bai, Jianjun; Bai, Ruhai; Baker, Jennifer L; Bakkannavar, Shankar M; Bako, Abdulaziz T; Balakrishnan, Senthilkumar; Balogun, Saliu A; Baltatu, Ovidiu Constantin; Bam, Kiran; Banach, Maciej; Bandyopadhyay, Soham; Banik, Biswajit; Banik, Palash Chandra; Bansal, Hansi; Barati, Shirin; Barchitta, Martina; Bardhan, Mainak; Barker-Collo, Suzanne Lyn; Barone-Adesi, Francesco; Barqawi, Hiba Jawdat; Barr, Ronald D; Barrero, Lope H; Basharat, Zarrin; Bashir, Asma'u IJ; Bashiru, Hameed Akande; Baskaran, Pritish; Basnyat, Buddha; Bassat, Quique; Basso, João Diogo; Basu, Saurav; Batra, Kavita; Batra, Ravi; Baune, Bernhard T; Bayati, Mohsen; Bayileyegn, Nebiyou Simegnew; Beaney, Thomas; Bedi, Neeraj; Begum, Tahmina; Behboudi, Emad; Behnoush, Amir Hossein; Beiranvand, Maryam; Bejarano Ramirez, Diana Fernanda; Belgaumi, Uzma Iqbal; Bell, Michelle L; Bello, Aminu K; Bello, Muhammad Bashir; Bello, Olorunjuwon Omolaja; Belo, Luis; Beloukas, Apostolos; Bendak, Salaheddine; Bennett, Derrick A; Bensenor, Isabela M; Benzian, Habib; Berezvai, Zombor; Berman, Adam E; Bermudez, Amiel Nazer C; Bettencourt, Paulo JG; Beyene, Habtamu B; Beyene, Kebede A; Bhagat, Devidas S; Bhagavathula, Akshaya Srikanth; Bhala, Neeraj; Bhalla, Ashish; Bhandari, Dinesh; Bhardwaj, Nikha; Bhardwaj, Pankaj; Bhardwaj, Prarthna V; Bhargava, Ashish; Bhaskar, Sonu; Bhat, Vivek; Bhatti, Gurjit Kaur; Bhatti, Jasvinder Singh; Bhatti, Manpreet S; Bhatti, Rajbir; Bhutta, Zulfiqar A; Bikbov, Boris; Binmadi, Nada; Bintoro, Bagas Suryo; Biondi, Antonio; Bisignano, Catherine; Bisulli, Francesca; Biswas, Atanu; Biswas, Raaj Kishore; Bitaraf, Saeid; Bjørge, Tone; Bleyer, Archie; Boampong, Mary Sefa; Bodolica, Virginia; Bodunrin, Aadam Olalekan; Bolarinwa, Obasanjo Afolabi; Bonakdar Hashemi, Milad; Bonny, Aime; Bora, Kaustubh; Bora Basara, Berrak; Borodo, Safiya Bala; Borschmann, Rohan; Botero Carvajal, Alejandro; Bouaoud, Souad; Boudalia, Sofiane; Boyko, Edward J; Bragazzi, Nicola Luigi; Braithwaite, Dejana; Brenner, Hermann; Britton, Gabrielle; Browne, Annie J; Brunoni, Andre R; Bulamu, Norma B; Bulto, Lemma N; Buonsenso, Danilo; Burkart, Katrin; Burns, Richard A; Burugina Nagaraja, Sharath; Busse, Reinhard; Bustanji, Yasser; Butt, Zahid A; Caetano dos Santos, Florentino Luciano; Cai, Tianji; Calina, Daniela; Cámera, Luis Alberto; Campos, Luciana Aparecida; Campos-Nonato, Ismael R; Cao, Chao; Cardenas, Carlos Alberto; Cárdenas, Rosario; Carr, Sinclair; Carreras, Giulia; Carrero, Juan J; Carugno, Andrea; Carvalho, Felix; Carvalho, Márcia; Castaldelli-Maia, Joao Mauricio; Castañeda-Orjuela, Carlos A; Castelpietra, Giulio; Catalá-López, Ferrán; Catapano, Alberico L; Cattaruzza, Maria Sofia; Caye, Arthur; Cederroth, Christopher R; Cembranel, Francieli; Cenderadewi, Muthia; Cercy, Kelly M; Cerin, Ester; Cevik, Muge; Chacón-Uscamaita, Pamela R Uscamaita; Chahine, Yaacoub; Chakraborty, Chiranjib; Chan, Jeffrey Shi Kai; Chang, Chin-Kuo; Charalampous, Periklis; Charan, Jaykaran; Chattu, Vijay Kumar; Chatzimavridou-Grigoriadou, Victoria; Chavula, Malizgani Paul; Cheema, Huzaifa Ahmad; Chen, An-Tian; Chen, Haowei; Chen, Lingxiao; Chen, Meng Xuan; Chen, Simiao; Cherbuin, Nicolas; Chew, Derek S; Chi, Gerald; Chirinos-Caceres, Jesus Lorenzo; Chitheer, Abdulaal; Cho, So Mi Jemma; Cho, William CS; Chong, Bryan; Chopra, Hitesh; Choudhary, Rahul; Chowdhury, Rajiv; Chu, Dinh-Toi; Chukwu, Isaac Sunday; Chung, Eric; Chung, Eunice; Chung, Sheng-Chia; Cini, Karly I; Clark, Cain CT; Coberly, Kaleb; Columbus, Alyssa; Comfort, Haley; Conde, Joao; Conti, Sara; Cortesi, Paolo Angelo; Costa, Vera Marisa; Cousin, Ewerton; Cowden, Richard G; Criqui, Michael H; Cruz-Martins, Natália; Culbreth, Garland T; Cullen, Patricia; Cunningham, Matthew; da Silva e Silva, Daniel; Dadana, Sriharsha; Dadras, Omid; Dai, Zhaoli; Dalal, Koustuv; Dalli, Lachlan L; Damiani, Giovanni; D'Amico, Emanuele; Daneshvar, Sara; Darwesh, Aso Mohammad; Das, Jai K; Das, Saswati; Dash, Nihar Ranjan; Dashti, Mohsen; Dávila-Cervantes, Claudio Alberto; Davis Weaver, Nicole; Davletov, Kairat; De Leo, Diego; Debele, Aklilu Tamire; Degenhardt, Louisa; Dehbandi, Reza; Deitesfeld, Lee; Delgado-Enciso, Ivan; Delgado-Ortiz, Laura; Demant, Daniel; Demessa, Berecha Hundessa; Demetriades, Andreas K; Deng, Xinlei; Denova-Gutiérrez, Edgar; Deribe, Kebede; Dervenis, Nikolaos; Des Jarlais, Don C; Desai, Hardik Dineshbhai; Desai, Rupak; Deuba, Keshab; Devanbu, Vinoth Gnana Chellaiyan; Dey, Sourav; Dhali, Arkadeep; Dhama, Kuldeep; Dhimal, Mandira Lamichhane; Dhimal, Meghnath; Dhingra, Sameer; Dias da Silva, Diana; Diaz, Daniel; Dima, Adriana; Ding, Delaney D; Dirac, M Ashworth; Dixit, Abhinav; Dixit, Shilpi Gupta; Do, Thanh Chi; Do, Thao Huynh Phuong; do Prado, Camila Bruneli; Dodangeh, Masoud; Dokova, Klara Georgieva; Dolecek, Christiane; Dorsey, E Ray; dos Santos, Wendel Mombaque; Doshi, Rajkumar; Doshmangir, Leila; Douiri, Abdel; Dowou, Robert Kokou; Driscoll, Tim Robert; Dsouza, Haneil Larson; Dube, John; Dumith, Samuel C; Dunachie, Susanna J; Duncan, Bruce B; Duraes, Andre Rodrigues; Duraisamy, Senbagam; Durojaiye, Oyewole Christopher; Dutta, Sulagna; Dzianach, Paulina Agnieszka; Dziedzic, Arkadiusz Marian; Ebenezer, Oluwakemi; Eboreime, Ejemai; Ebrahimi, Alireza; Echieh, Chidiebere Peter; Ed-Dra, Abdelaziz; Edinur, Hisham Atan; Edvardsson, David; Edvardsson, Kristina; Efendi, Defi; Efendi, Ferry; Eghdami, Shayan; Eikemo, Terje Andreas; Eini, Ebrahim; Ekholuenetale, Michael; Ekpor, Emmanuel; Ekundayo, Temitope Cyrus; El Arab, Rabie Adel; El Morsi, Doaa Abdel Wahab; El Sayed Zaki, Maysaa; El Tantawi, Maha; Elbarazi, Iffat; Elemam, Noha Mousaad; Elgar, Frank J; Elgendy, Islam Y; ElGohary, Ghada Metwally Tawfik; Elhabashy, Hala Rashad; Elhadi, Muhammed; Elmeligy, Omar Abdelsadek Abdou; Elshaer, Mohammed; Elsohaby, Ibrahim; Emami Zeydi, Amir; Emamverdi, Mehdi; Emeto, Theophilus I; Engelbert Bain, Luchuo; Erkhembayar, Ryenchindorj; Eshetie, Tesfahun C; Eskandarieh, Sharareh; Espinosa-Montero, Juan; Estep, Kara; Etaee, Farshid; Eze, Ugochukwu Anthony; Fabin, Natalia; Fadaka, Adewale Oluwaseun; Fagbamigbe, Adeniyi Francis; Fahimi, Saman; Falzone, Luca; Farinha, Carla Sofia E Sá; Faris, MoezAlIslam Ezzat Mahmoud; Farjoud Kouhanjani, Mohsen; Faro, Andre; Farrokhpour, Hossein; Fatehizadeh, Ali; Fattahi, Hamed; Fauk, Nelsensius Klau; Fazeli, Pooria; Feigin, Valery L; Fekadu, Ginenus; Fereshtehnejad, Seyed-Mohammad; Feroze, Abdullah Hamid; Ferrante, Daniela; Ferrara, Pietro; Ferreira, Nuno; Fetensa, Getahun; Filip, Irina; Fischer, Florian; Flavel, Joanne; Flaxman, Abraham D; Flor, Luisa S; Florin, Bobirca Teodor; Folayan, Morenike Oluwatoyin; Foley, Kristen Marie; Fomenkov, Artem Alekseevich; Force, Lisa M; Fornari, Carla; Foroutan, Behzad; Foschi, Matteo; Francis, Kate Louise; Franklin, Richard Charles; Freitas, Alberto; Friedman, Joseph; Friedman, Sara D; Fukumoto, Takeshi; Fuller, John E; Gaal, Peter Andras; Gadanya, Muktar A; Gaihre, Santosh; Gaipov, Abduzhappar; Gakidou, Emmanuela; Galali, Yaseen; Galehdar, Nasrin; Gallus, Silvano; Gan, Quan; Gandhi, Aravind P; Ganesan, Balasankar; Garg, Jalaj; Gau, Shuo-Yan; Gautam, Prem; Gautam, Rupesh K; Gazzelloni, Federica; Gebregergis, Miglas W; Gebrehiwot, Mesfin; Gebremariam, Tesfay Brhane; Gerema, Urge; Getachew, Motuma Erena; Getachew, Tamirat; Gething, Peter W; Ghafourifard, Mansour; Ghahramani, Sulmaz; Ghailan, Khalid Yaser; Ghajar, Alireza; Ghanbarnia, Mohammad Javad; Ghasemi, MohammadReza; Ghasemzadeh, Afsaneh; Ghassemi, Fariba; Ghazy, Ramy Mohamed; Ghimire, Sailaja; Gholamian, Asadollah; Gholamrezanezhad, Ali; Ghorbani Vajargah, Pooyan; Ghozali, Ghozali; Ghozy, Sherief; Ghuge, Arun Digambarrao; Gialluisi, Alessandro; Gibson, Ruth Margaret; Gil, Artyom Urievich; Gill, Paramjit Singh; Gill, Tiffany K; Gillum, Richard F; Ginindza, Themba G; Girmay, Alem; Glasbey, James C; Gnedovskaya, Elena V; Göbölös, Laszlo; Goel, Amit; Goldust, Mohamad; Golechha, Mahaveer; Goleij, Pouya; Golestanfar, Arefeh; Golinelli, Davide; Gona, Philimon N; Goudarzi, Houman; Goudarzian, Amir Hossein; Goyal, Anmol; Greenhalgh, Scott; Grivna, Michal; Guarducci, Giovanni; Gubari, Mohammed Ibrahim Mohialdeen; Gudeta, Mesay Dechasa; Guha, Avirup; Guicciardi, Stefano; Gunawardane, Damitha Asanga; Gunturu, Sasidhar; Guo, Cui; Gupta, Anish Kumar; Gupta, Bhawna; Gupta, Indarchand Ratanlal; Gupta, Rajat Das; Gupta, Sapna; Gupta, Veer Bala; Gupta, Vijai Kumar; Gupta, Vivek Kumar; Gutiérrez, Reyna Alma; Habibzadeh, Farrokh; Habibzadeh, Parham; Hachinski, Vladimir; Haddadi, Mohammad; Haddadi, Rasool; Haep, Nils; Hajj Ali, Adel; Halboub, Esam S; Halim, Sobia Ahsan; Hall, Brian J; Haller, Sebastian; Halwani, Rabih; Hamadeh, Randah R; Hamagharib Abdullah, Kanaan; Hamidi, Samer; Hamiduzzaman, Mohammad; Hammoud, Ahmad; Hanifi, Nasrin; Hankey, Graeme J; Hannan, Md Abdul; Haque, Md Nuruzzaman; Harapan, Harapan; Haro, Josep Maria; Hasaballah, Ahmed I; Hasan, Faizul; Hasan, Ikramul; Hasan, M Tasdik; Hasani, Hamidreza; Hasanian, Mohammad; Hasanpour- Dehkordi, Ali; Hassan, Abbas M; Hassan, Amr; Hassanian-Moghaddam, Hossein; Hassanipour, Soheil; Haubold, Johannes; Havmoeller, Rasmus J; Hay, Simon I; Hbid, Youssef; Hebert, Jeffrey J; Hegazi, Omar E; Heidari, Golnaz; Heidari, Mohammad; Heidari-Foroozan, Mahsa; Heidari-Soureshjani, Reza; Helfer, Bartosz; Herteliu, Claudiu; Hesami, Hamed; Hettiarachchi, Dineshani; Heyi, Demisu Zenbaba; Hezam, Kamal; Hiraike, Yuta; Hoffman, Howard J; Holla, Ramesh; Horita, Nobuyuki; Hossain, Md Belal; Hossain, Md Mahbub; Hossain, Sahadat; Hosseini, Mohammad-Salar; Hosseinzadeh, Hassan; Hosseinzadeh, Mehdi; Hostiuc, Mihaela; Hostiuc, Sorin; Hsairi, Mohamed; Hsieh, Vivian Chia-rong; Hu, Chengxi; Huang, Junjie; Huda, Md Nazmul; Hugo, Fernando N; Hultström, Michael; Hussain, Javid; Hussain, Salman; Hussein, Nawfal R; Huy, Le Duc; Huynh, Hong-Han; Hwang, Bing-Fang; Ibitoye, Segun Emmanuel; Idowu, Oluwatope Olaniyi; Ijo, Desta; Ikuta, Kevin S; Ilaghi, Mehran; Ilesanmi, Olayinka Stephen; Ilic, Irena M; Ilic, Milena D; Immurana, Mustapha; Inbaraj, Leeberk Raja; Iradukunda, Arnaud; Iravanpour, Farideh; Iregbu, Kenneth Chukwuemeka; Islam, Md Rabiul; Islam, Mohammad Mainul; Islam, Sheikh Mohammed Shariful; Islami, Farhad; Ismail, Nahlah Elkudssiah; Isola, Gaetano; Iwagami, Masao; Iwu, Chidozie CD; Iwu-Jaja, Chinwe Juliana; Iyer, Mahalaxmi; J, Linda Merin; Jaafari, Jalil; Jacob, Louis; Jacobsen, Kathryn H; Jadidi-Niaragh, Farhad; Jafarinia, Morteza; Jaggi, Khushleen; Jahankhani, Kasra; Jahanmehr, Nader; Jahrami, Haitham; Jain, Akhil; Jain, Nityanand; Jairoun, Ammar Abdulrahman; Jakovljevic, Mihajlo; Jalilzadeh Yengejeh, Reza; Jamshidi, Elham; Jani, Chinmay T; Janko, Mark M; Jatau, Abubakar Ibrahim; Jayapal, Sathish Kumar; Jayaram, Shubha; Jeganathan, Jayakumar; Jema, Alelign Tasew; Jemere, Digisie Mequanint; Jeong, Wonjeong; Jha, Anil K; Jha, Ravi Prakash; Ji, John S; Jiang, Heng; Jin, Yingzhao; Jin, Yinzi; Johnson, Olatunji; Jomehzadeh, Nabi; Jones, Darwin Phan; Joo, Tamas; Joseph, Abel; Joseph, Nitin; Joshua, Charity Ehimwenma; Jozwiak, Jacek Jerzy; Jürisson, Mikk; Kaambwa, Billingsley; Kabir, Ali; Kabir, Hannaneh; Kabir, Zubair; Kadashetti, Vidya; Kahe, Farima; Kakodkar, Pradnya Vishal; Kalani, Rizwan; Kalankesh, Leila R; Kaliyadan, Feroze; Kalra, Sanjay; Kamath, Ashwin; Kamireddy, Arun; Kanagasabai, Thanigaivelan; Kandel, Himal; Kanmiki, Edmund Wedam; Kanmodi, Kehinde Kazeem; Kantar, Rami S; Kapoor, Neeti; Karajizadeh, Mehrdad; Karami Matin, Behzad; Karanth, Shama D; Karaye, Ibraheem M; Karim, Asima; Karimi, Hanie; Karimi, Salah Eddin; Karimi Behnagh, Arman; Karkhah, Samad; Karna, Ajit K; Kashoo, Faizan Zaffar; Kasraei, Hengameh; Kassaw, Nigussie Assefa; Kassebaum, Nicholas J; Kassel, Molly B; Katamreddy, Adarsh; Katikireddi, Srinivasa Vittal; Katoto, Patrick DMC; Kauppila, Joonas H; Kaur, Navjot; Kaydi, Neda; Kayibanda, Jeanne Françoise; Kayode, Gbenga A; Kazemi, Foad; Kazemian, Sina; Kazeminia, sara; Keikavoosi-Arani, Leila; Keller, Cathleen; Kempen, John H; Kerr, Jessica A; Kesse-Guyot, Emmanuelle; Keykhaei, Mohammad; Khadembashiri, Mohamad Mehdi; Khadembashiri, Mohammad Amin; Khafaie, Morteza Abdullatif; Khajuria, Himanshu; Khalafi, Mohammad; Khalaji, Amirmohammad; Khalid, Nauman; Khalil, Ibrahim A; Khamesipour, Faham; Khan, Asaduzzaman; Khan, Gulfaraz; Khan, Ikramullah; Khan, Imteyaz A; Khan, Maseer; Khan, Moien AB; Khan, Taimoor; Khan suheb, Mahammed Ziauddin; Khanmohammadi, Shaghayegh; Khatab, Khaled; Khatami, Fatemeh; Khavandegar, Armin; Khayat Kashani, Hamid Reza; Kheirallah, Khalid A; Khidri, Feriha Fatima; Khodadoust, Elaheh; Khormali, Moein; Khosrowjerdi, Mahmood; Khubchandani, Jagdish; Khusun, Helda; Kifle, Zemene Demelash; Kim, Grace; Kim, Jihee; Kimokoti, Ruth W; Kinzel, Kasey E; Kiross, Girmay Tsegay; Kisa, Adnan; Kisa, Sezer; Kiss, Juniper Boroka; Kivimäki, Mika; Klu, Desmond; Knudsen, Ann Kristin Skrindo; Kolahi, Ali-Asghar; Kompani, Farzad; Koren, Gerbrand; Kosen, Soewarta; Kostev, Karel; Kotnis, Ashwin Laxmikant; Koul, Parvaiz A; Koulmane Laxminarayana, Sindhura Lakshmi; Koyanagi, Ai; Kravchenko, Michael A; Krishan, Kewal; Krishna, Hare; Krishnamoorthy, Vijay; Krishnamoorthy, Yuvaraj; Krohn, Kris J; Kuate Defo, Barthelemy; Kubeisy, Connor M; Kucuk Bicer, Burcu; Kuddus, Md Abdul; Kuddus, Mohammed; Kuitunen, Ilari; Kujan, Omar; Kulimbet, Mukhtar; Kulkarni, Vishnutheertha; Kumar, Ashish; Kumar, Harish; Kumar, Nithin; Kumar, Rahul; Kumar, Shiv; Kumari, Madhulata; Kurmanova, Almagul; Kurmi, Om P; Kusnali, Asep; Kusuma, Dian; Kutluk, Tezer; Kuttikkattu, Ambily; Kyei, Evans F; Kyriopoulos, Ilias; La Vecchia, Carlo; Ladan, Muhammad Awwal; Laflamme, Lucie; Lahariya, Chandrakant; Lahmar, Abdelilah; Lai, Daphne Teck Ching; Laksono, Tri; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lallukka, Tea; Lám, Judit; Lamnisos, Demetris; Lan, Tuo; Lanfranchi, Francesco; Langguth, Berthold; Lansingh, Van Charles; Laplante-Lévesque, Ariane; Larijani, Bagher; Larsson, Anders O; 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Skryabin, Valentin Yurievich; Skryabina, Anna Aleksandrovna; Sleet, David A; Slepak, Erica Leigh N; Sohrabi, Hanye; Soleimani, Hamidreza; Soliman, Sameh SM; Solmi, Marco; Solomon, Yonatan; Song, Yimeng; Sorensen, Reed JD; Soriano, Joan B; Soyiri, Ireneous N; Spartalis, Michael; Sreeramareddy, Chandrashekhar T; Starnes, Joseph R; Starodubov, Vladimir I; Starodubova, Antonina V; Stefan, Simona Cătălina; Stein, Dan J; Steinbeis, Fridolin; Steiropoulos, Paschalis; Stockfelt, Leo; Stokes, Mark A; Stortecky, Stefan; Stranges, Saverio; Stroumpoulis, Konstantinos; Suleman, Muhammad; Suliankatchi Abdulkader, Rizwan; Sultana, Abida; Sun, Jing; Sunkersing, David; Susanty, Sri; Swain, Chandan Kumar; Sykes, Bryan L; Szarpak, Lukasz; Szeto, Mindy D; Szócska, Miklós; Tabaee Damavandi, Payam; Tabatabaei Malazy, Ozra; Tabatabaeizadeh, Seyed-Amir; Tabatabai, Shima; Tabb, Karen M; Tabish, Mohammad; Taborda-Barata, Luis M; Tabuchi, Takahiro; Tadesse, Birkneh Tilahun; Taheri, Amirmasoud; Taheri Abkenar, Yasaman; 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Zaman, Burhan Abdullah; Zaman, Sojib Bin; Zamora, Nelson; Zand, Ramin; Zandi, Milad; Zandieh, Ghazal GZ; Zanghì, Aurora; Zare, Iman; Zastrozhin, Mikhail Sergeevich; Zeariya, Mohammed GM; Zeng, Youjie; Zhai, Chunxia; Zhang, Chen; Zhang, Haijun; Zhang, Hongwei; Zhang, Yunquan; Zhang, Zhaofeng; Zhang, Zhenyu; Zhao, Hanqing; Zhao, Yang; Zhao, Yong; Zheng, Peng; Zhong, Chenwen; Zhou, Juexiao; Zhu, Bin; Zhu, Zhaohua; Ziaeefar, Pardis; Zielińska, Magdalena; Zou, Zhiyong; Zumla, Alimuddin; Zweck, Elric; Zyoud, Samer H; Lim, Stephen S; Murray, Christopher JL
Global Burden of 288 Causes of Death and Life Expectancy Decomposition in 204 Countries and Territories and 811 Subnational Locations, 1990–2021: A Systematic Analysis for the Global Burden of Disease Study 2021
(Elsevier BV, 2024) Naghavi, M; Ong, KL; Aali, A; Ababneh, HS; Abate, YH; Abbafati, C; Abbasgholizadeh, R; Abbasian, M; Abbasi-Kangevari, M; Abbastabar, H; Abd ElHafeez, S; Abdelmasseh, M; Abd-Elsalam, S; Abdelwahab, A; Abdollahi, M; Abdollahifar, MA; Abdoun, M; Abdulah, DM; Abdullahi, A; Abebe, M; Abebe, SS; Abedi, A; Abegaz, KH; Abhilash, ES; Abidi, H; Abiodun, O; Aboagye, RG; Abolhassani, H; Abolmaali, M; Abouzid, M; Aboye, GB; Abreu, LG; Abrha, WA; Abtahi, D; Abu Rumeileh, S; Abualruz, H; Abubakar, B; Abu-Gharbieh, E; Abu-Rmeileh, NM; Aburuz, S; Abu-Zaid, A; Accrombessi, MMK; Adal, TG; Adamu, AA; Addo, IY; Addolorato, G; Adebiyi, AO; Adekanmbi, V; Adepoju, AV; Adetunji, CO; Adetunji, JB; Adeyeoluwa, TE; Adeyinka, DA; Adeyomoye, OI; Admass, BAA; Adnani, QES; Adra, S; Afolabi, AA; Afzal, MS; Afzal, S; Agampodi, SB; Agasthi, P; Aggarwal, M; Aghamiri, S; Agide, FD; Agodi, A; Agrawal, A; Agyemang-Duah, W; Ahinkorah, BO; Ahmad, A; Ahmad, D; Ahmad, F; Ahmad, MM; Ahmad, S; Ahmad, S; Ahmad, T; Ahmadi, K; Ahmadzade, AM; Ahmed, A; Ahmed, A; Ahmed, H; Ahmed, LA; Ahmed, MS; Ahmed, MS; Ahmed, MB; Ahmed, SA; Ajami, M; Aji, B; Akara, EM; Akbarialiabad, H; Akinosoglou, K; Akinyemiju, T; Akkaif, MA; Akyirem, S; Al Hamad, H; Al Hasan, SM; Alahdab, F; Alalalmeh, SO; Alalwan, TA; Al-Aly, Z
Background: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings: The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation: Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. Funding: Bill & Melinda Gates Foundation.
Global Incidence, Prevalence, Years Lived with Disability (YLDs), Disability-Adjusted Life-Years (DALYs), and Healthy Life Expectancy (Hale) for 371 Diseases and Injuries in 204 Countries and Territories and 811 Subnational Locations, 1990–2021: A Systematic Analysis for the Global Burden of Disease Study 2021
(Elsevier BV, 2024) GBD 2021 Diseases and Injuries Collaborators
BACKGROUND: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. METHODS: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. FINDINGS: Global DALYs increased from 2·63 billion (95% UI 2·44-2·85) in 2010 to 2·88 billion (2·64-3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7-17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8-6·3) in 2020 and 7·2% (4·7-10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0-234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7-198·3]), neonatal disorders (186·3 million [162·3-214·9]), and stroke (160·4 million [148·0-171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3-51·7) and for diarrhoeal diseases decreased by 47·0% (39·9-52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54-1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5-9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0-19·8]), depressive disorders (16·4% [11·9-21·3]), and diabetes (14·0% [10·0-17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7-27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6-63·6) in 2010 to 62·2 years (59·4-64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6-2·9) between 2019 and 2021. INTERPRETATION: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. FUNDING: Bill & Melinda Gates Foundation.
Symptoms and Engagement in Anti-social Behaviour 10 Years Following Mild Traumatic Brain Injury Within a Community Civilian Sample: A Prospective Cohort Study with Age-Sex Matched Control Group.
(Elsevier, 2023) Theadom, Alice; Jones, Kelly; Starkey, Nicola; Barker-Collo, Suzanne; Ameratunga, Shanthi; Faulkner, Josh; Ao, Braden Te; Feigin, V
OBJECTIVE: To determine if there are longer-term impacts on symptoms, health status, mood and behaviour 10-years following a mild traumatic brain injury (mTBI). DESIGN: Prospective cohort study SETTING: Community-based, civilian sample PARTICIPANTS: Adults aged ≥16 years at follow up who experienced a mTBI 10-years ago, and an age and sex-matched non-injured control group. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: MTBI cases and controls were asked to complete self-report assessments of functioning (WHODAS 2.0), symptoms (Rivermead Post-Concussion Symptom Questionnaire), health status (100-point scale), alcohol (AUDIT-C) and substance use (ASSIST), and whether they had engaged in any anti-social behaviours over the past 12-months. RESULTS: Data were analysed for 368 participants (184 mTBI cases and 184 age-sex matched controls). Just over a third of mTBI cases (64, 34.8%) reported that they were still affected by their index mTBI 10-years later. After adjusting for education and ethnicity, the mTBI group had statistically higher overall symptom burden (F=22.32, p<0.001, ηp2 =0.07) compared to controls. This difference remained after excluding those who experienced a recurrent TBI. The mTBI group were more than three times as likely to have engaged in anti-social behaviour during the previous 12-months (F=5.89, p=0.02). There were no group differences in health status, functioning, or problematic alcohol or substance use 10-years post-injury. CONCLUSIONS: This study provides evidence of potential longer-term associations between mTBI, post-concussion symptoms and anti-social behaviour which warrants further evaluation. Future research should also examine if longer-term effects may be preventable with access to early rehabilitation post-injury.

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