Burden of Neurological Disorders Across the US From 1990-2017

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aut.relation.journalJAMA Neurologyen_NZ
aut.researcherFeigin, Valery
dc.contributor.authorFeigin, VLen_NZ
dc.contributor.authorVos, Ten_NZ
dc.contributor.authorAlahdab, Fen_NZ
dc.contributor.authorAmit, AMLen_NZ
dc.contributor.authorBärnighausen, TWen_NZ
dc.contributor.authorBeghi, Een_NZ
dc.contributor.authorBeheshti, Men_NZ
dc.contributor.authorChavan, PPen_NZ
dc.contributor.authorCriqui, MHen_NZ
dc.contributor.authorDesai, Ren_NZ
dc.contributor.authorDhamminda Dharmaratne, Sen_NZ
dc.contributor.authorDorsey, ERen_NZ
dc.contributor.authorWilder Eagan, Aen_NZ
dc.contributor.authorElgendy, IYen_NZ
dc.contributor.authorFilip, Ien_NZ
dc.contributor.authorGiampaoli, Sen_NZ
dc.contributor.authorGiussani, Gen_NZ
dc.contributor.authorHafezi-Nejad, Nen_NZ
dc.contributor.authorHole, MKen_NZ
dc.contributor.authorIkeda, Ten_NZ
dc.contributor.authorOwens Johnson, Cen_NZ
dc.contributor.authorKalani, Ren_NZ
dc.contributor.authorKhatab, Ken_NZ
dc.contributor.authorKhubchandani, Jen_NZ
dc.contributor.authorKim, Den_NZ
dc.contributor.authorKoroshetz, WJen_NZ
dc.contributor.authorKrishnamoorthy, Ven_NZ
dc.contributor.authorKrishnamurthi, RVen_NZ
dc.contributor.authorLiu, Xen_NZ
dc.contributor.authorLo, WDen_NZ
dc.contributor.authorLogroscino, Gen_NZ
dc.contributor.authorMensah, GAen_NZ
dc.contributor.authorMiller, TRen_NZ
dc.contributor.authorMohammed, Sen_NZ
dc.contributor.authorMokdad, AHen_NZ
dc.contributor.authorMoradi-Lakeh, Men_NZ
dc.contributor.authorMorrison, SDen_NZ
dc.contributor.authorShivamurthy, VKNen_NZ
dc.contributor.authorNaghavi, Men_NZ
dc.contributor.authorNichols, Een_NZ
dc.contributor.authorNorrving, Ben_NZ
dc.contributor.authorOdell, CMen_NZ
dc.contributor.authorPupillo, Een_NZ
dc.contributor.authorRadfar, Aen_NZ
dc.contributor.authorRoth, GAen_NZ
dc.contributor.authorShafieesabet, Aen_NZ
dc.contributor.authorSheikh, Aen_NZ
dc.contributor.authorSheikhbahaei, Sen_NZ
dc.contributor.authorShin, JIen_NZ
dc.contributor.authorSingh, JAen_NZ
dc.contributor.authorSteiner, TJen_NZ
dc.contributor.authorStovner, LJen_NZ
dc.contributor.authorWallin, MTen_NZ
dc.contributor.authorWeiss, Jen_NZ
dc.contributor.authorWu, Cen_NZ
dc.contributor.authorZunt, JRen_NZ
dc.contributor.authorAdelson, JDen_NZ
dc.contributor.authorMurray, CJLen_NZ
dc.date.accessioned2020-11-03T00:58:16Z
dc.date.available2020-11-03T00:58:16Z
dc.date.copyright2020en_NZ
dc.date.issued2020en_NZ
dc.description.abstractIMPORTANCE 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.
dc.identifier.citationJAMA Neurology. Published online November 02, 2020. doi:10.1001/jamaneurol.2020.4152
dc.identifier.doi10.1001/jamaneurol.2020.4152en_NZ
dc.identifier.issn2168-6149en_NZ
dc.identifier.urihttps://hdl.handle.net/10292/13762
dc.languageenen_NZ
dc.publisherAmerican Medical Association (AMA)en_NZ
dc.relation.urihttps://jamanetwork.com/journals/jamaneurology/fullarticle/2772579
dc.rightsThis is an open access article distributed under the terms of the CC-BY License. © 2020 GBD 2017 US Neurological Disorders Collaborators. JAMA Neurology.
dc.rights.accessrightsOpenAccessen_NZ
dc.titleBurden of Neurological Disorders Across the US From 1990-2017en_NZ
dc.typeJournal Article
pubs.elements-id393483
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Health & Environmental Science
pubs.organisational-data/AUT/Health & Environmental Science/Public Health & Psych Studies
pubs.organisational-data/AUT/PBRF
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences/HY Public Health & Psychosocial Studies 2018 PBRF
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