Even with all this factual documentation on stroke, NOTHING will be done by our fucking failures of stroke associations to solve and prevent the disabilities from stroke. You're screwed, your children will be screwed, your grandchildren will be screwed.
Neurologic Diseases Found to Be the Largest Cause of Disability Worldwide
Neurology Today:
November 16, 2017 - Volume 17 - Issue 22 -
p 1,32–35
doi: 10.1097/01.NT.0000527316.80068.88
Features
ARTICLE IN BRIEF
In
an analysis of data for 195 countries, the Global Burden of Disorders
Study Group found that neurological disorders caused 250.7 million
disability-adjusted life years (DALYs) in 2015, an increase of 7.4
percent from 1990. Stroke was reported to be one of the leading causes
of DALYs worldwide.
Neurological diseases are the world's largest cause
of disability-adjusted life years (DALYs), or years of healthy life lost
to due to death or disability, according to a systematic analysis
performed for the Global Burden of Disease Study 2015, the most current
overview of the way neurological diseases are affecting people around
the world.
Neurologists specializing in global health told Neurology Today
the analysis brings into sharp focus the immense burden of neurological
disorders around the globe. Importantly, they said, its bold statement
should help free up resources for neurological care, while the
country-by-country breakdown — data for 195 nations are included — will
help guide the way forward in addressing the problems faced around the
world.
Published in the September 17 online edition of Lancet Neurology,
the analysis includes data for disease groupings broken down from a
myriad of perspectives: nation, socio-demographics, age, gender, and in
proportion to one another.
THE IMPACT OF STROKE
The analysis is largely a story about the devastating
impact of stroke — no longer categorized as a cardiovascular disorder
but as neurological by the World Health Organization (WHO) and the
Global Burden of Disease study group.
With stroke included for the first time in such a
broad and detailed analysis, neurological disorders caused 250.7 million
DALYs in 2015, an increase of 7.4 percent from 1990.
“The most surprising findings were the amount of
increase in the burden from 1990 to 2015 in virtually all countries of
the world and that neurological disorders are now the leading causes of
disability among all groups of diseases,” said Valery Feigin, MD, PhD, a
lead author of the analysis and director of the National Institute for
Stroke and Applied Neurosciences at Auckland University of Technology in
New Zealand.
Neurological disorders caused 9.4 million deaths in
2015, up 36.7 percent from 1990, making them the second-leading cause of
mortality around the world. Cardiovascular disorders, even without
stroke, continue to be the leading mortality cause.
The increase in years of healthy life that have been
lost among the world's population due to neurological disorders comes
despite decreases in rates of DALYs per 100,000 when they are adjusted
for age. This age-adjusted rate fell by 29.7 percent from 1990 to 2015.
“In terms of absolute number of people affected by
neurological disorders, most of the increase in the burden was
associated with aging of the population and population growth,” the
study authors wrote.
The researchers found that stroke accounted for 118.6
million DALYs in 2015, an increase of 21.7 percent from 1990, and 6.3
million deaths, an increase of 36.4 percent.
Globally, stroke accounted for the largest proportion of DALYs, at 47.3 percent of the total, and deaths, at 67.3 percent.
MIGRAINE, MENINGITIS, ALZHEIMER'S DISEASE
Migraine, meningitis, and Alzheimer's disease and
other forms of dementia accounted for the next highest proportion of
DALYs. The second largest contributor to deaths from neurological
disorders was Alzheimer's disease and other dementia causes, with the
other causes accounting for a much smaller proportion.
Stroke was also found to be the leading cause of age-adjusted DALY rates in 18 of 21 Global Burden of Disease regions.
The lowest age-adjusted DALY rates were seen in
high-income countries, while the highest rates were seen in Afghanistan,
Central African Republic, Guinea-Bissau, Kiribati, and Somalia.
Communicable neurological diseases, such as meningitis, were a big
contributor to the disease burden in low-income regions, while they
ranked very low in high-income regions.
THE SUBSTANIAL BURDEN
Jerome H. Chin, MD, PhD, MPH, FAAN, chair of the
International Subcommittee of the AAN and adjunct professor of neurology
at New York University, said the report illustrates how the burden of
neurological disorders is “substantial, varied, and growing.”
“Despite improvements in the prevention and treatment
of some neurological disorders, for example, stroke, meningitis, and
epilepsy, the absolute global burden has increased as a result of
population expansion and increasing life expectancies,” he said.
“Currently, 84 percent of the world's population resides in low- and
middle-income countries where most of the population growth is
occurring. The fastest growing region is sub-Saharan Africa whose
population will double in the next few decades. Stroke is clearly the
biggest threat to neurological health globally, responsible for 47
percent of the global burden of neurological disorders.”
INTERNATIONAL RESOURCES
Wolfgang Grisold, MD, Secretary General of the World
Federation of Neurology (WFN), said that with this study, the authors
were “courageous enough to reach over the prevalent corset of
classification,” thereby “allowing a more expanded and timely view on
the prevalence of neurological diseases.”
“The new study provides important evidence that brain
diseases have moved on from an under-estimated, under-recognized, and
under-resourced group of conditions to a major challenge for health
policy worldwide and that sufficient resources have to be provided for
disease prevention and management,” he said.
The WFN cooperates with a wide range of organizations at the global and regional level to address this challenge, he said.
“The important impact of neurological diseases on
global health is increasingly being discussed in the framework of
international organizations,” he said. The WHO Global NCD
(non-communicable diseases) Action Plan 2013-2020 and the Sustainable
Development Goals of the United Nations are two projects aimed at the
prevention of neurological conditions.
But he added that the recent WHO-WFN Neurology Atlas
publication “shows that the resources available for neurological
diagnosis, therapy, and access to neurological care are still very
unevenly distributed globally. These new data will give us additional
arguments to make the point that sufficient resources for brain health
have to be provided at all levels.”
WFN is also devoted to improving neurological care
worldwide, he said, with a program to “ensure knowledge transfer across
national borders,” with low-income countries as the main target.
“The disparity and inequalities of health systems,
the lack of financial resources in many countries, cultural and
religious hurdles, as well as political aspects are among the major
obstacles to making more progress in the field of neurological care on
the global scale.”
The World Stroke Organization (WSO) is leading
awareness campaigns among the general population and among health
professionals, said Bo Noorving, MD, PhD, past president of the WSO.
“We advise decision-makers and governmental bodies
on best scientifically-based policies,” he said. “We arrange stroke
congresses, and we have many education activities ongoing. The greatest
barriers relate to shortage of resources in the health system, the
underfunding of stroke services, and the difficulties to change
established habits.”
He said that the organization will continue its
strong advocacy for stroke resources and that stroke “is no longer
invisible under the umbrella of ‘cardiovascular diseases,’ but
identified on its own as one of the core NCDs, possible to prevent and
treat.”
Dr. Chin, who is now teaching and providing pro bono
neurological care in Uganda, where he spends two months a year, said
the barriers to basic neurological care in sub-Saharan Africa and South
Asia, where he has also worked, are “numerous and complex.”
“The neurological workforce gap is a key element, in
addition to a lack of universal health care coverage, limited
health-sector budgets, and inadequate preventive care and health
education,” he said.
For its part, the AAN, the membership of which 20
percent is international, offers reduced membership rates for members in
low- and middle-income countries; offers an international scholarship
award to attend the annual AAN meeting; provides education programs at
its Annual Meeting; supports the annual European Academy of Neurology
regional teaching course in Africa; and offers free copies of Continuum, a publication for lifelong learning, to eligible institutions through the WFN.
Dr. Chin said that the AAN Global Health Section,
launched by him and four colleagues in 2011, has grown from 50
signatories to 400 members.
“As a result of the formation of the section, there
are science and education topic categories in global health at the AAN
Annual Meeting, which has stimulated increasing interest in global
neurology.”
LINK UP FOR MORE INFORMATION:
•. GBD
2015 Neurological Disorders Collaborator Group. Global, regional, and
national burden of neurological disorders during 1990-2015: A systematic
analysis for the Global Burden of Disease Study 2015 http://http://www.thelancet.com/journals/laneur/article/PIIS1474-4422(17)30299-5/fulltext. Lancet Neurol 2017; Epub 2017 Sep 17.
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