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Incidence, prevalence and disability associated with neurological disorders in Italy between 1990 and 2019: an analysis based on the Global Burden of Disease Study 2019

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Abstract

Background

Neurological conditions are highly prevalent and disabling, in particular in the elderly. The Italian population has witnessed sharp ageing and we can thus expect a rising trend in the incidence, prevalence and disability of these conditions.

Methods

We relied on the Global Burden of Disease 2019 study to extract Italian data on incidence, prevalence and years lived with a disability (YLDs) referred to a broad set of neurological disorders including, brain and nervous system cancers, stroke, encephalitis, meningitis, tetanus, traumatic brain injury, and spinal cord injury. We assessed changes between 1990 and 2019 in counts and age-standardized rates.

Results

The most prevalent conditions were tension-type headache, migraine, and dementias, whereas the most disabling were migraine, dementias and traumatic brain injury. YLDs associated with neurological conditions increased by 22.5%, but decreased by 2.3% in age-standardized rates. The overall increase in prevalence and YLDs counts was stronger for non-communicable diseases with onset in old age compared to young to adult-age onset ones. The same trends were in the opposite direction when age-standardized rates were taken into account.

Conclusions

The increase in YLDs associated with neurological conditions is mostly due to population ageing and growth: nevertheless, lived disability and, as a consequence, impact on health systems has increased. Actions are needed to improve outcome and mitigate disability associated with neurological conditions, spanning among diagnosis, treatment, care pathways and workplace interventions.

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Availability of data and materials

The data used for this publication are available on the GHDx website of the Institute for Health Metrics and Evaluation: http://ghdx.healthdata.org/gbd-results-tool.

Code availability

Not applicable.

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Acknowledgements

A. Raggi, D. Sattin and S. Schiavolin are supported by a grant from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C. Besta, Linea 4—Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). F.G. Magnani is supported by a grant from the Italian Ministry of Health (GR-2016-02365049). C. Toppo is supported by a grant from the European Union’s Horizon 2020 Research and Innovation Programme (Grant Agreement No. 848180). S. Mondello is supported by a grant from the Italian Ministry of Health (GR-2013-02354960).

Funding

None for this article. The GBD initiative is supported by the Bill and Melinda Gates Foundation.

Author information

Authors and Affiliations

  1. Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy

    Alberto Raggi, Francesca Giulia Magnani, Davide Sattin, Silvia Schiavolin, Claudia Toppo & Matilde Leonardi

  2. S.C.R. Epidemiologia Clinica e Ricerca Sui Servizi Sanitari, IRCCS Materno Infantile “Burlo Garofolo”, Trieste, Italy

    Lorenzo Monasta, Luca Ronfani & Eugenio Traini

  3. Department of Neurosciences, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy

    Ettore Beghi, Giorgia Giussani & Elisabetta Pupillo

  4. Stroke Unit and Division of Internal and Cardiovascular Medicine, Università di Perugia, Perugia, Italy

    Valeria Caso

  5. Region Friuli Venezia Giulia, Central Health Directorate, Outpatient and Inpatient Care Service, Trieste, Italy

    Giulio Castelpietra

  6. Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy

    Stefania Mondello

  7. Department of Basic Medical Sciences, Neuroscience, and Sense Organs, Università di Bari Aldo Moro, Bari, Italy

    Giancarlo Logroscino

  8. Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany

    Marco Piccininni

  9. Neurology and Stroke Unit, USL Umbria 1, Gubbio and Città di Castello Hospital, Perugia, Italy

    Stefano Ricci

  10. Neurology and Stroke Unit, Ospedale San Giuseppe-Multimedica, Milan, Italy

    Paola Santalucia

  11. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands

    Eugenio Traini

  12. Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA

    Jaimie Steinmetz, Emma Nichols, Rui Ma & Theo Vos

  13. National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, Australia

    Valery Feigin

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Corresponding author

Correspondence to Alberto Raggi.

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Conflicts of interest

E. Beghi reports grants from UCB-Pharma, SOBI, Revalesio, the American ALS Association and the Italian Ministry of Health, outside the submitted work. M. Piccininni reports being partially funded by a research grant from Novartis Pharma for a self-initiated research project on migraine remission, and being awarded a research grant from the Center for Stroke Research Berlin (private donations). The remaining authors declare no conflicts of interest.

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Raggi, A., Monasta, L., Beghi, E. et al. Incidence, prevalence and disability associated with neurological disorders in Italy between 1990 and 2019: an analysis based on the Global Burden of Disease Study 2019. J Neurol 269, 2080–2098 (2022). https://doi.org/10.1007/s00415-021-10774-5

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