Burden of neurological disorders in China and its provinces, 1990–2021: Findings from the global burden of disease study 2021

Abstract

Context and significance

Neurological disorders have been the leading cause of global health loss, yet the neurological burden in China remains poorly understood. Researchers in this study comprehensively examined the distribution and trends of burden due to neurological disorders in China and its provinces. They found that neurological disorders extensively affected the Chinese population across the lifespan, disproportionately impacting the elderly, with population aging being a major driver for the substantial increases in prevalence and health loss. The disparities in the neurological burden among provinces were correlated with socioeconomic development. These findings highlight the heavy burden of neurological disorders in China, underscoring the necessity for improved access to neurological services, early prevention, and standardized treatment to address this growing public health challenge.

Highlights

• Neurological disorders affected nearly one-third of China’s population in 2021
• Population aging was a key driver of the increasing burden of neurological disorders
• Neurological burden varied between western and eastern provinces despite rising SDI
• Our findings could guide targeted strategies to improve neurological services

Summary

Background

The burden of neurological disorders in China has not been systematically analyzed. We aim to provide a comprehensive estimation of the national and subnational neurological burden across China from the Global Burden of Disease Study (GBD) 2021.

Methods

We assessed burden estimates for 16 neurological disorders by age, sex, and province from 1990 to 2021, with prevalence, death, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs). We performed decomposition analysis to determine contributing factors for DALYs and used the socio-demographic index (SDI) to assess relations with development level.

Findings

In 2021, there were 468.29 million prevalent cases of neurological disorders in China, corresponding to 78.10 million DALYs. Intracerebral hemorrhage was the leading cause of DALYs, followed by ischemic stroke, dementias, and migraine. DALYs of neurological disorders were higher in males than females, peaking at 70–74 years. From 1990 to 2021, the number and age-standardized rate of DALYs significantly decreased for idiopathic epilepsy and subarachnoid hemorrhage, primarily attributed to the reduction in YLLs, while the number of DALYs disproportionately increased for dementias, Parkinson’s disease, and ischemic stroke contributed by population aging. The age-standardized DALY rates of seven neurological disorders had more than 5-fold variation between western and eastern provinces, despite reduced burdens with rising SDI.

Conclusions

Neurological disorders pose a large and growing burden on public health, primarily driven by population aging. Our findings could inform priority setting and targeted strategies to optimize neurological service delivery.

Funding

The funding information is presented in the acknowledgments.