Stroke, Headaches, Dementia Doubled Among Indians Between 1990-2019: Study
The burden of neurological disorders among Indians varies across states and this is the first study to highlight the need of state-specific policies to deal with them
The proportion of Indians suffering from strokes, headaches, Alzheimer's and other dementias doubled between the years of 1990-2019, according to The Global Burden of Disease In India study published by the Indian Council of Medical Research along with neurologists from various institutes across the country. These non-communicable neurological disorders contributed to 8.2 per cent of the diseases reported in the country in 2019.
This is the first comprehensive report to provide a state-wise bifurcation about strokes, epilepsy, and the other injuries
While the proportion of non-communicable neurological disorders doubled, India also witnessed a decrease in the proportion of communicable neurological disorders such as encephalitis and meningitis decreased by three quarters says the study published in the British Medical journal The Lancet Global Health. There was a slight increase in the proportion of people who faced traumatic brain and spinal injury reported the authors who conducted this study in collaboration with Public Health Foundation of India.
This study comes at a time when the World Health Organisation is insisting on focusing on neurological disorders. In the 73rd World Health Assembly held in 2020, the WHO passed a resolution on global actions on epilepsy and other neurological disorders calling for a globally integrated strategy driven by preventive, diagnostic, therapeutic, and rehabilitative plans to address neurological conditions more effectively in low-and middle-income countries.
The age-wise breakdown revealed that communicable neurological disorders were found to be high among children below the age of five.
Strokes had the highest neurological disease burden along with being the cause of the highest number of deaths due to neurological disorders. India reported close to 6,99,000 deaths due to stroke in 2019.
The table below shows the contribution of each type of neurological disorder to the total neurological disease burden in the country.- non- communicable disorders 8.2 per cent, communicable disorders 1.1 per cent, traumatic injury 0.6 per cent.
| Disease | Burden in percentage |
| Stroke | 37.9 |
| Headaches | 17.5 |
| Epilepsy | 11.3 |
| Cerebral palsy | 5.7 |
| Alzheimer's and other dementias | 4.6 |
| Brain and central nervous system cancers | 2.2 |
| Parkinson's | 1.7 |
| Communicable diseases | 11.3 |
| Injury and Trauma | 6.0 |
The plausible risk factors for the non-communicable diseases according to the report are high systolic blood pressure, air pollution, dietary risks, high fasting plasma glucose, high body-mass index (BMI); smoking as well as secondhand smoke.
In terms of different genders, it was found that women were more prone to undergoing migraines, Alzheimer's and other dementias, encephalitis, meningitis, and traumatic injuries, men were at a higher risk of suffering from strokes, cancers, and Parkinson's.
State-wise Bifurcation
The disease burden for specific disorders varied drastically in the country. While some states showed a high prevalence of certain non-communicable disorders, some states ranked higher in disorders due to injuries.
The calculated score- the disability adjusted life years (DALY) rate was found to be 2.1 times higher in the states of West Bengal, Odisha, Tripura than other states for non-communicable diseases, while it was 2 times higher for injuries in the states of Karnataka and Kerala, and 4 times higher for communicable diseases in the states of Rajasthan, Madhya Pradesh, Uttar Pradesh, Bihar and Uttarakhand.
The country witnessed close to 1.29 million strokes and 488 million episodes of headaches across the country in 2019.
India also reported close to 10. 1 million cases of epilepsy, 16.8 million cases of cerebral palsy, and close 3.69 million cases of Alzheimer's and other diseases, 49 thousand cases of brain and CNS cancer, 7.71 lakh cases of Parkinson's.
With 6.1 lakh new cases of encephalitis and close to 51.9 thousand deaths, India also reported 5.52 lakhs of new meningitis cases and 34.7 thousand deaths as well as 16,600 new cases of tetanus with 7,330 deaths. Thus, communicable neurological diseases continue to remain an area of concern.
The scientists estimate that the country reported close to 7.46 million new cases of traumatic injuries in 2019 which were also very skewed across the country.
While India has neurological interventions intertwined in several existing national programmes, there is not one specially addressing these disorders. The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke deals with stroke and brain cancer and the National Programme for the Elderly focuses on the neuronal degenerative disorders.
Balrama Bhargava, Director General ICMR, and Dr. K Srinath Reddy, PHFI, both believe that these findings will enhance the need of state-specific interventions and will help in the policy framework to tackle and control the same.
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