Burden of non-communicable neurological disorders doubles in 30 yrs: Study

Obesity, high BP and air pollution are major causes of non-communicable neurological disorders. India does not have enough neurologists to cater to the growing disease burden

Although India is already facing a considerable challenge emerging from the Covid-19 health crisis, a new report indicates that the country may have more worries in the future.

A study done by the India State-Level Disease Burden Initiative, published in Lancet Global Health, shows that the incidence of non-communicable neurological disorders, like stroke, has doubled between 1990 and 2019. Although the increase in non-communicable neurological diseases accompanies a decrease in communicable neurological disorders, the results indicate that India may witness more such cases in the coming years and lifestyle changes are necessary to avert a crisis.

As per the report, the contribution to non-communicable neurological disorders to total disability-adjusted life years doubled from 4 per cent in 1990 to 8.2 per cent in 2019. The contribution of communicable neurological disorders to disability-adjusted life years declined from 4.1 per cent to 1.1 per cent during the same period.

Disability-adjusted life years (DALYs) are calculated by adding years of life lost due to the disease and years lived with disability.

The findings also indicate that non-communicable disorders accounted for 82 per cent of all neurological disorders. Stroke in this case alone was responsible for 699,000 deaths during this period.

The study highlights that lifestyle problem are the main reason for non-communicable neurological disorders. For instance, in the case of stroke, high systolic blood pressure had a risk factor of 55.3 per cent, air pollution had a risk factor of 42.2 per cent, followed by dietary risks at 28.1 per cent. The risk factor in stroke cases was usually higher for men than women except in the case of high BP and obesity.

“The rise of non-communicable disease-related risk factors, as leading contributors to neurological disorders and resultant disability in India, is not a surprise. It reflects the demographic, socio-economic and nutrition transitions that have steered the shift in our epidemiological profile over the past 30 years. What is helpful is the recognition that much of this burden of disease and disability is related to modifiable risk factors which can be reduced at the population level and corrected at the individual level,” said K Srinath Reddy, President, Public Health Foundation of India.

Although the report does not indicate any correlation between social development and non-communicable neurological disorders, some states tend to perform worse. Chhattisgarh, Odisha, Assam, West Bengal and Tripura are the worst performers.

In terms of communicable diseases, like encephalitis, UP, Madhya Pradesh and Uttarakhand had 4.6 times higher rates than the rest.

The report does not focus on the availability of neurologists in the country. India has one neurologist for every 500,000 people, but the WHO prescribes a ratio of 1:100,000. The prevalence of neurological disorders is double that of developed economies.

A paper published in Neurology India by Dr Ganapathy Krishnan had in 2015 had highlighted that “not a single member lived in a geographical area covering 934.8 million people. 30.09 per cent live in the four major metropolitan cities, 29.54 per cent in the state capitals, 30.58 per cent in Tier 2 cities, 7.12 per cent in tier 3 cities and 2.67 per cent in rural areas covering a population of 84.59 million.