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April 13, 2021; 96 (15 Supplement) Saturday, April 17

Stroke and dementia, leading causes of neurological disability and death, potential for prevention (5108)

Abolfazl Avan, Vladimir Hachinski
First published April 13, 2021,
Abolfazl Avan
1Department of Public Health, Mashhad University of Medical Sciences
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Vladimir Hachinski
2Department of Clinical Neurological Sciences, Western University
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Citation
Stroke and dementia, leading causes of neurological disability and death, potential for prevention (5108)
Abolfazl Avan, Vladimir Hachinski
Neurology Apr 2021, 96 (15 Supplement) 5108;

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Abstract

Objective: To realize the potentially preventable disability and deaths related to ischemic heart disease, stroke and dementia, and their changes between 2010 and 2019.

Background: Stroke and dementia share a number of modifiable risk factors and are the leading cause of disability and the second leading cause of death worldwide, after cardiovascular diseases.

Design/Methods: We report the Global Burden of Disease study (GBD) 2019 estimations for disability-adjusted life years (DALYs) and death numbers and rates per 100,000 population related to ischemic heart diseases, stroke, and Alzheimer’s disease and other dementias in the world, as well as their risk attributed DALYs and deaths and their changes between 2010 and 2019.

Results: In 2019, neurological diseases have remained globally the leading cause of DALYs (273.1 million) and second leading cause of deaths (9.4 million) after cardiovascular diseases (excluding stroke). Stroke and dementia combined contributed to 87.2% (8.2 million) of neurological deaths and 61.7% (168.5 million) of neurological DALYs in 2019. From 2010 to 2019, the absolute number of deaths and DALYs from ischemic heart disease, stroke, and dementias increased, while their age-standardized rates decreased (ischemic heart disease: −9.7% and −9.8%, stroke: −14.7% and −13.7%, and dementia: −1.2% and −0.3%, respectively). For stroke, 86.4% of DALYs and for dementias 32.8% of DALYs are attributable to risk factors. Globally, hypertension (54.8%) and unhealthy diet (30.0%) pose the greatest risk for stroke DALYs, and smoking (15.1%) and obesity (12.5%) for dementia DALYs.

Conclusions: Stroke and dementia are increasing in numbers, but show decreasing age-standardized mortality and disability rates. They account for 62% DALYs and 87% deaths due to neurological diseases, pose risks for each other, offering the possibility of their joint delay, mitigation or prevention. It will require global, population, and individual management to flatten the curve of stroke and dementia.

Disclosure: Dr. Avan has nothing to disclose. Dr. Avan has nothing to disclose.

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