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Lancet study: Stroke caused nearly 7 lakh deaths in India in 2019, 7.4% of all mortalities

Headache was the most prevalent neurological disorder in India in 2019, affecting 488 million people. The prevalence of infectious disorders has gone down considerably and non-communicable disorders such as stroke, headache and epilepsy have become common.

dementia riskThe study predicts that the greatest increase in prevalence will occur in eastern sub-Saharan Africa, where the number of people living with dementia is expected to climb by 357%.

Stroke is the predominant cause of mortality due to neurological disorders in India and caused 6,99,000 deaths in 2019, which was 7.4 per cent of the total deaths in the country, a study published in Lancet Global Health has said. Stroke was responsible for 68 per cent of deaths from neurological disorders followed by Alzheimer’s and other dementia (12 per cent), and encephalitis (5 per cent).

Stroke (37.9 per cent), headache disorders (17.5 per cent) and epilepsy (11.3 per cent) are the leading contributors to the burden of neurological disorders in the country followed by cerebral palsy (5.7 per cent), encephalitis (5.3 per cent) meningitis (4.8 per cent), Alzheimer’s and other dementias (4.6 per cent) and traumatic brain injuries (4.1 per cent).

Headache (comprising migraine and tension-type headache) was the most prevalent neurological disorder in India in 2019, affecting 488 million people. The prevalence of migraine was higher in females aged 35–59 years than in males of the same age.

With an ageing population, the burden of neurological disorders is increasing worldwide. However, evidence regarding the burden in India was scarce and this new scientific paper published online today (Wednesday) in Lancet Global Health has summarised the first comprehensive estimates of the disease burden from neurological disorders and their trends in each state from 1990-2019.

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The initiative is a collaborative effort between the Indian Council of Medical Research (ICMR), Public Health Foundation of India, Institute for Health Metrics and Evaluation and others. Over 300 scientists and experts from 100 institutions were engaged in this collaborative work.

Prof Gagandeep Singh, head of the department of neurology at Dayanand Medical College Ludhiana and first author of the paper, told The Indian Express, “Stroke deaths were highest in West Bengal and Chhattisgarh. The reasons for this observation are not clear. Perhaps, medical infrastructure to treat stroke should be scaled up in these states or more people might be having strokes in these states and hence we need to work on preventing strokes by treating hypertension, diabetes and reducing smoking.”

Though earlier infectious disorders of the brain were thought to be most common, it is no longer the case. According to the report, the prevalence of infectious disorders has gone down considerably and non-communicable disorders such as stroke, headache and epilepsy have become the most common causes of disability and death.

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“We need to work around these disorders in terms of providing health infrastructure and personnel. This is an epidemiological transition or flip. Injury-related neurological disorders have increased threefold since 1991. These are entirely preventable. So, this is a noteworthy finding and we need to work on preventing head injuries by simple measures like wearing helmets,’ Prof Singh said.

These neurological disorders include non-communicable neurological disorders (stroke, headache disorders, epilepsy, cerebral palsy, Alzheimer’s disease and other dementias, brain and central nervous system cancer, Parkinson’s disease, multiple sclerosis, motor neuron diseases, and other neurological disorders), communicable neurological disorders (encephalitis, meningitis, and tetanus), and injury-related neurological disorders (traumatic brain injuries and spinal cord injuries).

According to the estimates, at least 82.8 per cent of the total neurological disorders burden is due to non-communicable disorders, 11.2 per cent due to communicable ones and 6 per cent due to injury-related ones.

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N Girish Rao, professor at National Institute of Mental Health and Neuro Sciences and a co-author on this paper said, “headache is the most common neurological disorder affecting 1 in 3 Indians, and is often neglected in terms of public health priority. It is the second leading contributor to the disease burden from neurological disorders in India. Migraine affects females more than males, greatly affecting adults in the working-age population. Available data indicate the huge unrecognised burden of headaches in India. There is an urgent need to initiate and bring about comprehensive, structured headache services across all the states. Headache, especially migraine, needs to be recognised as a public health problem and included under the national non-communicable disease control programme.”

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First published on: 14-07-2021 at 11:11:17 am
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