A new analysis published in JAMA Neurology shows that brain and nervous system conditions affect more than half of all Americans. The study found that approximately 180 million people in the United States are currently living with at least one neurological disease or disorder.
The research is based on data from the Global Burden of Disease 2021 study, analyzing U.S. figures from 1990 to 2021. It evaluated 36 conditions affecting the brain, spinal cord, and peripheral nerves. The study used a measure called disability-adjusted life years, which accounts for both early death and time lived with disability.
This metric showed that disorders affecting the nervous system were the leading cause of disability in the United States in 2021, accounting for 16.6 million disability-adjusted life years.
The most common neurological conditions were not Alzheimer’s or Parkinson’s disease, which are often the first to come to mind. Instead, the analysis found the top conditions by prevalence are tension-type headaches, affecting about 122 million Americans, migraine, affecting about 58 million, and diabetic neuropathy, affecting about 17 million.
These conditions often start earlier in life and may not be life-threatening, but they can disrupt daily functioning and quality of life. The conditions responsible for the greatest overall health loss, however, were stroke, Alzheimer’s disease and other dementias, diabetic neuropathy, and migraine.
While the total number of people with neurological conditions has risen, the age-adjusted rate has remained essentially flat over the past three decades, even declining slightly. This indicates people are not suddenly more likely to develop these conditions.
The driving force behind the increasing numbers is an aging population, as many neurological conditions are more common later in life. At the same time, deaths from neurological diseases have fallen by about 15% since 1990, attributed to better prevention, faster diagnosis, and advances in treatment and emergency care.
This creates a paradox where more people are surviving neurological conditions and living with them longer. Years lived with disability from these causes increased by nearly 10%, pointing to a growing need for long-term management and support.
The research underscores that brain health is influenced by everyday choices. Factors that protect cardiovascular and metabolic health also support the nervous system. These include managing blood sugar and blood pressure, regular physical activity, prioritizing sleep, a diet with omega-3s and antioxidants, and staying socially and cognitively engaged.
The findings indicate that neurological conditions are common and long-lasting, touching nearly every family. The burden is not fixed, however, as many of the biggest drivers of neurological disability are influenced by factors that can be addressed earlier in life. Supporting brain health shapes not only lifespan but also long-term functional capacity.
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