Projecting neurologic disease burden

Neurologic disease affects millions of people worldwide, with the burden of such disease likely to grow as populations become older. The increasing burden of neurologic disease is well demonstrated in three articles in this issue of Neurology .1–3 In the first, Dorsey et al.1 show that the number of people with Parkinson disease (PD) will double from about 4.3 to 9 million people worldwide over the next 25 years. This burden is likely to be most visible among older Americans. In the second, Hirtz et al.2 report that 67 of every 1,000 older Americans carry a diagnosis of Alzheimer disease (AD) and 9.5 a diagnosis of PD. But the burden of neurologic disease extends to younger populations as well. In the United States, 121 of every 1,000 people have migraine, 7.1 epilepsy, and 0.9 multiple sclerosis. Of every 1,000 children, 5.8 meet criteria for autism spectrum disorder and 2.4 criteria for cerebral palsy.2 Other disorders, while rarer, carry extraordinary costs for medical and supportive care and impose severe psychological burdens on families. The annual incidence (per 100,000) of stroke is 183, major traumatic brain injury 101, spinal cord injury 4.5, and amyotrophic lateral sclerosis 1.6.2 The severe disability, high risk of associated cognitive impairment, repeated hospitalizations, and need for assistive devices and ongoing neurorehabilitation make …