Summary: A comprehensive national analysis finds that more than 180 million Americans—over half of the U.S. population—live with a neurological disease or disorder. These conditions affect people across the lifespan, from neurodevelopmental disorders and childhood conditions to migraines and age-related illnesses such as Parkinson’s and Alzheimer’s disease.
Although deaths attributable to neurological conditions have fallen by about 15% since 1990, years lived with disability (YLDs) have increased by roughly 10%, driven by improved survival and an aging population. The findings highlight a pressing need to expand neurological care, strengthen prevention and early detection efforts, and ensure equitable access to services for a growing population affected by brain and nerve disorders.
Key Facts
- Widespread prevalence: Over 180 million Americans—54% of the population—have at least one neurological condition.
- Conditions with the highest burden: Stroke, Alzheimer’s disease and related dementias, diabetic neuropathy, and migraine contribute the most to years lived with disability.
- Shift in outcomes: Mortality from neurological disease has declined since 1990, but disability has increased because people are living longer with these conditions.
Source: AAN
A new systematic analysis conducted by the American Academy of Neurology and the Institute for Health Metrics and Evaluation (IHME) and published in JAMA Neurology shows that roughly one in two people in the United States is affected by a neurological disease or disorder. The study draws on data from the Global Burden of Disease 2021 study, the largest effort to quantify health loss across countries and over time, coordinated by IHME at the University of Washington.
Researchers assessed disability and mortality for 36 conditions that affect nervous system health, including neurological and neurodevelopmental disorders, congenital and neonatal conditions, systemic illnesses with neurological impacts, and certain infectious diseases. Using those data, they estimated that 180.3 million Americans (95% UI, 170.7 million to 190.4 million) in 2021 had at least one nervous system condition.
“This analysis showing that half of Americans are affected by a neurological disease or disorder is an urgent call to action,” said American Academy of Neurology President Natalia S. Rost, MD, MPH, FAAN, FAHA. She emphasized the importance of accelerating research into prevention and treatment and expanding clinical care led by neurologists and neuroscientists to improve brain health for everyone.
The 36 conditions in the study span the life course: from congenital anomalies and neurodevelopmental disorders such as attention-deficit/hyperactivity disorder, through headaches and migraine that often begin in adolescence or early adulthood, to neurodegenerative diseases like Parkinson’s and Alzheimer’s that typically appear later in life.
Among the most prevalent conditions were tension-type headache (about 121.9 million Americans), migraine (about 57.7 million), and diabetic neuropathy (about 17.1 million). While tension-type headaches are extremely common, they generally contribute less disability per case than many other neurological disorders.
“Disorders of the nervous system are both common and disabling for millions of Americans,” said John P. Ney, MD, MPH, FAAN, an author of the study. He noted that maintaining healthy brain, spinal cord, and nerve function supports participation in work and relationships and improves quality of life, and that broadened access to neurological and disability care could yield substantial benefits nationwide.
Overall, the analysis found that disorders affecting the nervous system accounted for 16.6 million disability-adjusted life-years (DALYs) in the U.S. in 2021. The conditions with the largest aggregate health loss were stroke (3.9 million DALYs), Alzheimer disease and other dementias (3.3 million DALYs), diabetic neuropathy (2.2 million DALYs), and migraine (2.1 million DALYs).
After adjusting for changes in the age structure of the population, the prevalence rate of neurological disorders in the U.S. was essentially unchanged between 1990 and 2021 (a 0.2% decrease). At the same time, attributable deaths fell by about 14.6%, while years lived with disability increased by 9.8%. That combination—fewer deaths but more disability years—reflects longer survival with disabling neurological conditions and the growing proportion of older adults in the population.
The authors caution that some multi-system illnesses that include neurological involvement, such as HIV, were excluded when the neurological component could not be isolated. They also note that while the U.S. shows a higher prevalence of some conditions than the global population (43%), it performs relatively well in preventing deaths and long-term disability from certain disorders—for example, U.S. stroke mortality is lower than in some other regions despite a higher incidence.
Funding: The systematic analysis was funded by the Bill & Melinda Gates Foundation.
Key Questions Answered:
A: New national estimates indicate that one in two Americans lives with at least one neurological condition.
A: Stroke, Alzheimer’s disease and related dementias, diabetic neuropathy, and migraine account for the greatest aggregate burden.
A: Improved survival means more people are living longer with neurological conditions, which increases years lived with disability even as mortality falls.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- The full journal paper was reviewed.
- Additional context was added by staff to clarify findings and implications.
About this neurology research news
Author: Natalie Conrad
Source: AAN
Contact: Natalie Conrad – AAN
Image: The image is credited to Neuroscience News
Original Research: “US Burden of Disorders Affecting the Nervous System: From the Global Burden of Disease 2021 Study” by John P. Ney et al., JAMA Neurology (open access).
Abstract
US Burden of Disorders Affecting the Nervous System: From the Global Burden of Disease 2021 Study
Importance
Nervous system health is a central determinant of population health because neurological conditions and disorders that damage the nervous system contribute substantially to disability, morbidity, and mortality.
Objective
To quantify aggregated health loss in the United States from diseases and disorders that affect nervous system function, including neurological and neurodevelopmental disorders, congenital and neonatal conditions, systemic illnesses with neurological effects, and selected infectious diseases.
Design, Setting, and Participants
This cross-sectional analysis used Global Burden of Disease 2021 data focused on the United States from 1990 through 2021. Data analysis was performed from December 2021 to January 2025 and covered the entire U.S. population.
Exposure
Thirty-six distinct conditions that cause harm to the nervous system were assessed.
Main Outcomes and Measures
Totals and age-standardized estimates with 95% uncertainty intervals (UIs) were calculated for disability-adjusted life-years (DALYs), years lived with disability (YLDs), years of life lost (YLLs), total attributable deaths (where applicable), and prevalence.
Results
In 2021, of a U.S. population of 332.7 million, an estimated 180.3 million individuals (95% UI, 170.7 million to 190.4 million) were affected by disorders impacting nervous system health. These disorders were the leading cause of disability, accounting for 16.6 million DALYs (95% UI, 12.9 million to 20.9 million). The most prevalent conditions were tension-type headache (121.9 million; 95% UI, 109.4 million to 135.1 million), migraine (57.7 million; 95% UI, 50.1 million to 66.1 million), and diabetic neuropathy (17.1 million; 95% UI, 14.4 million to 19.9 million).
Conditions with the greatest collective disability burden were stroke (3.9 million DALYs; 95% UI, 3.5 million to 4.2 million), Alzheimer disease and other dementias (3.3 million DALYs; 95% UI, 1.6 million to 6.9 million), diabetic neuropathy (2.2 million DALYs; 95% UI, 1.5 million to 3.0 million), and migraine (2.1 million DALYs; 95% UI, 0.4 million to 4.6 million).
Compared with age-standardized metrics from 1990, prevalence was largely unchanged (−0.2%; 95% UI, −1.5% to 1.9%), attributable deaths decreased (−14.6%; 95% UI, −18.3% to −11.3%), and YLDs increased (9.8%; 95% UI, 4.6% to 16.6%). Geographic variation by state showed higher age-standardized DALY rates in Mississippi, Alabama, and Louisiana and lower rates in New York, Massachusetts, and New Jersey.
Conclusions and Relevance
Disorders affecting the nervous system are highly prevalent in the United States and cause substantial disability for millions. Reduced mortality combined with an aging population has increased the years lived with disability. The study underscores the need for prioritized investment in prevention, effective therapeutics, early detection, and targeted rehabilitation to reduce the burden of neurological conditions nationwide.