Neurological Disorders Now Affect Over Half of Americans, New Research Shows

Abstract 

• Neurological and nervous-system disorders are a major source of disability in the United States.

• GBD 2021 data show 180.3 million Americans (54.2%) had at least one nervous system disorder in 2021.

• The analysis covered 36 conditions, including neurological, congenital, systemic, and infectious disorders.

• These conditions caused 16.6 million DALYs nationwide.

• The greatest disability burden came from stroke, Alzheimer’s and dementias, diabetic neuropathy, and migraine.

• Prevalence was highest among adults 80 years and older.

• State-level DALY rates varied widely.

• Since 1990, prevalence has stayed stable, mortality has declined, and YLDs have increased, indicating more chronic disability.

• Findings emphasize the need for better research, stronger public health planning, and improved resources to address the rising neurological burden in the U.S.

Neurological and nervous-system–related disorders have become one of the most significant contributors to disability in the United States, according to new findings published in JAMA Neurology. Researchers report that more than 54% of the U.S. population — approximately 180 million people — live with at least one condition affecting the brain, spinal cord, or peripheral nerves.

Lead investigator Dr. John P. Ney of Yale University explained that the burden extends well beyond classic neurological illnesses. Many systemic and developmental conditions, including diabetic neuropathy, autism spectrum disorders, and metabolic diseases, also play a major role in shaping nervous system health.

Key Data From the Global Burden of Disease (GBD) 2021 Analysis

Using cross-sectional U.S. data from 1990–2021, researchers evaluated 36 nervous system–related disorders, including neurological, congenital, neonatal, infectious, and systemic conditions. The study assessed disability-adjusted life-years (DALYs), years lived with disability (YLDs), years of life lost (YLLs), prevalence, and state-level variations.

Most Common Nervous-System Conditions in 2021

• Tension-type headache: 121.9 million people

• Migraine: 57.7 million people

• Diabetic neuropathy: 17.1 million people

These conditions are major drivers of chronic disability and reduced productivity.

Leading Causes of Neurological Disability

• Stroke: 3.9 million DALYs

• Alzheimer’s disease & dementias: 3.3 million DALYs

• Diabetic neuropathy: 2.2 million DALYs

• Migraine disorders: 2.1 million DALYs

Stroke and dementia remain dominant, but neuropathy and chronic headache disorders contribute heavily to daily functional impairment.

Geographic Differences in Neurological Health Burden

Highest DALY rates were recorded in:

• Mississippi

• Missouri

• Alabama

• Indiana

• Iowa

• Louisiana

• South Carolina

Lowest rates were found in:

• California

• New York

• Washington

• New Jersey

Age and Sex Trends

• Adults 80+ years had the highest DALY rates (32,928).

• Children under 5 years experienced a higher burden than those aged 5–19.

• Burden increased 2x–4x across adult age categories.

• Women showed slightly higher prevalence, but men had more deaths and YLLs.

Long-Term Trend (1990–2021)

• Overall prevalence remained stable

• Mortality declined 14.6%

• YLDs increased 9.8%, indicating more people survive but live with chronic impairment

Dr. Ney emphasized that understanding this expanding burden is essential for shaping U.S. research funding, neurotherapeutic development, and clinical resource allocation.

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