The burden of neurological diseases
FACT SHEET: The burden of neurological diseases in Europe
Neurological diseases are common, and neurologists are the ones who care for patients suffering from these diseases in most European countries. The European Academy of Neurology (EAN) is conducting a research project to estimate the current situation regarding neurological diseases and the care of neurology patients in Europe (NeuroStructure and NeuroCare). The study of the current burden of neurological disease in Europe (part of NeuroStructure) is based on the database of the Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, USA, from which we have extracted data. Additional data on neurologists have been taken from the EAN database.
Here we present some key data from this study reflecting the situation of neurology in Europe in 2017.
For the purposes of this fact sheet, Europe is statistically considered as the countries of the European Union (EU28), the Western, Central and Eastern subregions of Europe according to the IHME1 and WHO-defined Europe2. The latter coincides with the area of member societies of EAN.
The table shows numbers illustrating the burden of neurological disease in Europe.
| Region | Population | Prevalence of neurological diseases | Deaths due to neurological disease | DALYs | Number of neurologists3 | Number of EAN associate members |
| European Union (EU28) | 512,355,000 | 307,859,199 | 1,116,038 | 21,046,899 | 43,306 | 19,166 |
| Western Europe | 432,969,000 | 260,827,756 | 892,162 | 16,499,342 | 36,009 | 15,465 |
| Central Europe | 114,803,000 | 67,368,506 | 300,317 | 6,024,036 | 9,031 | 5,529 |
| Eastern Europe | 210,199,000 | 130,372,328 | 604,144 | 13,110,119 | 29,016 | 11,024 |
| WHO Region Europe | 925,631,000 | 542,935,521 | 1,981,463 | 41,319,938 | 83,397 | 35,798 |
1The IHME Global Burden of Disease group (GBD) divided the WHO European countries into the following categories as shown in the factsheet:
Central Europe: Albania, Bosnia Herzegovina, Bulgaria, Croatia, Czech Republic, Hungary, Macedonia, Montenegro, Poland, Romania, Serbia, Slovakia, Slovenia. Eastern Europe: Belarus, Estonia, Latvia, Lithuania, Moldova, Russia, Ukraine.
Western Europe: Andorra, Austria, Belgium, Cyprus, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Israel, Italy, Luxembourg, Malta, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, UK.
2WHO-Europe further includes: Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Turkey and Uzbekistan.
3 The following countries do not have a neurological Society: Andorra, San Marino, Malta, Monaco. We are not aware of neurological Societies in Turkmenistan and Tajikistan. For these countries numbers of neurologists are not included
More neurologists are needed to serve the huge number of patients.
EAN and its 47 member societies are striving to improve the situation of patients with neurological diseases.
Many neurological diseases such as stroke and Alzheimer’s can be fatal. Others, such as headaches, are not deadly but are chronic and cause major disabilities. Neurological disease is the number one disease category causing disability in the world and ranks number three in Europe. The disability adjusted life-year (DALY) is the generally accepted epidemiological measure of disease burden and
it covers years-of-life lost (YLLs) and years lived with disability (YLDs) due to disease. It is noteworthy that very common neurological diseases such as restless legs syndrome (prevalence approx. 5%) or essential tremor (prevalence: approx. 1%) are not yet included in the IHME database.
Currently, approximately 85,000 neurologists in EAN/WHO region Europe provide care to these pa- tients, which corresponds to approximately 10,000 patients per neurologist. However, there are huge disparities across European countries, ranging from 2,500 patients to 46,000 patients per neurologist.
We conclude:
- More than half of the European population (approx. 60%) suffers from a neurological disease, as - epidemiologically - prevalence roughly corresponds to patient numbers.
- The death and disease burden due to neurological diseases is high and ranks number three among all disease groups in Europe.
- Only roughly 85,000 neurologists are available to provide care for around 900 million citizens across Europe, which is a large number compared with other macroregions of the world and is not enough to fulfil current needs.
Authors:
Günther Deuschl, Past President EAN
Ettore Beghi, Neuro Epidemiologist
Timea Varga, EAN Project Manager European Affairs
All figures correct at time of print (24.6.2019)