Neurological disorders – preventable yet the leading cause of disability worldwide

World Brain Day 22 July 2024

Although brain disorders are emphasised worldwide across all ages, sex and socio-economies, more than 70% of neurological diseases are prevalent in low-to-middle-income countries and are the second leading cause of death globally, accounting for 9 million deaths per year.

Neurological diseases are the second leading cause of disability worldwide yet up to 80% of strokes[i], 40% of dementia cases and 25% of epilepsies[ii] can be prevented.

However, in South Africa:

  • one in every 100 people in South Africa are affected by epilepsy[iii],
  • Two South Africans suffer a stroke every 10 minutes of every day,[iv]
  • Around 4-8% suffer from Dementia[v]

Dr Patty Francis, President of the Neurological Association of South Africa, says neurological disorders are preventable through early detection and effective management. Still, not all patients have equal access to early detection and effective management.

“Socioeconomic status or geographic location should not be barriers to prevention. In South Africa, the treatment gap is exasperated by severe staff and resource shortages. The ratio of neurologists to the population in South Africa is 1 per 500 000, compared to 35 per 500 000 population in high-income countries, limiting access to medication, knowledge and preventative care programmes which leads to misperceptions, stigma, lowered living standards and preventable death.”

“Healthcare professionals, researchers, and policymakers play pivotal roles in addressing the global neurological needs. Recognising brain health as a fundamental human right is at the core of our and World Brain Day mission.”

Dr Francis says in children and adolescents, headache disorders and Meningitis are among the top ten causes of global disability-adjusted life years (DALYs), and within the top three causes in girls 10-24 years old.

“Globally, 52·9 million children younger than 5 years had developmental disabilities and 95% of these children live in low- and middle-income countries. The high burden associated with neurological disorders is met by profound inequities.”

“Disabilities associated with neurological conditions disproportionately affect women, older people, those living in poverty and rural or remote areas, and other vulnerable populations. Children from underprivileged households, indigenous populations and ethnic minorities are also at significantly higher risk of experiencing disability associated with neurological conditions.”

Dr Francis says medical treatment of hypertension, diabetes, depression, arrhythmia, and elevated cholesterol and triglycerides, can improve the risk of strokes and dementia.

“The most important aspect of managing neurological diseases is our choice of lifestyle. By prioritising a healthy lifestyle, people can protect their brain health which is essential for healthy cognitive, emotional and social skills. Optimising brain health ought to begin early in life and remain a focal health priority throughout one’s entire life.”

“Inactivity, alcohol intake, smoking, and diets high in fat and processed foods, and lack of sleep, increase our risk. Almost everyone can protect themselves from the devastating impact of neurological disease by making small improvements.”

Dr Francis says in addition, the COVID-19 pandemic highlighted the relevance of neurology to global public health.

“Headaches, impaired sense of smell and taste, agitation, delirium, stroke and meningo-encephalitis all represent neurological manifestations associated with COVID-19 as well as long term manifestations such as cognitive impairment. Underlying neurological conditions represent a risk factor for hospitalisation especially for older adults (vi).”

Dr Francis says brain health is essential for brain skills which are in turn central to the development of brain capital and the brain economy.

“Brain capital includes the creativity, knowledge and skills that individuals accrue and develop during their lifetime, which enable them to fulfill potential and contribute productively to their local economy and society at large.”

She suggests implementing the following strategies to protect your brain’s health:

  • Stay socially connected – maintain strong social ties (in person, not online) to improve cognitive function and emotional well-being.
  • Avoid alcohol and stop smoking – smoking damages neurons (brain cells) and alcohol consumption can lead to memory impairment and cognitive decline.
  • Stay hydrated
  • Exercise regularly – physical activity increases blood flow to the brain, promotes new brain cell growth and enhances cognitive function
  • Prioritise sleep – aim for 7-9 hours of quality sleep each night to support memory consolidation, information processing and toxin removal in the brain.
  • Eat a balanced diet – fuel your brain with a variety of fruits, vegetables, whole grains, lean proteins and healthy fats for optimal cognitive function.
  • Manage stress – practice relaxation techniques like deep breathing, contemplation, prayer and daily periods of “no screen time”.
  • Breathe clean air – minimise, as far as possible, time spent in highly polluted environments. By simply taking a 15-20 minute walk in fresh air fulfills many of the brain-effective recommendations listed above.
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To raise awareness of brain health and disease prevention, the World Federation of Neurology will host a public webinar on 22 July at 12.00 GMT. The event is free to attend with experts from the World Health Organization (WHO) and the World Stroke Organization.  Anyone can register for the event by visiting https://wfneurology.org/world-brain-day-2024


[i] Centers for Disease Control and Prevention. https://www.cdc.gov/vitalsigns/stroke/index.html

[ii] Favas TT, Dev P, Chaurasia RN, et al. Neurological manifestations of COVID-19: a systematic review and meta-analysis of proportions. Neurological Sciences. 2020. Abdullahi A, Candan SA, Abba MA, et al. Neurological and musculoskeletal features of COVID-19: a systematic review and meta-analysis. Frontiers in Neurology. 2020.

[iii] 002-Brochure-Facts-about-Epilepsy.pdf

[iv] Heart and Stroke Foundation, South Africa. https://www.heartfoundation.co.za/

(iv) World Health Organization, Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022-2031, Available from, https://www.who.int/publi cations/m/item/intersectoral-global-action-plan-on-eepilepsy-and-other-neurologi cal-disorders-2022-2031, 2022.

(v) Dementia Prevalence in a Rural Region of South Africa: A Cross-Sectional Community Study, Celeste A. de Jager,a,* William MsemburiKaty Pepper and Marc I. Combrinck, J Alzheimers Dis. 2017; 60(3): 1087–1096.

(vi) Favas TT, Dev P, Chaurasia RN, et al. Neurological manifestations of COVID-19: a systematic review and meta-analysis of proportions. Neurological Sciences. 2020. Abdullahi A, Candan SA, Abba MA, et al. Neurological and musculoskeletal features of COVID-19: a systematic review and meta-analysis. Frontiers in Neurology. 2020.

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