Table 2.
Risk-specific DALYs of neurological conditions in north Africa and the Middle East, from 1990 to 2019
| Population attributable fraction, 2019 | Female to male ratio of population attributable fraction, 2019 | Change in population attributable fraction, from 1990 to 2019 | Risk-attributed DALY rate per 100 000, 2019 | Percentage change in DALY rate, from 1990 to 2019 | |
|---|---|---|---|---|---|
| All risk factors | |||||
| Meningitis | 7·1% (5·4 to 9·4) | 0·75 | −11·4% (−36·7 to 21·3) | 5·0 (3·5 to 7·0) | −78·5% (−85·6 to −67·8) |
| Encephalitis | 3·8% (2·2 to 6·1) | 0·81 | 7·7% (−32·2 to 72·6) | 1·6 (0·9 to 2·6) | −15·4% (−52·1 to 49·5) |
| Stroke | 85·8% (82·6 to 89·1) | 1·01 | 9·1% (4·8 to 14·4) | 1566·9 (1393·2 to 1757·1) | −25·8% (−34·1 to −14·0) |
| Ischaemic stroke | 87·1% (82·8 to 92·0) | 1·00 | 5·0% (2·8 to 8·2) | 1031·0 (912·5 to 1161·6) | −4·2% (−16·2 to 9·0) |
| Intracerebral haemorrhage | 84·5% (81·1 to 87·7) | 1·02 | 8·9% (3·6 to 18·4) | 463·3 (401·0 to 535·2) | −47·4% (−55·4 to −35·9) |
| Subarachnoid haemorrhage | 77·2% (72·5 to 81·8) | 1·07 | 26·4% (10·7 to 56·8) | 72·7 (60·5 to 89·5) | −53·1% (−66·3 to −27·2) |
| Neurological disorders* | 11·2% (4·5 to 22·3) | 0·69 | 25·9% (13·4 to 41·8) | 152·6 (56·5 to 371·9) | 20·2% (7·5 to 39·9) |
| Alzheimer's disease and other dementias | 39·9% (26·4 to 54·7) | 0·71 | 20·3% (9·2 to 30·5) | 154·7 (58·8 to 375·1) | 19·0% (6·7 to 37·7) |
| Parkinson's disease | −9·1% (−13·4 to −4·8) | 0·10 | −19·7% (−30·0 to −9·3) | −7·6 (−11·5 to −4·0) | −19·0% (−31·8 to −1·7) |
| Idiopathic epilepsy | 2·1% (1·4 to 3·1) | 0·28 | 11·8% (−16·0 to 45·8) | 3·4 (1·9 to 5·5) | −17·0% (−44·5 to 21·7) |
| Multiple sclerosis | 10·8% (7·8 to 14·5) | 0·18 | −12·0% (−28·2 to 5·0) | 2·2 (1·5 to 3·0) | −6·7% (−28·5 to 8·8) |
| Metabolic risk factors† | |||||
| Stroke | 73·9% (67·6 to 80·1) | 1·04 | 18·3% (12·1 to 26) | 1349·7 (1156 to 1552·3) | −19·6% (−29·1 to −6·3) |
| Ischaemic stroke | 75·1% (66·7 to 84·3) | 1·03 | 12·7% (8·0 to 18·8) | 888·8 (753·9 to 1040·5) | 2·8% (−11·2 to 18) |
| Intracerebral haemorrhage | 72·9% (66·0 to 78·6) | 1·05 | 19·0% (11·2 to 31·9) | 399·9 (339·2 to 470·1) | −42·6% (−51·5 to −29·4) |
| Subarachnoid haemorrhage | 64·7% (57·3 to 71·4) | 1·11 | 39·2% (19·4 to 78·0) | 60·9 (49·0 to 76·6) | −48·4% (−63·2 to −19·4) |
| Neurological disorders* | 8·2% (2·8 to 17·4) | 1·07 | 55·3% (38·6 to 85) | 111·7 (34·2 to 279·7) | 48·4% (31·4 to 80·4) |
| Alzheimer's disease and other dementias | 28·8% (14·7 to 45·8) | 1·15 | 50·2% (35·7 to 76·7) | 111·7 (34·2 to 279·7) | 48·4% (31·4 to 80·4) |
| High systolic blood pressure | |||||
| Stroke | 52·8% (45·7 to 59·4) | 1·05 | 10·5% (4·2 to 18·4) | 965·0 (800·6 to 1143·2) | −24·9% (−34·3 to −12·0) |
| Ischaemic stroke | 51·3% (41·6 to 60·2) | 1·05 | 8·4% (4·2 to 13·7) | 607·8 (477·7 to 734·5) | −1·1% (−13·7 to 13·3) |
| Intracerebral haemorrhage | 56·4% (47·4 to 64·3) | 1·06 | 12·1% (5·3 to 23·8) | 309·1 (247·8 to 378) | −45·9% (−54·5 to −33·5) |
| Subarachnoid haemorrhage | 51·1% (42·6 to 59·1) | 1·11 | 30·7% (11·8 to 67·3) | 48·1 (37·3 to 61·4) | −51·5% (−65·5 to −23·8) |
| High BMI | |||||
| Stroke | 33·8% (24·3 to 42·8) | 1·11 | 37·9% (22·8 to 61·1) | 618·0 (440·1 to 822·7) | −6·2% (−21·8 to 16·6) |
| Ischaemic stroke | 27·3% (18·8 to 36·0) | 1·14 | 50·1% (34·0 to 77·5) | 323·4 (218·8 to 443·9) | 37·1% (13·1 to 68·5) |
| Intracerebral haemorrhage | 46·0% (34·5 to 56·7) | 1·11 | 47·3% (29·8 to 76·7) | 252·2 (182·5 to 329·8) | −28·8% (−42·6 to −7·3) |
| Subarachnoid haemorrhage | 45·1% (34·0 to 55·2) | 1·24 | 65·6% (37·8 to 115·7) | 42·4 (30·6 to 56·2) | −38·1% (−55·5 to −5·0) |
| Neurological disorders* | 5·3% (1·6 to 11·9) | 1·17 | 55·7% (35·3 to 100·0) | 72·6 (21·0 to 181·2) | 48·7% (28·5 to 94·4) |
| Alzheimer's disease and other dementias | 18·7% (8·2 to 33·1) | 1·27 | 50·5% (31·6 to 90·9) | 72·6 (21·0 to 181·2) | 48·7% (28·5 to 94·4) |
| High fasting plasma glucose | |||||
| Stroke | 27·6% (17·7 to 42·8) | 1·04 | 98·2% (68·5 to 132·0) | 504·9 (318·8 to 793·9) | 34·8% (7·9 to 64·8) |
| Ischaemic stroke | 29·9% (15·7 to 53·0) | 1·01 | 83·6% (61·2 to 111·5) | 353·8 (190·4 to 627·5) | 67·7% (38·9 to 103·2) |
| Intracerebral haemorrhage | 24·2% (15·6 to 33·9) | 1·08 | 94·8% (68·2 to 126·8) | 132·5 (81·9 to 191·0) | −5·9% (−23·4 to 18·3) |
| Subarachnoid haemorrhage | 19·8% (12·9 to 28·3) | 1·08 | 121·7% (80·7 to 199·7) | 18·6 (11·4 to 27·2) | −18·1% (−41·7 to 32·6) |
| Neurological disorders* | 3·5% (0·6 to 9·7) | 0·94 | 66·6% (54·4 to 89·3) | 48·3 (8·7 to 151·5) | 59·1% (47·1 to 88·7) |
| Alzheimer's disease and other dementias | 12·4% (3·0 to 25·9) | 1·02 | 61·0% (52·2 to 77·0) | 48·3 (8·7 to 151·5) | 59·1% (47·1 to 88·7) |
| High LDL cholesterol | |||||
| Stroke | 15·0% (9·1 to 24·8) | 1·13 | 45·8% (34·3 to 56·5) | 274·7 (160·6 to 448·1) | −0·9% (−14 to 13·7) |
| Ischaemic stroke | 23·2% (13·9 to 38·2) | 1·08 | 8·5% (5·0 to 14·1) | 274·7 (160·6 to 448·1) | −0·9% (−14 to 13·7) |
| Kidney dysfunction | |||||
| Stroke | 11·0% (8·7 to 13·3) | 1·12 | 51·9% (38·8 to 65·2) | 200·8 (155·6 to 247·9) | 3·2% (−12·2 to 21·1) |
| Ischaemic stroke | 12·5% (9·2 to 15·7) | 1·08 | 38·8% (28·4 to 47·9) | 148·5 (107·9 to 190·0) | 26·7% (6·0 to 45·3) |
| Intracerebral haemorrhage | 9·5% (7·8 to 11·5) | 1·21 | 40·2% (28·7 to 58·8) | 52·3 (41·0 to 64·9) | −32·4% (−42·9 to −15·8) |
| Behavioural risk factors‡ | |||||
| Meningitis | 6·8% (5·2 to 9·0) | 0·75 | −10·3% (−35·5 to 22·9) | 4·8 (3·4 to 6·7) | −78·3% (−85·5 to −67·4) |
| Encephalitis | 3·7% (2·1 to 5·9) | 0·81 | 8·8% (−31·6 to 74·9) | 1·5 (0·9 to 2·5) | −14·5% (−51·5 to 51·4) |
| Stroke | 34·0% (29·6 to 38·9) | 0·70 | 1·3% (−4·8 to 7·5) | 621·8 (518·0 to 746·8) | −31·1% (−39·8 to −19·7) |
| Ischaemic stroke | 35·3% (29·2 to 42·0) | 0·72 | −2·5% (−6·4 to 0·7) | 418·1 (335·0 to 521·4) | −11·0% (−23·6 to 1·1) |
| Intracerebral haemorrhage | 32·1% (27·9 to 37·1) | 0·65 | −1·4% (−7·4 to 6·5) | 176·3 (144·0 to 214·4) | −52·4% (−59·6 to −42·2) |
| Subarachnoid haemorrhage | 29·1% (24·7 to 33·9) | 0·75 | 17·3% (1·5 to 44) | 27·4 (21·5 to 36·3) | −56·5% (−68·5 to −33·2) |
| Neurological disorders* | 4·2% (1·6 to 8·7) | 0·16 | −5·5% (−15·0 to 5·0) | 57·4 (21·1 to 137·7) | −9·8% (−18·9 to 4·0) |
| Alzheimer's disease and other dementias | 15·4% (9·9 to 20·7) | 0·15 | −9·8% (−16·6 to −3·1) | 59·5 (23·6 to 138·6) | −10·8% (−19·1 to 0·9) |
| Parkinson's disease | −9·1% (−13·4 to −4·8) | 0·10 | −19·7% (−30·0 to −9·3) | −7·6 (−11·5 to −4·0) | −19·0% (−31·8 to −1·7) |
| Idiopathic epilepsy | 2·1% (1·4 to 3·1) | 0·28 | 11·8% (−16·0 to 45·8) | 3·4 (1·9 to 5·5) | −17·0% (−44·5 to 21·7) |
| Multiple sclerosis | 10·8% (7·8 to 14·5) | 0·18 | −12·0% (−28·2 to 5·0) | 2·2 (1·5 to 3·0) | −6·7% (−28·5 to 8·8) |
| Tobacco | |||||
| Stroke | 16·9% (15·6 to 18·1) | 0·38 | −4·1% (−10·2 to 2·0) | 307·8 (267·1 to 351) | −34·8% (−44·0 to −23·9) |
| Ischaemic stroke | 15·6% (14·4 to 16·8) | 0·36 | −7·0% (−12·4 to −1·8) | 184·4 (161·0 to 210·0) | −15·1% (−31·8 to −2·3) |
| Intracerebral haemorrhage | 19·4% (17·9 to 21·0) | 0·42 | 1·5% (−6·1 to 9·6) | 106·5 (90·3 to 125·1) | −51·0% (−58·9 to −40·7) |
| Subarachnoid haemorrhage | 18·0 % (16·1 to 20·1) | 0·50 | 21·3% (0·3 to 50·2) | 16·9 (14·1 to 21·4) | −55·0% (−67·9 to −29·2) |
| Neurological disorders* | 3·9% (1·4 to 8·5) | 0·16 | −4·9% (−15·0 to 7·7) | 54·0 (17·8 to 133·9) | −9·3% (−18·6 to 5·1) |
| Alzheimer's disease and other dementias | 15·4% (9·9 to 20·7) | 0·15 | −9·8% (−16·6 to −3·1) | 59·5 (23·6 to 138·6) | −10·8% (−19·1 to 0·9) |
| Parkinson's disease | −9·1% (−13·4 to −4·8) | 0·10 | −19·7% (−30·0 to −9·3) | −7·6 (−11·5 to −4·0) | −19·0% (−31·8 to −1·7) |
| Multiple sclerosis | 10·8% (7·8 to 14·5) | 0·18 | −12·0% (−28·2 to 5·0) | 2·2 (1·5 to 3·0) | −6·7% (−28·5 to 8·8) |
| Smoking | |||||
| Stroke | 13·5% (12·5 to 14·5) | 0·22 | −4·3% (−11·5 to 2·9) | 246·0 (214·2 to 280·1) | −34·9% (−44·3 to −23·8) |
| Ischaemic stroke | 12·4% (11·5 to 13·4) | 0·21 | −8·0% (−14·8 to −1·1) | 147·0 (128·6 to 166·4) | −16·0% (−32·2 to −2·9) |
| Intracerebral haemorrhage | 15·6% (14·3 to 16·9) | 0·24 | 2·0% (−6·8 to 10·9) | 85·5 (72·4 to 100·0) | −50·7% (−59·1 to −40·5) |
| Subarachnoid haemorrhage | 14·2% (12·7 to 16·0) | 0·31 | 23·9% (−1·7 to 60·1) | 13·4 (11·2 to 17·2) | −54·1% (−67·6 to −26·6) |
| Neurological disorders* | 3·9% (1·4 to 8·5) | 0·16 | −4·9% (−15·0 to 7·7) | 54·0 (17·8 to 133·9) | −9·3% (−18·6 to 5·1) |
| Alzheimer's disease and other dementias | 15·4% (9·9 to 20·7) | 0·15 | −9·8% (−16·6 to −3·1) | 59·5 (23·6 to 138·6) | −10·8% (−19·1 to 0·9) |
| Parkinson's disease | −9·1% (−13·4 to −4·8) | 0·10 | −19·7% (−30·0 to −9·3) | −7·6 (−11·5 to −4·0) | −19·0% (−31·8 to −1·7) |
| Multiple sclerosis | 10·8% (7·8 to 14·5) | 0·18 | −12·0% (−28·2 to 5·0) | 2·2 (1·5 to 3·0) | −6·7% (−28·5 to 8·8) |
| Secondhand smoke | |||||
| Stroke | 3·9% (3·0 to 4·9) | 1·49 | −5·5% (−10·2 to 0·3) | 71·9 (53·5 to 91·9) | −35·7% (−43·7 to −24·8) |
| Ischaemic stroke | 3·6% (2·7 to 4·5) | 1·38 | −4·9% (−8·9 to −0·2) | 42·9 (31·6 to 54·7) | −13·2% (−26·0 to −0·1) |
| Intracerebral haemorrhage | 4·5% (3·4 to 5·7) | 1·65 | −1·9% (−8·4 to 8·2) | 24·9 (18·1 to 32·3) | −52·6% (−60·2 to −41·9) |
| Subarachnoid haemorrhage | 4·4% (3·3 to 5·6) | 1·90 | 11·3% (−6·0 to 42·8) | 4·1 (2·9 to 5·6) | −58·5% (−70·5 to −35·3) |
| Child and maternal malnutrition | |||||
| Meningitis | 6·8% (5·2 to 9·0) | 0·75 | −10·3% (−35·5 to 22·9) | 4·8 (3·4 to 6·7) | −78·3% (−85·5 to −67·4) |
| Encephalitis | 3·7% (2·1 to 5·9) | 0·81 | 8·8% (−31·6 to 74·9) | 1·5 (0·9 to 2·5) | −14·5% (−51·5 to 51·4) |
| Low birthweight and short gestation | |||||
| Meningitis | 6·8% (5·2 to 9·0) | 0·75 | −10·3% (−35·5 to 22·9) | 4·8 (3·4 to 6·7) | −78·3% (−85·6 to −67·5) |
| Encephalitis | 3·7% (2·1 to 5·9) | 0·81 | 8·8% (−31·6 to 74·9) | 1·5 (0·9 to 2·5) | −15·1% (−52·3 to 50·9) |
| Short gestation | |||||
| Meningitis | 4·8% (3·6 to 6·3) | 0·78 | 1·8% (−26·9 to 40·4) | 3·4 (2·4 to 4·7) | −75·3% (−83·4 to −62·9) |
| Encephalitis | 2·7% (1·5 to 4·4) | 0·84 | 23·6% (−22 to 100·5) | 1·1 (0·6 to 1·8) | −2·9% (−45·9 to 69·7) |
| Low birthweight | |||||
| Meningitis | 6·5% (4·9 to 8·6) | 0·74 | −10·7% (−36·1 to 22·6) | 4·5 (3·2 to 6·4) | −78·3% (−85·6 to −67·5) |
| Encephalitis | 3·5% (2·0 to 5·6) | 0·80 | 8·1% (−32·0 to 75·9) | 1·4 (0·9 to 2·4) | −15·1% (−52·3 to 50·9) |
| Dietary risk factors | |||||
| Stroke | 16·7% (12·6 to 21·5) | 0·98 | −1·7% (−10·2 to 6·8) | 304·6 (223·3 to 400·8) | −33·2% (−42·5 to −21·5) |
| Ischaemic stroke | 17·4% (12·1 to 22·4) | 0·96 | −4·1% (−8·8 to 0·0) | 206·1 (140·3 to 270·9) | −12·5% (−23·8 to −0·8) |
| Intracerebral haemorrhage | 15·5% (10·1 to 21·3) | 1·00 | −6·1% (−14·1 to 3·6) | 84·9 (54·4 to 121·0) | −54·6% (−62·1 to −44·9) |
| Subarachnoid haemorrhage | 14·3% (9·2 to 19·9) | 1·12 | 11·1% (−5·3 to 39·6) | 13·5 (8·3 to 20·3) | −58·8% (−70·3 to −36·6) |
| Diet high in red meat | |||||
| Stroke | 3·6% (1·4 to 5·5) | 0·99 | 1·4% (−21·0 to 28·5) | 66·0 (25·9 to 102·1) | −30·9% (−48·0 to −10·0) |
| Ischaemic stroke | 3·2% (0·6 to 4·9) | 0·98 | 4·4% (−0·5 to 8·9) | 38·3 (6·5 to 61·1) | −4·6% (−18·1 to 9·4) |
| Intracerebral haemorrhage | 4·3% (0·7 to 6·8) | 1·02 | 4·1% (−5·9 to 14·4) | 23·5 (3·7 to 39·4) | −49·6% (−58 to −38·1) |
| Subarachnoid haemorrhage | 4·4% (0·7 to 7·0) | 1·10 | 28·5% (11·0 to 58·4) | 4·1 (0·6 to 6·9) | −52·3% (−65·9 to −26·6) |
| Diet high in sodium | |||||
| Stroke | 1·8% (0·3 to 7·2) | 0·51 | 4·4% (−7·4 to 30·0) | 33·6 (5·8 to 133·3) | −28·8% (−40·4 to −8·7) |
| Ischaemic stroke | 1·7% (0·3 to 6·7) | 0·52 | 2·9% (−11·5 to 25·2) | 20·3 (3·8 to 80·5) | −5·9% (−25·7 to 18·8) |
| Intracerebral haemorrhage | 2·1% (0·3 to 8·4) | 0·51 | 8·6% (−5·9 to 39·0) | 11·6 (1·7 to 46·7) | −47·4% (−57·9 to −29·6) |
| Subarachnoid haemorrhage | 1·9% (0·3 to 7·4) | 0·55 | 29·2% (−0·6 to 75·1) | 1·8 (0·3 to 6·9) | −52·0% (−66·6 to −18·5) |
| Diet low in fibre | |||||
| Stroke | 2·0% (0·5 to 3·6) | 1·06 | −5·9% (−13·1 to 6·6) | 36·2 (9·2 to 66·7) | −36·1% (−44·0 to −23·8) |
| Ischaemic stroke | 1·8% (0·5 to 3·3) | 1·04 | −10·2% (−16·2 to 0·3) | 21·2 (5·6 to 39·0) | −18·2% (−28·1 to −4·8) |
| Intracerebral haemorrhage | 2·4% (0·6 to 4·3) | 1·10 | 2·7% (−7·4 to 19·7) | 13·1 (3·1 to 23·9) | −50·5% (−58·7 to −37·9) |
| Subarachnoid haemorrhage | 2·1% (0·5 to 4·0) | 1·28 | 21·5% (3·3 to 52·2) | 2·0 (0·5 to 4·2) | −54·9% (−65·7 to −32·7) |
| Diet low in fruits | |||||
| Stroke | 3·9% (2·0 to 5·9) | 1·08 | −22·0% (−35·9 to −8·3) | 70·5 (35·4 to 112·5) | −47·0% (−58·1 to −34·3) |
| Ischaemic stroke | 2·9% (0·8 to 5·3) | 1·08 | −15·6% (−21·4 to −6·2) | 34·1 (9·6 to 63·6) | −23·1% (−34·1 to −9·1) |
| Intracerebral haemorrhage | 5·7% (2·9 to 9·5) | 1·11 | −13·3% (−20·5 to −3·7) | 31·5 (15·9 to 54·1) | −58·1% (−64·9 to −48·3) |
| Subarachnoid haemorrhage | 5·2% (2·8 to 8·4) | 1·31 | −1·9% (−16·8 to 23·2) | 4·9 (2·4 to 8·7) | −63·5% (−73·3 to −44·2) |
| Diet low in vegetables | |||||
| Stroke | 1·7% (0·7 to 2·7) | 1·07 | −28·8% (−41·7 to −7·6) | 31·1 (13·4 to 50·9) | −51·6% (−61·6 to −36·8) |
| Ischaemic stroke | 1·3% (0·3 to 2·3) | 1·00 | −25·1% (−32·2 to −4·4) | 15·4 (4·0 to 27·6) | −31·5% (−41·6 to −11·6) |
| Intracerebral haemorrhage | 2·5% (0·7 to 4·8) | 1·17 | −21·1% (−31·9 to −2·3) | 13·6 (3·5 to 26·9) | −61·9% (−69·4 to −50·7) |
| Subarachnoid haemorrhage | 2·2% (0·6 to 4·3) | 1·31 | −4·5% (−23·1 to 33·0) | 2·1 (0·5 to 4·4) | −64·8% (−73·9 to −44·4) |
| Diet low in whole grains | |||||
| Stroke | 5·3% (2·6 to 7·0) | 1·06 | 35·5% (23·1 to 42·8) | 96·7 (46·5 to 131·4) | −8·0% (−19·2 to 3·7) |
| Ischaemic stroke | 8·2% (4·0 to 10·7) | 1·01 | 0·9% (−2·9 to 3·4) | 96·7 (46·5 to 131·4) | −8·0% (−19·2 to 3·7) |
| Low physical activity | |||||
| Stroke | 5·0% (1·1 to 11·2) | 1·12 | 48·9% (35·5 to 63) | 91·7 (18·8 to 203·4) | 1·2% (−11·8 to 16·0) |
| Ischaemic stroke | 7·7% (1·7 to 17·2) | 1·07 | 10·7% (4·5 to 20·3) | 91·7 (18·8 to 203·4) | 1·2% (−11·8 to 16·0) |
| Alcohol use | |||||
| Stroke | 0·4% (0·2 to 0·7) | 0·00 | −30·8% (−55·2 to −8·8) | 7·7 (3·2 to 12·3) | −52·9% (−69·5 to −37·4) |
| Ischaemic stroke | 0·0% (−0·2 to 0·3) | −0·72 | −48·2% (−399·7 to 533·7) | 0·4 (−2·4 to 3·3) | −52·7% (−370 to 468·5) |
| Intracerebral haemorrhage | 1·3% (0·8 to 1·9) | 0·20 | −2·5% (−21·3 to 16·6) | 7·3 (4·3 to 10·9) | −52·9% (−63·2 to −41·1) |
| Neurological disorders* | 0·3% (0·1 to 0·5) | 0·20 | −13·2% (−39·9 to 23·5) | 3·4 (1·9 to 5·5) | −17·0 % (−44·5 to 21·7) |
| Idiopathic epilepsy | 2·1% (1·4 to 3·1) | 0·28 | 11·8% (−16·0 to 45·8) | 3·4 (1·9 to 5·5) | −17·0 % (−44·5 to 21·7) |
| Environmental and occupational risk factors§ | |||||
| Meningitis | 1·6% (1·2 to 2·2) | 0·78 | −10·2% (−39·3 to 27·6) | 1·1 (0·8 to 1·6) | −78·3% (−86·3 to −65·8) |
| Encephalitis | 0·8% (0·5 to 1·4) | 0·82 | 8·3% (−36·9 to 85·9) | 0·4 (0·2 to 0·6) | −14·9% (−54·3 to 56·2) |
| Stroke | 37·5% (34·5 to 40·7) | 0·97 | −2·2% (−6·9 to 3·9) | 685·0 (590·6 to 792·8) | −33·5% (−41·7 to −22·2) |
| Ischaemic stroke | 36·4% (33·4 to 39·7) | 0·95 | −2·3% (−6·4 to 1·9) | 430·7 (370·7 to 494·6) | −10·9% (−24·0 to 2·5) |
| Intracerebral haemorrhage | 40·0% (36·9 to 43·3) | 1·00 | −2·0% (−8·2 to 7·1) | 219·4 (184·6 to 260·2) | −52·7% (−60·4 to −41·9) |
| Subarachnoid haemorrhage | 37·1% (33·5 to 40·8) | 1·07 | 12·8% (0·2 to 36·4) | 35·0 (27·8 to 44·8) | −58·2% (−69·6 to −33·8) |
| Air pollution | |||||
| Meningitis | 1·6% (1·2 to 2·2) | 0·78 | −10·2% (−39·3 to 27·6) | 1·1 (0·8 to 1·6) | −78·3% (−86·3 to −65·8) |
| Encephalitis | 0·8% (0·5 to 1·4) | 0·82 | 8·3% (−36·9 to 85·9) | 0·4 (0·2 to 0·6) | −14·9% (−54·3 to 56·2) |
| Stroke | 29·2% (26·5 to 32·1) | 1·00 | −2·5% (−8·3 to 5·1) | 533·2 (450·2 to 622·2) | −33·5% (−41·7 to −22·2) |
| Ischaemic stroke | 28·1% (25·3 to 31) | 0·98 | −2·7% (−8·3 to 2·3) | 332·5 (281·9 to 387·2) | −10·9% (−24·0 to 2·5) |
| Intracerebral haemorrhage | 31·6% (28·7 to 34·6) | 1·04 | −1·9% (−9·8 to 9·6) | 173·3 (142·8 to 209·6) | −52·7% (−60·4 to −41·9) |
| Subarachnoid haemorrhage | 29·1% (25·8 to 32·3) | 1·14 | 16·4% (−0·1 to 47·7) | 27·4 (21·4 to 35·1) | −58·2% (−69·6 to −33·8) |
| Particulate matter pollution | |||||
| Meningitis | 1·6% (1·2 to 2·2) | 0·78 | −10·2% (−39·3 to 27·6) | 1·1 (0·8 to 1·6) | −78·3% (−86·3 to −65·8) |
| Encephalitis | 0·8% (0·5 to 1·4) | 0·82 | 8·3% (−36·9 to 85·9) | 0·4 (0·2 to 0·6) | −14·9% (−54·3 to 56·2) |
| Stroke | 29·2% (26·5 to 32·1) | 1·00 | −2·5% (−8·3 to 5·1) | 533·2 (450·2 to 622·2) | −33·7% (−42·6 to −21·4) |
| Ischaemic stroke | 28·1% (25·3 to 31) | 0·98 | −2·7% (−8·3 to 2·3) | 332·5 (281·9 to 387·2) | −11·3% (−24·9 to 2·1) |
| Intracerebral haemorrhage | 31·6% (28·7 to 34·6) | 1·04 | −1·9% (−9·8 to 9·6) | 173·3 (142·8 to 209·6) | −52·6% (−60·5 to −40·9) |
| Subarachnoid haemorrhage | 29·1% (25·8 to 32·3) | 1·14 | 16·4% (−0·1 to 47·7) | 27·4 (21·4 to 35·1) | −56·9% (−69·5 to −31·9) |
| Ambient particulate matter pollution | |||||
| Meningitis | 0·9% (0·6 to 1·3) | 0·79 | 17·5% (−20·5 to 75·9) | 0·6 (0·4 to 0·9) | −71·5% (−81·8 to −54·2) |
| Encephalitis | 0·7% (0·2 to 1·3) | 0·80 | 32·2% (−30·3 to 152·9) | 0·3 (0·1 to 0·5) | 3·5% (−48·6 to 109·4) |
| Stroke | 25·5% (22·5 to 28·5) | 0·94 | 51·1% (32·0 to 79·4) | 466·4 (391·1 to 553·9) | 2·8% (−14·7 to 26·1) |
| Ischaemic stroke | 25·0% (22·1 to 27·9) | 0·94 | 43·0% (26·5 to 68·6) | 296·5 (249·2 to 349·1) | 30·6% (8·7 to 58·7) |
| Intracerebral haemorrhage | 26·8% (23·6 to 30·0) | 0·94 | 58·5% (35·5 to 88·9) | 147·0 (120·3 to 178·4) | −23·4% (−38·7 to −3·4) |
| Subarachnoid haemorrhage | 24·4% (20·8 to 27·7) | 1·05 | 77·7% (47 to 132·4) | 23·0 (18·5 to 28·8) | −33·7% (−52·9 to 6·2) |
| Household air pollution from solid fuels | |||||
| Meningitis | 0·7% (0·4 to 1·1) | 0·75 | −31·9% (−63·3 to 19·9) | 0·5 (0·3 to 0·8) | −83·5% (−91·5 to −68·6) |
| Encephalitis | 0·2% (0·1 to 0·3) | 0·93 | −39·2% (−71·4 to 29·4) | 0·1 (0·0 to 0·2) | −51·1% (−78·0 to 26·9) |
| Stroke | 3·7% (2·5 to 5·0) | 1·57 | −71·9% (−76·9 to −66·1) | 66·8 (44·8 to 93·1) | −80·9% (−84·8 to −76·1) |
| Ischaemic stroke | 3·0% (2·1 to 4·3) | 1·45 | −73·2% (−77·9 to −67·4) | 36·1 (24·1 to 52·9) | −75·6% (−80·2 to −69·8) |
| Intracerebral haemorrhage | 4·8% (3·3 to 6·5) | 1·76 | −68·6% (−74·3 to −62·6) | 26·4 (17·6 to 37·1) | −84·9% (−88·3 to −80·3) |
| Subarachnoid haemorrhage | 4·6% (2·5 to 7·1) | 1·83 | −58·7% (−73·6 to −46·3) | 4·4 (2·1 to 7·5) | −84·7% (−88·8 to −77·9) |
| Non-optimal temperature | |||||
| Stroke | 7·1% (5·0 to 9·1) | 0·97 | 0·1% (−12·5 to 18·5) | 129·1 (90·0 to 168·5) | −31·9% (−44·4 to −17·3) |
| Ischaemic stroke | 6·8% (4·8 to 8·8) | 0·96 | −0·4% (−12·5 to 15·6) | 80·3 (56·2 to 104·7) | −9·2% (−28·0 to 9·5) |
| Intracerebral haemorrhage | 7·6% (5·3 to 9·8) | 1·00 | 4·0% (−10·4 to 26·2) | 41·7 (28·7 to 55·6) | −49·8% (−59·0 to −36·9) |
| Subarachnoid haemorrhage | 7·5% (5·4 to 9·6) | 0·96 | 4·9% (−10·2 to 29·3) | 7·0 (4·9 to 9·7) | −61·0% (−71·5 to −33·3) |
| High temperature | |||||
| Stroke | 1·6% (0·5 to 3·1) | 0·88 | 15·9% (−40·6 to 99·9) | 29·4 (10·2 to 59·3) | −21·2% (−59·9 to 33·6) |
| Ischaemic stroke | 1·5% (0·5 to 3·0) | 0·87 | 21·8% (−30·5 to 127·1) | 17·9 (6·1 to 36·2) | 11·1% (−39·8 to 103·6) |
| Intracerebral haemorrhage | 1·8% (0·6 to 3·6) | 0·90 | 17·5% (−43·1 to 89·1) | 10·0 (3·5 to 20·3) | −43·2% (−71·3 to −8·4) |
| Subarachnoid haemorrhage | 1·5% (0·6 to 3·0) | 0·93 | 11·0% (−53·8 to 89·5) | 1·5 (0·5 to 3·1) | −58·5% (−83·3 to −17·7) |
| Low temperature | |||||
| Stroke | 5·5% (3·5 to 7·7) | 0·99 | −3·5% (−12·9 to 5·4) | 100·9 (62·0 to 140·7) | −34·4% (−43·8 to −23·6) |
| Ischaemic stroke | 5·3% (3·4 to 7·5) | 0·98 | −5·1% (−15·6 to 2·4) | 63·1 (39·4 to 87·8) | −13·4% (−28·1 to 0·3) |
| Intracerebral haemorrhage | 5·9% (3·6 to 8·3) | 1·03 | 0·5% (−9·4 to 12·3) | 32·1 (19·1 to 45·9) | −51·5% (−59·1 to −41·7) |
| Subarachnoid haemorrhage | 6·0% (4·0 to 8·3) | 0·96 | 3·5% (−9·8 to 29·6) | 5·6 (3·5 to 8·0) | −61·6% (−72·0 to −35·0) |
| Other environmental risks | |||||
| Stroke | 5·2% (3·3 to 7·3) | 0·72 | −12·9% (−22·2 to −5·2) | 95·5 (57·8 to 137·7) | −40·8% (−50·5 to −30·4) |
| Ischaemic stroke | 5·2% (3·2 to 7·4) | 0·69 | −7·1% (−13·5 to −2·2) | 61·3 (36·2 to 89·0) | −15·2% (−28·5 to −3·3) |
| Intracerebral haemorrhage | 5·4% (3·2 to 8·0) | 0·77 | −19·1% (−29·6 to −9·5) | 29·9 (17·2 to 44·8) | −60·9% (−68·6 to −52·2) |
| Subarachnoid haemorrhage | 4·6% (2·5 to 7·1) | 0·80 | −4·7% (−20·6 to 19·1) | 4·4 (2·1 to 7·3) | −64·8% (−74·1 to −46·8) |
| Lead exposure | |||||
| Stroke | 5·2% (3·3 to 7·3) | 0·72 | −12·9% (−22·2 to −5·2) | 95·5 (57·8 to 137·7) | −40·8% (−50·5 to −30·4) |
| Ischaemic stroke | 5·2% (3·2 to 7·4) | 0·69 | −7·1% (−13·5 to −2·2) | 61·3 (36·2 to 89·0) | −15·2% (−28·5 to −3·3) |
| Intracerebral haemorrhage | 5·4% (3·2 to 8·0) | 0·77 | −19·1% (−29·6 to −9·5) | 29·9 (17·2 to 44·8) | −60·9% (−68·6 to −52·2) |
| Subarachnoid haemorrhage | 4·6% (2·5 to 7·1) | 0·80 | −4·7% (−20·6 to 19·1) | 4·4 (2·1 to 7·3) | −64·8% (−74·1 to −46·8) |
All 22 risk factors within four Levels of classification are listed in this table, as well as aggregates of these risk factors within the Levels above them in the risk factors hierarchy. Level 1 and Level 2 risk factors in bold. Data in parentheses are 95% uncertainty intervals. All data are provided to one decimal place, except female to male ratio, which is provided to two decimal places. Percentages of DALYs are not mutually exclusive: the sum of percentages of DALYs in the columns exceeds the totals for all risk factors combined because of overlap between various risk factors. Risk factors with insufficient data and neurological conditions with insufficient data for each risk factor are not reported here. The crude sum of population attributable fraction of the risk factors might exceed 100% because the effects of many of these risk factors are mediated partly or wholly through another risk factor or risk factors. DALY=disability-adjusted life-year. PM2·5=particulate matter with a diameter of <25 μm.
*
Neurological disorders in the Global Burden of Disease Study 2019 include Alzheimer's disease and other dementias, Parkinson's disease, idiopathic epilepsy, multiple sclerosis, headache disorders (including migraine and tension-type headache), motor neuron disease, and other neurological disorders.
†
Metabolic risk factors cluster includes high BMI, high fasting plasma glucose, high LDL cholesterol, high systolic blood pressure, and kidney dysfunction.
‡
Behavioural risk factors cluster includes tobacco (including tobacco smoke and secondhand smoke), dietary risks (diet high in sodium, diet low in fruits, diet low in vegetables, diet high in red meat, and diet low in whole grains), low physical activity, alcohol consumption, and child and maternal malnutrition (including low birthweight and short gestation).
§
Environmental risk factors cluster includes air pollution (including ambient PM2·5 pollution and household air pollution from solid fuels), non-optimal temperature (including low ambient temperature and high ambient temperature), and other environmental risks (including lead exposure).