Impact of Brain illness

The effect of Brain illness at global level is profound with an impact on communities worldwide from social, cultural and economic perspectives 1. The Global Burden of Disease studies that cover comprehensively all disease groups and injury categories 2 have found that increasingly higher proportions of the global burden of disease can be attributed to disorders of the Brain.

Suffering caused by Brain disorders extends beyond the patient to family members and to communities. Collins et al (NIH, 2011)3 estimate that about 13% of Global disease is due to disorders of the Brain, surpassing both cardiovascular disease and cancer.

Following President Obama’s announcement, Dr. Collins tasked a working group of his Advisory Committee to the Director (ACD) to identify high priority areas of research for fiscal 2014 funding and to develop a long-term scientific plan.

The time is right to exploit recent advances in neuroscience research and technologies to advance our understanding of the Brain’s functions and processes and what causes them to go wrong in disease,

said Dr. Collins.

The BRAIN Working Group3 has been on a fast track to identify key areas of research for funding. This group of visionary neuroscientists has provided an excellent set of recommendations, and I am eager to move these areas forward.

Europe is currently the world’s leader in elderly person’s populations and is projected to remain so for at least the next 50 years. About 37% of the European population is projected to be 60 or over in 2050. This projected increase in longevity is also related to an increase of chronic disease and a rise in the cost of health. It is only in the past decade that compelling evidence has become available showing that disorders of the Brain are not only much more frequent than previously thought, but also contribute to a greater burden of disease than previously thought, and therefore, can be considered as a top global health challenge of the 21st century.

The Brain is our most complex organ, and Brain research is one of the frontiers of modern sciences. Every years, tens of millions of people in the EU, from teenagers to the elderly, will experience at least one episode of mental illness-and they sometimes have to wait years for adequate treatment…
Maire Geogheran-Quinn European Commissioner for Research, Innovation and Science Healthy Brain: Healthy Europe Conference Dublin 27 May 2013

Cost of Brain Health in Europe

Already today the cost of Brain Health in Europe is very high. In 2004, The European Brain Council (EBC) estimated total cost of Brain disorders at €386 billion per year (2004 prices including direct costs of treatment and care plus indirect cost of lost workdays and lost productivity) - twice the estimated cost of cancer5. The latest study conducted by the European Brain Council (EBC) in 2010 provides the total cost of disorders of the Brain was estimated at €798 billion. Direct costs constitute the majority of costs (37% direct healthcare costs and 23 % direct non-medical costs) whereas the remaining 40% were indirect costs associated with patients’ production losses.6

The challenges are complex as Brain disorders encompass dozens of groups of disorders and hundreds of specific diagnoses that might require preventive, therapeutic and rehabilitative interventions of different type and intensity in the different age groups.

Many brain disorders are chronic and incurable conditions whose disabling effects may continue for years or even decades. Thus, the overall disease burden from these disorders is much greater than would be suggested by mortality figures alone. The extent of this burden is underlined by data from the World Health Organization. To compare the impact of different diseases, the WHO estimates for each disease category the "Disability Adjusted Life Years" or DALYs – years of healthy life that are lost to disability as well as death. Each disease is assigned a weighting factor according to the severity of the resulting disability. The WHO estimates that unipolar depression is the third leading causes of disease burden worldwide, (after lower respiratory infections and diarrheal diseases), and the number one cause in the high-income countries. (see table below).

Table : Leading causes of burden of disease (DALYs), all ages, 2004 from the latest WHO Global Burden of disease report

Disease or injury DALYs (millions) Per cent of total DALYs
1 Lower respiratory infections 94.5 6.2
2 Diarrhoeal diseases 72.8 4.8
3 Unipolar depressive disorders 65.5 4.3
4 Ischaemic heart disease 62.6 4.1
5 HIV/AIDS 58.5 3.8
6 Cerebrovascular disease 46.6 3.1
7 Prematurity and low birth weight 44.3 2.9
8 Birth asphyxia and birth trauma 41.7 2.7
9 Road traffic accidents 41.2 2.7
10 Neonatal infections and other 40.4 2.7
11 Tuberculosis 34.2 2.2
12 Malaria 34.0 2.2
13 COPD 30.2 2.0
14 Refractive errors 27.7 1.8
15 Hearing loss, adult onset 27.4 1.8
16 Congenital anomalies 25.3 1.7
17 Alcohol use disorders 23.7 1.6
18 Violence 21.7 1.4
19 Diabetes mellitus 19.7 1.3
20 Self-inflicted injuries 19.6 1.3
COPD, chronic obstructive pulmonary disease. a This category also includes other non-infectious causes arising in the perinatal period apart from prematurity, low birth weight, birth trauma and asphyxia. These non-infectious causes are responsible for about 20% of DALYs shown in this category

On this measure, brain disorders emerge as leading contributors to global disease burden; for example, according to the most recent (2004) WHO survey, unipolar depressive disorders are the single biggest source of lost DALYs in the high income countries, and the third biggest worldwide. In Europe it has been estimated that 35% of all disease burden is attributable to brain disorders (Olesen & Leonardi 2003).

Alcohol and substance abuse can also be taken as part of the burden of Brain disease as it has been shown in an American study. The US National Bureau of Economic Research has estimated that 38 percent of all alcohol, 44 percent of all cocaine, and 40 percent of all cigarettes are consumed by people with an existing mental illness.

The economic costs of brain disorders are correspondingly large. These include not only the cost of treatment, but also the lost productivity of patients and their caregivers, for whom looking after chronically disabled family members can represent an enormous source of emotional, practical, and financial burden.

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