According to a report by Public Health Foundation Of India(PHFI) published in 2021, the prevalence and incidence of neurological disorders in India has almost doubled in non communicable neurological disorders in the last 2-3 decades from 1990 to 2019, whereas the contribution of communicable neurological diseases reduced by 75 per cent during the same period.

Communicable brain disorders are prevalent mostly in younger children of less than 5 years of age while non communicable brain diseases dominate the rest of the age groups. Brain or neurological disorders affect our brain and the nerves found throughout the human body as well as the spinal cord, which lead to higher rates of Disability Adjusted Life Years (DALYs) and deaths among the patients. With the onset of the pandemic matters have only been made worse for the brain problems in India.

“Covid-19 pandemic has been a huge blow to our brain health. It is a known fact that our brain is impacted by the pathology of Covid infection itself and neurological complications of Covid are a widely known phenomenon. The pandemic has also impacted our brain health negatively as resources, both financial and health care resources have been directed to tackle the unprecedented pandemic pushing brain health to the background making matters much worse, especially while dealing with time-dependent neurological conditions such as stroke, leaving us with a huge death and disability burden,” stated Dr Tamphasana Wairokpam, Consultant, Neurologist, American Oncology Institute at Babina Specialty Hospital.

Brain strokes, a non communicable disorder, has become the third largest fatal disease in India after heart attacks and cancer. According to an estimate by WHO in 2021, 130 people out of 100,000 people in India will end up getting brain strokes in their lives. In 2019, India had 1.9 million incident cases of brain strokes with 699,000 deaths in the same year which is 7.4 per cent of all deaths in the country. Majority of these brain strokes occur due to blockage of blood vessels in the brain known as the Ischemic strokes. 

“Factors such as our diet, lifestyle, and genetic make-up could be responsible for the rise in common neurological conditions such as dementia and stroke , we may put ourselves at a higher risk for numerous prevalent neurological diseases such as stroke and dementia, with uncontrolled diabetes, obesity with a high BMI, and a high blood pressure,” Dr Pankaj Agarwal, Senior Consultant, Neurology, Global Hospital, Mumbai. 

While brain stroke remains the most fatal non communicable disease, Headaches have become the most prevalent disorder followed by Cerebral Palsy and Epilepsy among other disorders. As per estimates in 2019, 488 million people in India suffered from headaches, while 10.1 million had Epilepsy. With about 327,200 deaths registered in 2019 due to Epilepsy alone.

Dr Wairokpam explains migraine headaches and tension-type headaches have been on a rise in recent years. He says, one needs to understand that this type of headache is closely associated with lifestyle and common triggers of these headaches as well as epilepsy include stress, lack of sleep, excessive alcohol consumption, and exhaustion. He also believes that the ever-increasing demands to deliver in our personal and professional lives as well as the culture to glorify overworking has contributed a huge deal to this development.

“Stress at the workplace and family issues have triggered the growing incidence of headaches. Obesity and sleep apnea are other possible causes” said Dr Suryanarayana Sharma P.M. Senior Consultant Neurologist, Apollo Hospitals.

When it comes young kids below 5 years, they are more susceptible to non communicable neurological disorders such as encephalitis, meningitis and tetanus although the stack of disorders have declined considerably over the years, Dr Wairokpam informs why it is more prevalent among young kids, he says that children, especially those at the lower spectrum of extremes of age have weaker immune systems which are yet to be fully developed and are more prone to catch these infections. Even with the improvement in our vaccination programme and advances in diagnostic techniques (such as PCR tests), there is much room for improvement in this aspect. Children also have a limited idea about personal and social hygiene which may further contribute to the spreading of these infections.

Awareness and acceptance of the brain disorders has long been a challenge in India coupled with inability to access a equitable healthcare to find treatment, Dr Agarwal says that this massive two-fold increase in the burden of neurological disorders can also be attributed to the lack of awareness and acceptance amongst the Indian population about neurological disorders, which leads to delayed detection, paired with a lack of access to cheap healthcare and rehabilitation centres. Awareness of dietary and lifestyle variables that increase the risk of stroke and dementia in India will help improve the quality of life for many.

Dr Wairokpam further stresses that the government should also unite towards building more accessible, equitable and affordable healthcare “for every penny that we spend on the prevention of neurological diseases, we save much more,” he added.