Research published in The Lancet Regional Health – Americas shows that the burden of neurological conditions is increasingly shifting from premature death to long-term disability
Washington, D.C., July 22, 2026 (PAHO) – Nearly 470 million people in the Americas, or about two in five people in the Region, are living with at least one noncommunicable or injury-related neurological disorder, including migraine, stroke, epilepsy, and Alzheimer’s disease, according to a new study published in The Lancet Regional Health – Americas.
The study, based on estimates from the Global Burden of Disease Study 2023, found that the burden of neurological disorders in the Americas is evolving. While age-adjusted death rates have declined since 1990, more people are surviving these conditions and living longer with disability, increasing demand for rehabilitation, long-term care, and support services.
Led by researchers from the Pan American Health Organization (PAHO), the study examined 19 noncommunicable and injury-related neurological conditions across 38 countries and territories between 1990 and 2023. These included stroke, Alzheimer’s disease and other dementias, Parkinson’s disease, epilepsy, migraine, tension-type headache, autism spectrum disorders, and traumatic brain injuries.
Neurological disorders affect the brain, spinal cord, and peripheral nerves and can impair movement, memory, learning, communication, and behavior.
In 2023, these conditions were responsible for an estimated 1.1 million deaths and 37.5 million disability-adjusted life years (DALYs), a measure that combines years of life lost due to premature death and years lived with illness or disability. Together, they accounted for about 12% of the total burden from noncommunicable diseases and injuries in the Americas.
“Today, more people are surviving neurological disorders, but they are also living longer with their consequences,” said Ramón Martínez, PAHO Health Metrics Specialist and lead author of the study. “Health systems must adapt to meet growing needs for rehabilitation, long-term care, and support services for people living with disability.”
A shift toward chronic disability
Although age-standardized mortality and disease burden rates declined between 1990 and 2023, the total number of people affected continued to rise influenced by population growth and aging.
The findings point to an epidemiological transition in the region. While the burden associated with some vascular and congenital conditions has fallen, neurodegenerative and other chronic neurological disorders linked to aging are becoming increasingly important.
Migraine and tension-type headache accounted for the largest number of people affected, underscoring the significant impact of chronic neurological conditions on quality of life and productivity. Migraine was also the leading contributor to neurological disability-adjusted life years (DALYs), followed by Alzheimer's disease and other dementias, ischemic stroke, and intracerebral hemorrhage.
The study also found that neurological conditions affect people differently across the life course. Among children under five, neural tube defects, autism spectrum disorders, and epilepsy were the leading causes of neurological health loss. Among adolescents and young adults, migraine emerged as a major cause of disability. In older adults, Alzheimer’s disease, other dementias, and stroke accounted for the largest share of the burden.
Researchers also observed sustained increases in several neurodevelopmental and neurodegenerative conditions, including Parkinson’s disease, multiple sclerosis, motor neuron diseases, and autism spectrum disorders. Notably, autism spectrum disorders were the only high-burden condition whose DALY rates continued to rise throughout the study period, highlighting growing needs for health, developmental, and support services for children and adolescents.
Preventable risk factors continue to drive disease burden
The study found that a substantial share of neurological health loss in the Americas could be prevented by reducing exposure to modifiable risk factors.
High blood pressure was the leading risk factor for stroke, while elevated blood glucose levels contributed significantly to the burden of Alzheimer’s disease and other dementias. Researchers also identified environmental exposures, particularly lead and air pollution, as important contributors to several neurological conditions.
“Many neurological disorders share risk factors with other noncommunicable diseases,” said Dr. Anselm Hennis, Director of PAHO’s Department of Noncommunicable Diseases and Mental Health and co-author of the study. “Improving prevention and control of high blood pressure, diabetes, obesity, tobacco use, and harmful environmental exposures could deliver major benefits for brain health across the region.”
“Protecting brain health starts long before the first symptoms appear,” added Renato Oliveira, Chief of PAHO’s Mental Health Unit and co-author of the study. “Investing in prevention and risk-factor control can help reduce the burden of neurological disorders while also lowering the risk of other noncommunicable diseases that share the same determinants.”
Persistent gaps in access to care
The burden of neurological disorders is not evenly distributed across the Americas. Researchers found nearly a fourfold difference between countries with the highest and lowest burden. The highest burden was observed in Haiti, Guyana, Suriname, Saint Kitts and Nevis, the Dominican Republic, and Paraguay, while the lowest rates were recorded in Puerto Rico and several South American countries.
These disparities reflect differences in exposure to risk factors as well as persistent gaps in access to prevention, diagnosis, treatment, rehabilitation, and long-term care. The study highlights shortages of specialists, limited rehabilitation services, and barriers to accessing essential medicines and technologies as continuing challenges across the region.
The authors conclude that addressing the growing burden of neurological disorders will require stronger prevention efforts, integrating neurological care into primary health care, and expanding access to rehabilitation, long-term care, and disability support services. With populations across the Americas aging rapidly, these investments will be critical to reducing disability and improving quality of life in the decades ahead.
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