Global burden shift from infectious to non-communicable neurological disorders in adolescents and young adults (10–24 years): findings from the global burden of disease study 1990–2021

INTRODUCTION: Neurological disorders are a leading cause of disability and death worldwide; however, their age- and sex-specific patterns among adolescents and young adults remain poorly characterized. Understanding these trends is essential for developing targeted health strategies and optimizing pharmacotherapy in this population. AIM: This study aimed to assess global trends and sex-specific patterns in the burden of neurological and neurodevelopmental disorders among individuals aged 10-24 years from 1990 to 2021, providing evidence to inform clinical pharmacy practice and global health policies. METHOD: Data for 34 neurological conditions among individuals aged 10-24 years were extracted from the 2021 Global Burden of Disease database. Age-standardized prevalence and disability-adjusted life-year (DALY) rates were analyzed according to sex and disorders. Estimated annual percentage changes were derived using log-linear regression models. Joinpoint regression identified significant shifts in the temporal trends. Heatmaps were generated to rank disorders by prevalence and DALYs across global and specific regions. Analyses were conducted using R, version 4.4.3. RESULTS: Between 1990 and 2021, infectious neurological diseases, including malaria, cysticercosis, rabies, meningitis, encephalitis, and tetanus, have declined substantially in both prevalence and DALYs. Conversely, perinatal and developmental disorders showed marked increases, particularly neonatal encephalopathy, preterm birth complications, and neonatal sepsis in both measures. Migraine and tension-type headaches remain the most prevalent conditions in 2021 with minimal temporal changes. Pronounced sex disparities emerged: multiple sclerosis increased more rapidly in females, while alcohol use disorders declined faster in males. Regional inequalities persisted, with infectious burdens concentrated in low- SDI areas, and chronic disorders predominant in high-SDI regions. CONCLUSION: Neurological disease burden among adolescents and young adults has transitioned from infectious to chronic, neonatal, and behavioral conditions, accompanied by significant sex-specific and regional differences. These results highlight the importance for youth-centered prevention, early diagnosis, and equitable access to care. Integrating pharmacists into multidisciplinary neurological care teams can enhance medication optimization, adherence support, and the long-term management of chronic neurological conditions, ultimately improving health outcomes in this vulnerable population.