TBI, age-related dementia and stroke fuel neurologic disability in India

The 'Global Perspectives' published in the Nov. 20, 2012 issue of Neurology-, the medical journal of the American Academy of Neurology, features "Neurologic Disability: A Hidden Epidemic for India". The authors, a team of US and Indian scientists, detail three emerging trends contributing to this public heath problem and outline measures to stem its growth. Abhijit Das, MD, DM, Amanda Botticello, PhD, MPH, and Glenn Wylie, DPhil, are researchers at Kessler Foundation in West Orange, New Jersey. Kurupath Radhakrishnan, MD, DM, FAAN, is the director and professor of neurology at Sree Chitra Tirunal Institute for Medical Sciences and Technology in Trivandrum, India.

Analysis of epidemiologic data showed the rise in neurologic disability in India is fueled by increases in traumatic brain injury (TBI), age-related dementia, and stroke. Together, these three account for more than 3.5 million new cases of disability each year. That is 11,000 each day, or 7 people every minute who acquire a neurologic disability, emphasized Dr. Radhakrishnan. "Because of the uneven distribution of wealth and health care, the rural poor are disproportionately affected. Lack of awareness and stigma associated with disability contribute to the problem," he noted. "To combat the immense implications for India, urgent changes are needed in health policy, education, research and delivery of care." The authors identified four areas where urgent action can help stem this epidemic-enforcement of traffic safety measures to reduce TBI, development of standardized data tools for assessment and accurate statistics, training of more professionals in neurorehabilitative care, and expanded research in neurorehabilitation.

The socioeconomic burden of neurological disability cannot be overstated, according to Nancy Chiaravalloti, PhD, director of Neuropsychology, Neuroscience & TBI Research at Kessler Foundation. "This includes the significant burdens on the patients' families, both financially and psychologically. This article identifies the actions that are needed in India. Research and clinical collaborations between the US and India could greatly facilitate the development and implementation of neurologically focused data collection tools, as well as the training of professionals in research and clinical care."