Global trends in rehabilitation needs for individuals with neurological disorders across 204 countries: data analysis from the global burden of disease study 2021.

BACKGROUND

Neurological disorders are leading contributors to global disability, yet the scale and distribution of rehabilitation needs remain insufficiently quantified. Accurate estimates are essential for informing global health strategies amid population ageing and epidemiological transitions.

METHOD: We analyzed data from the Global Burden of Disease Study 2021 to estimate rehabilitation needs for 10 neurological disorders across 204 countries and territories from 1990 to 2021. Outcomes included age-standardized prevalence rates (ASPR), years lived with disability (YLD), and absolute case numbers, disaggregated by sex, age, region, and Socio-demographic Index (SDI). Temporal trends were assessed using estimated annual percentage change (EAPC) with 95% CIs.

RESULTS

In 2021, an estimated 225.4 million (95% UI, 210.4-241.8) individuals worldwide required rehabilitation for neurological disorders, representing a 92% increase from 117.1 million (107.5-128.1) in 1990. The global ASPR rose from 3066.4 (2810.3-3330.2) to 3133.1 (2926.3-3351.7) per 100 000 population (EAPC = 0.17; 95% CI, 0.16-0.18]). Age-standardized YLD rates increased from 314.2 (290.7-339.5) to 331.1 (309.2-354.7) per 100000 (EAPC = 0.13; 95% CI, 0.12-0.14). Cerebral palsy accounted for the largest share of rehabilitation needs, with 70.8 million (63.2-79.1) cases, followed by cerebrovascular disease (57.4 million [54.9-60.1]). Regionally, South Asia and Sub-Saharan Africa exhibited the highest ASPRs and YLD rates, whereas High-income regions showed moderate rates but the steepest increases over time, driven by population ageing. East and Southeast Asia experienced the largest absolute growth in the number of individuals requiring rehabilitation. Age-specific burden peaked among females aged ≥95 years, with an ASPR of 45706.3 (43321.9-48223.0) per 100000. Strong positive correlations with the SDI were observed for motor neuron disease (ASPR and YLD rate: R = 0.885; P < 0.001), whereas neural tube defects showed the strongest inverse association.

CONCLUSIONS

Global rehabilitation needs for neurological disorders have nearly doubled since 1990, driven by demographic ageing, population expansion, and improved survival with disabling conditions. Large regional, national, and socio-demographic disparities demand targeted investment in community-based rehabilitation, long-term care infrastructure, and integration of rehabilitation into universal health coverage schemes.