Neuro and MSK conditions Flashcards
Describe the ‘burden of disease’
- The Global Burden of Disease (GBD) Study’1990 quantifies death and disability attributable to specific causes.
- Burden of disease measures the impact of diseases and injuries on a population.
- It combines the years of healthy life lost due to living with ill health (non-fatal burden or YLD) with the years of life lost due to dying prematurely (fatal burden or YLL).
- Remember, under BOD, diseases are quantified or weighted differently!
- The DALY of COVID-19 in 2020 ≠ COVID-19 in 2023. Why is this? Remember DALY= YLD+ YLL
- YLD is estimated by multiplying the point prevalence of all sequelae (i.e. consequences of disease) by a disability weight which reflects the severity of the health state.
- YLD depends on disease progression and management/treatment
- As management/treatment improves, the effect of a disease or broadly DALY can shift-think HIV before ART and after ART
Describe diseases that constitute a large share of the burden of disease
- Top 5 diseases that caused burden (% of total DALY) in 2022 as per 2021-2022 Australia BOD study: coronary heart disease (5.5%), dementia (4.4%), back pain (4.2%), chronic obstructive pulmonary disease (COPD) (3.7%) and anxiety disorders (2.9%)
- Self-Reported Chronic Conditions 2020-2021(NHS), estimated that:
- 5.0 million (20%) people had a mental or behavioural condition, most commonly reported chronic condition for both males and females.
- 3.9 million (16%) had back problems, which include sciatica, disc disorders, and curvature of the spine.
- 3.1 million (12%) had arthritis- more females (15%) than males (10%)
- ## In Au: more burden from living with illness vs premature death
Describe reasons behind changes in diseases and their burden profile
- Showcase changes in disease rank
- Additionally: Tobacco use, physical inactivity, and unhealthy diets all increase the risk of dying from an NCD.
- The effects of chronic disease can be profound, both on an individual’s health & wellbeing, health of the population/s and on the health care systems.
List some ‘burdensome’ neurological conditions
These disorders broadly include epilepsy, Alzheimer disease and other dementias, cerebrovascular diseases including stroke, migraine and other headache disorders, multiple sclerosis, Parkinson’s disease, neuroinfections, brain tumours, traumatic disorders of the nervous system due to head trauma, and neurological disorders as a result of malnutrition.
- Globally in 2016, the major neurological contributors to DALYs were stroke (42·2%), migraine (16·3%), Alzheimer’s disease and other dementias (10·4%), and meningitis
Describe the classification of neurological conditions
Multifactorial in nature
- Degenerative
- Traumatic
- Bacterial(Mycobacterial tuberculosis, Neisseria meningitides)
- Viral (HIV, Enteroviruses-AFM, West Nile Virus, Zika)
- Fungal (i.e. Cryptococcus, Aspergillus)
- Parasitic (Malaria, Chagas)
- Congenital
- Prion(Creutzfield Jakob Disease,Kuru)
- Aging(shrinking of white/grey matter)
- Neurological conditions can be causatively classified as
- Non-communicable diseases (stroke, migraine, Alzheimer’s disease and other dementias, idiopathic epilepsy, brain and central nervous system cancer, neural tube defects, Parkinson’s disease, multiple sclerosis, motor neuron diseases, other degenerative nervous system disorders, and other neurological disorders).
- Communicable, maternal, perinatal, and nutritional conditions (meningitis, encephalitis, tetanus, and other neurological infections; cerebral palsy and other paralytic syndromes).
List and briefly describe some musculoskeletal issues
- Include a range of more than 150 diagnoses that affect the locomotor system; that is, muscles, bones, joints, and associated tissues such as tendons and ligaments, as listed in the International Classification of Diseases.
- These conditions range from those that arise suddenly and are short-lived, such as fractures, sprains, and strains, to lifelong conditions associated with ongoing pain and disability.
- Musculoskeletal conditions include osteoarthritis, rheumatoid arthritis, back pain, and osteoporosis with fragility fractures.
- Musculoskeletal conditions are typically characterized by pain (often persistent) and limitations in mobility, dexterity, and functional ability, thereby reducing people’s ability to work and participate in society.
- Musculoskeletal conditions have a high socioeconomic cost in terms of healthcare expenditure and lost productivity.
- Osteoarthritis (OA) is the most prevalent musculoskeletal condition and a leading cause of pain and disability worldwide.
Describe the epidemiology of falls
Falls are one of the most common health problems among older adults and a leading cause of substantial injury.
- Globally, falls are a major public health problem.
- An estimated 684,000 individuals die from falls annually, with over 80% of these deaths occurring in low- and middle-income countries.
- Adults older than 60 years of age suffer the greatest number of fatal falls.
- Risk factors for falls among the elderly include lower body weakness, difficulties with walking and balance, use of medicines, such as tranquilizers, sedatives, or antidepressants, vision problems, foot pain, or poor footwear, and home hazards or dangers such as broken or uneven steps, throw rugs or clutter that can be tripped over, and no handrails along stairs or in the bathroom.
Who is at risk of falls and what are some prevention strategies?
- Older Adults and Fall Risks: Older people who have experienced a fall are more likely to fall again within a year, increasing their risk significantly. The fear of falling can lead to further complications like depression and reduced mobility.
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High-Risk Groups:
- Those with limited mobility, both at home and outside.
- Individuals unable to meet their daily needs independently.
- People with chronic diseases, physical or mental impairments, or a lower quality of life.
- Study Findings (Tsai et al, PLoS 2020): Women in Taiwan showed a higher risk of falls, potentially due to higher instances of osteoporosis and weaker knee muscles, and a greater likelihood of indoor falls.
- Prevention Strategies: Effective strategies include multi-factor interventions targeting risk factors, muscle-strengthening and balance exercises, and avoiding psychedelic drugs.
What are some risk factors for falls?
- Demographic and Health Factors: Age, gender, underlying medical conditions (neurological, cardiac), medication side effects, poor mobility, cognition, and vision.
- Environmental and Socioeconomic Factors: Unsafe living environments, socioeconomic challenges like poverty and overcrowded housing, alcohol or substance use, hazardous work conditions.
What is the financial cost of falls?
- Projections for NSW: The population aged 65 and over is expected to increase, leading to a rise in costs associated with hip fractures, from an estimated $139-209 million in 2017 to $321-482 million by 2051.
- Hospital Bed Needs: An anticipated increase in bed days/year required for fall-related treatments.
- Total Costs: The overall cost of falls is projected to reach around $1.4 billion by 2051.
What are some risk factors in the elderly?
- Risk Factors in the Elderly: Higher risks associated with older age, being female, unmarried or widowed, lower education levels, unemployment, and lower relationship satisfaction.
- Gender and Relationship Satisfaction: These factors are crucial in determining fall risks, particularly for older females with lower relationship satisfaction.
Describe falls in younger adults
- Incidence Among Young Adults: Falls are not uncommon in this group, with 48% experiencing at least one fall.
- Activities During Falls: Common activities at the time of the fall differ by gender, with women more likely to fall while walking and during sports, and men during sports activities.
- Differences in Young Adults: Factors like muscle mass, reaction time, bone mass, social versus physical focus, and footwear type contribute to higher fall risks, particularly in young adult females.
