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. 2024 Dec 19:50:101189.
doi: 10.1016/j.lanepe.2024.101189. eCollection 2025 Mar.

Occurrence, mortality, and economic burden of brain disorders in Denmark, 2015-2021: a population-based cohort study

Cecilia Hvitfeldt Fuglsang  1 , Thomas Bøjer Rasmussen  1 , Jan Håkon Rudolfsen  2 , Jens Olsen  2 , Niels Skipper  3 , Sinna Pilgaard Ulrichsen  1 , Henrik Toft Sørensen  1   4 , Christian Fynbo Christiansen  1
Affiliations

Occurrence, mortality, and economic burden of brain disorders in Denmark, 2015-2021: a population-based cohort study

Cecilia Hvitfeldt Fuglsang et al. Lancet Reg Health Eur. .

Abstract

Background: Brain disorders (neurological and mental disorders) are common and burdensome diseases. We examined occurrence, mortality, and economic burden of brain disorders in Denmark from 2015 to 2021.

Methods: We conducted a nationwide population-based cohort study using individual-level registry data. We computed the prevalence of any brain disorder and 25 individual brain disorders for each year from 2015 to 2021 and incidence for 2011-2015 and 2016-2021. We computed one-year hazard ratios (HRs) for all-cause mortality by comparing individuals with brain disorders to matched controls without and calculated attributable direct and indirect costs (i.e., economic burden) of brain disorders.

Findings: The prevalence of any brain disorder in Denmark was 1,893,318/5,705,540 = 33.2% in 2015, increasing to 2,059,852/5,856,666 = 35.2% in 2021. The most prevalent conditions were depression (793,419/5,856,666 = 13.5% in 2021), sleep disorders (788,209/5,856,666 = 13.5% in 2021), and headache (461,353/5,856,666 = 7.9% in 2021). The incidence rate of any brain disorder was 1792 and 1634 per 100,000 person-years in 2011-2015 and 2016-2021, respectively. The one-year HR of mortality for any brain disorder was 5.5 (95% confidence interval [CI]: 5.4; 5.6) for 2011-2015 and 5.3 (95% CI: 5.2; 5.3) for 2016-2021. The total attributable direct costs for individuals with any brain disorder were €7.5 billion in both 2015 and 2021. Total indirect costs increased from €17.7 billion in 2015 to €23.2 billion in 2021.

Interpretation: Brain disorders remain common, with a fivefold higher one-year mortality compared to persons without brain disorders. While total direct costs were similar in 2015 and 2021, total indirect costs increased over this period.

Funding: The Lundbeck Foundation (R433-2023-1140).

Keywords: Epidemiology; Health economics; Neurology; Psychiatry.

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Conflict of interest statement

The authors have no personal conflicts of interest to declare. Cecilia Hvitfeldt Fuglsang, Thomas Bøjer Rasmussen, Sinna Pilgaard Ulrichsen, Henrik Toft Sørensen and Christian Fynbo Christiansen are employed at the Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, which receives funding from private and public institutions in the form of research grants to (and administered by) Aarhus University. None of these grants are related to the present study. Jan Håkon and Jens Olsen work as consultants in the life science sector in EY and have acted as paid vendors for clients in the pharmaceutical industry.

Figures

Fig. 1
Fig. 1
Patient characteristics of the 2021 prevalent cohort.
Fig. 2
Fig. 2
Relative changes in the prevalence of brain disorders in 2015–2021.
Fig. 3
Fig. 3
1-Year counts of death due to all causes and adjusted one-year all-cause mortality hazard ratios (HRs) for the 2011–2015 and 2016–2021 incident cohorts by brain disorder and their comparison cohort.
Fig. 4
Fig. 4
Attributable direct and indirect costs, per person and in total, for persons with brain disorders, 2015–2021.
Fig. 5
Fig. 5
Total attributable direct costs (left) and indirect costs (right) for 2021 according to brain disorder. Disorders are sorted according to direct costs.
See this image and copyright information in PMC

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