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

Cecilia Hvitfeldt Fuglsang; Thomas Bøjer Rasmussen; Jan Håkon Rudolfsen; Jens Olsen; Niels Skipper; Sinna Pilgaard Ulrichsen; Henrik Toft Sørensen; Christian Fynbo Christiansen

doi:10.1016/j.lanepe.2024.101189

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

Cecilia Hvitfeldt Fuglsang^*, Thomas Bøjer Rasmussen, Jan Håkon Rudolfsen, Jens Olsen, Niels Skipper, Sinna Pilgaard Ulrichsen, Henrik Toft Sørensen, Christian Fynbo Christiansen

^*Corresponding author for this work

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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).

Original language	English
Article number	101189
Journal	The Lancet Regional Health - Europe
Volume	50
ISSN	2666-7762
DOIs	https://doi.org/10.1016/j.lanepe.2024.101189
Publication status	Published - Mar 2025

Keywords

Epidemiology
Health economics
Neurology
Psychiatry

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@article{def773cd18d74ee29142bc9296b577db,

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

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",

author = "Fuglsang, {Cecilia Hvitfeldt} and Rasmussen, {Thomas B{\o}jer} and Rudolfsen, {Jan H{\aa}kon} and Jens Olsen and Niels Skipper and Ulrichsen, {Sinna Pilgaard} and S{\o}rensen, {Henrik Toft} and Christiansen, {Christian Fynbo}",

note = "Publisher Copyright: {\textcopyright} 2024 The Author(s)",

year = "2025",

month = mar,

doi = "10.1016/j.lanepe.2024.101189",

language = "English",

volume = "50",

journal = "The Lancet Regional Health - Europe",

issn = "2666-7762",

publisher = "Elsevier",

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Occurrence, mortality, and economic burden of brain disorders in Denmark, 2015–2021: a population-based cohort study. / Fuglsang, Cecilia Hvitfeldt ; Rasmussen, Thomas Bøjer; Rudolfsen, Jan Håkon et al.
In: The Lancet Regional Health - Europe, Vol. 50, 101189, 03.2025.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Occurrence, mortality, and economic burden of brain disorders in Denmark, 2015–2021

T2 - a population-based cohort study

AU - Fuglsang, Cecilia Hvitfeldt

AU - Rasmussen, Thomas Bøjer

AU - Rudolfsen, Jan Håkon

AU - Olsen, Jens

AU - Skipper, Niels

AU - Ulrichsen, Sinna Pilgaard

AU - Sørensen, Henrik Toft

AU - Christiansen, Christian Fynbo

PY - 2025/3

Y1 - 2025/3

N2 - 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).

AB - 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).

KW - Epidemiology

KW - Health economics

KW - Neurology

KW - Psychiatry

UR - http://www.scopus.com/inward/record.url?scp=85212325257&partnerID=8YFLogxK

U2 - 10.1016/j.lanepe.2024.101189

DO - 10.1016/j.lanepe.2024.101189

M3 - Journal article

C2 - 39810989

AN - SCOPUS:85212325257

SN - 2666-7762

VL - 50

JO - The Lancet Regional Health - Europe

JF - The Lancet Regional Health - Europe

M1 - 101189

ER -

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

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