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Neurological conditions (also known as diseases of the nervous system) arise as a result of damage to the brain, spinal column or nerves. They are caused by illness or injury. Some conditions are life threatening, most of them severely affect people's quality of life and many cause lifelong disability.

Between 2012 and 2014, it was estimated that across the whole of England, the potential years of life lost (PYLL) to neurological conditions that are usually treatable was 43.0 per 100,000 people. [1] Data is not available below the national level, but applying the England rate to the Gateshead population means that the potential years of life lost could be in the region of 86 years.

As with other conditions, neurological conditions add pressure to secondary care systems. In 2011/12 there were 1,081 inpatient and day case hospital admissions for patients registered with a Gateshead GP who had long term neurological conditions. [2] However, in Gateshead, the average length of stay for inpatients with long term neurological conditions is just over 6 days, compared with an England average of almost 11. [3]

Neurological conditions vary and include, amongst others…

 

Alzheimer's Disease

  • Alzheimer's disease is the most common type of dementia. Symptoms of dementia include loss of memory, confusion and problems with speech.
  • According to the Alzheimer's Society, 62% of those with dementia are estimated to have Alzheimer's disease. [4] Applying this estimate to the estimate of people with dementia in Gateshead suggests that there could be around 1,570 people with Alzheimer's disease in Gateshead.

     

    Cerebral Palsy

  • Cerebral Palsy is a disorder of movement and posture. It is due to damage to, or failure in, the areas of the brain which control movement. The effects include awkwardness in walking, or of hand and arm movements, or speech.
  • According to the organisation Scope, the disorder affects about one in every 400 children. [5] Applying this estimate to the more than 2,000 births in Gateshead every year [6] suggests that 5 of the children born will have cerebral palsy.
  • There are three main types of cerebral palsy - spastic, dyskinetic, and ataxic. Many people will have a mixture of these types.
  • Factors that can increase the likelihood of cerebral palsy include difficult or premature birth (less than 37 weeks), twins or multiple birth, mother's age being below 20 or over 40, father under 20 years, first child or fifth (or more) child, and a baby of low birth weight (less than 2.5 pounds). A combination of the above factors can further increase the probability of cerebral palsy.

     

    Dementia

  • Dementia is a term used to describe various different brain disorders, that have in common a loss of brain function that is usually progressive and eventually severe. Symptoms of dementia include loss of memory, confusion and problems with speech.
  • The number of people 65 years of age or older currently with dementia is estimated to be 2,632. [7] By 2035 this is projected to rise to 4,064.
  • Diagnosis of dementia has been high in Gateshead: the ratio of recorded to expected prevalence (in 2010/11) was significantly higher in Gateshead than England (0.51 compared with 0.42). [8]
  • Prevalence of diagnosed dementia is gradually increasing both nationally and locally. In Gateshead the prevalence has increased from 0.60% in 2010/11 to 0.91% in 2015/16 [Chart - Dementia prevalence]. [9]
  • After adjusting for age, the rate of hospital admissions for Alzheimer's and other related dementia from 2009/10 to 2011/12 was significantly higher in Gateshead than in England overall (122 compared to 80 per 100,000 population). [10]
  • The cost of prescribing (drug cost only) for dementia in Gateshead was £8,015 per 1,000 people in quarters 1 and 2 of 2012/13. This was £3,245 higher than the England average. [11]

     

    Epilepsy

  • Epilepsy is the tendency to have recurrent seizures, which also tend to recur spontaneously. These seizures occur when there is an electrical disturbance in the brain, and the signals it sends to the body become mixed up, rather like an electrical storm in the brain.
  • In 2015/16 3,603 people aged 18 or over were recorded as having epilepsy in NewcastleGateshead CCG area (previous data for Gateshead only showed there were 1,482 people with epilepsy in 2012/13). [12] As a percentage, the NewcastleGateshead average of 0.9% compares with the England average of 0.8% [Chart - Epilepsy prevalence].
  • There were 254 emergency hospital admissions due to epilepsy in Gateshead during 2012/13. [13] As a rate, this equates to 153 people per 100,000 aged 18 and over and was not significantly different from the England average of 118. There were a further 634 emergency admissions where epilepsy was not the primary diagnosis, but was mentioned - a rate of 381 per 100,000 compared with the England average of 298. This data is no longer available at local authority level, however it has been updated at CCG level for those aged 20+. In 2013/14 there were 161 emergency hospital admissions per 100,000 people due to epilepsy in NewcastleGateshead CCG, significantly higher than the 121 per 100,000 for England as a whole. There were a further 538 per 100,000 emergency admissions where epilepsy was not the primary diagnosis, but was mentioned, again significantly higher than the England average of 401.
  • The cost of prescribing (drug cost only) for epilepsy in Gateshead was £51,777 per 1,000 people in quarters 1 and 2 of 2012/13. This was £11,107 higher than the England average. [14]

     

    Motor Neurone Disease

  • Motor Neurone Disease is an uncommon disease which causes a progressive degeneration of the motor system (the nerve cells that control the muscles). It is a slowly progressive disease and symptoms include muscle wasting/weakness, muscle cramps and difficulty with swallowing and with speech.
  • According to the Motor Neurone Disease Association, approximately 2 in every 100,000 people develop motor neurone disease every year. [15] However, due to the rapid progression of motor neurone disease, the actual number living with the disease at any one time is about 7 per 100,000. Applying these estimates to Gateshead's population suggests that each year an estimated 4 new cases of the disease develop and there are about 14 people living with the disease in total.
  • There were 7 emergency hospital admissions due to motor neurone disease and spinal muscular atrophy in Gateshead during 2012/13. [16] As a rate, this equates to 3 admissions per 100,000 people aged 18 and over. The England average was 1 admission. There were a further 19 emergency admissions where motor neurone disease and spinal muscular atrophy were not the primary diagnosis, but were mentioned - a rate of 9 per 100,000 compared with the England average of 3. This data is no longer available at local authority level, however it has been updated at CCG level for those aged 20+. In 2013/14 there were 8 emergency hospital admissions in NewcastleGateshead CCG per 100,000 people where motor neurone disease and spinal muscular atrophy were not the primary diagnosis, but were mentioned. This compares with the England average of 9.

     

    Multiple Sclerosis

  • Multiple Sclerosis is the most common disabling neurological disorder affecting young adults. Multiple Sclerosis occurs as the result of damage to myelin - the protective sheath surrounding nerve fibres of the central nervous system. The damage interferes with messages between the brain and other parts of the body.
  • According to the Multiple Sclerosis Trust, in England and Wales there may be between 100 and 140 people in every 100,000 who have multiple sclerosis. [17] Applying this estimate to Gateshead's population suggests that there are between 200 and 280 people living with multiple sclerosis.
  • There were 8 emergency hospital admissions due to multiple sclerosis and inflammatory disorders in Gateshead during 2012/13. [18] As a rate, this equates to 4 people per 100,000 aged 18 and over. The England average was 6 people. There were a further 102 emergency admissions where multiple sclerosis and inflammatory disorders were not the primary diagnosis, but were mentioned - a rate of 49 per 100,000 compared with the England average of 43. This data is no longer available at local authority level, however it has been updated at CCG level for those aged 20+. In 2013/14 there were 3 emergency hospital admissions due to multiple sclerosis and inflammatory disorders in NewcastleGateshead CCG per 100,000, which was significantly lower than the England average of 7. There were 59 admissions per 100,000 where multiple sclerosis and inflammatory disorders were not the primary diagnosis, but were mentioned, similar to the England average of 58 per 100,000.
  • MS is most commonly diagnosed in people aged 20-40, although it can happen at any age. Children can also get MS, but this is rare. MS is three times as common in women than it is in men, and more common in white people than black and Asian people.

     

    Muscular Dystrophy

  • Muscular Dystrophy is a term used to describe a group of neuromuscular disorders. These conditions are characterised by the loss of muscle strength, as progressive muscle wasting or nerve deterioration occurs. Many conditions, but not all, are inherited.
  • The most common types of muscular dystrophy are Duchenne, Myotonic, and Facioscapulohumeral. Across the UK, these affect, 1 boy born in every 3,500 (Duchenne), 1 person born in every 8,000 (Myotonic), and 1 person born in every 20,000 (Facioscapulohumeral). [19] Applying these estimates to the more than 2,000 births in Gateshead every year [20] suggests that 1 boy will be born with Duchenne muscular dystrophy every three years, 1 person will be born with Myotonic dystrophy every four years, and 1 person will be born with Facioscapulohumeral muscular dystrophy every 9 years.

     

    Parkinson's Disease

  • Parkinson's disease is a progressive neurological condition which can affect talking, walking, swallowing, writing etc. It is characterised by slowness in the initiation and performance of movement, and sometimes by tremors - usually when at rest.
  • Parkinson's UK estimates that one person in every 500 has Parkinson's disease. [21] That equates to around 400 people in Gateshead.
  • There were 12 emergency hospital admissions due to Parkinson's disease in Gateshead during 2012/13. [22] As a rate, this equates to 6 people per 100,000 aged 18 and over. The England average was 7 people. There were a further 363 emergency admissions where Parkinson's disease was not the primary diagnosis, but was mentioned - a rate of 176 per 100,000 which is the highest rate in the country and significantly higher than the England average of 108. This data is no longer available at local authority level, however it has been updated at CCG level for those aged 20+. In 2013/14 there were 13 emergency hospital admissions per 100,000 in NewcastleGateshead CCG due to Parkinsonism and other Extrapyramidal and Tic disorders, similar to the England rate of 12. However, there were 304 emergency hospital admissions per 100,000 people where it was not the primary reason for the visit, but it was mentioned. This is significantly higher than the England rate of 183.
  • The cost of prescribing (drug cost only) for Parkinson's disease and movement disorders/tremor in Gateshead was £11,918 per 1,000 people in quarters 1 and 2 of 2012/13. This was £2,177 higher than the England average. [23]

    [1] HSCIC Potential Years of Life Lost - Indicator 1.1, 2011-13 (HSCIC website)

    [2] HSCIC Total Admissions for Long Term Neurological Conditions, 2011/12 (HSCIC website)

    [3] HSCIC Mean Length of Stay for Inpatients With Long Term Neurological Conditions, 2010/11 (HSCIC website)

    [4] Alzheimer's Society Demography, Types of Dementia (Alzheimer's Society website)

    [5] Cerebral Palsy Overview (Scope website)

    [6] Live births by Area of Usual Residence (ONS website)

    [7] Projecting Older People Population Information System 2014 based population projections for 2017 estimate (POPPI website)

    [8] PHE Community Mental Health Profile 2010/11

    [9] Quality Outcomes Framework, NHS Digitial, Dementia Prevalence, 2015/16 (Dementia Profile website)

    [10] PHE, Gateshead Community mental Health profile, 2013

    [11] HSCIC Compendium of Neurology Data - CCG Level Analysis, 2012/13 (HSCIC website)

    [12] Quality Outcomes Framework, Epilepsy Prevalence, 2015/16 (Disease and Risk Factor Prevalence website)

    [13] Epilepsy Admissions - Primary Diagnosis, HSCIC HES, 2012/13 and 2013/14 (Neurology Profiles website)

    [14] HSCIC Compendium of Neurology Data - CCG Level Analysis, 2012/13 (HSCIC website)

    [15] Motor Neurone Disease Association Information Sheet H - Statistics of MND, May 2014 (MND Association website)

    [16] HSCIC HES, 2012/13 and 2013/14 (Neurology Profiles website)

    [17] Multiple Sclerosis Trust (Multiple Sclerosis Trust website)

    [18] HSCIC HES, 2012/13 (Neurology Profiles website)

    [19] Muscular Dystrophy Campaign Types of Muscle Disease, 2012 (muscular-dystrophy.org website)

    [20] Live births by Area of Usual Residence (ONS website)

    [21] Parkinson's UK - Facts for Journalists (Parkinson's UK website)

    [22] HSCIC HES, 2012/13 (Neurology Profiles website)

    [23] HSCIC Compendium of Neurology Data - CCG Level Analysis, 2012/13 (HSCIC website)