"The sheer scale and impact of neurological disease in Europe is underestimated and often overlooked. As a specialisation, neurology is under-resourced in many European countries. Research activities and providing care for neurological patients must be given a much higher priority at all levels," cautioned Prof Guenther Deuschl of the University Medical Center Schleswig-Holstein in Kiel, President of the European Academy of Neurology (EAN), at the society's inaugural congress in Berlin. The EAN was set up last year following a merger between the European Federation of Neurological Societies (EFNS) and the European Neurological Society (ENS).
According to Prof Deuschl, around one third of the population requires treatment by a neurologist at least once in their lifetime. "Data published by the European Brain Council shows that 220.7 million people in Europe suffer from at least one neurological disease - more than the populations of France, Germany and the United Kingdom put together," he noted.
There are just around 25,000 neurologists in the EU countries to serve this demand, albeit with some regions better covered than others: depending on the country, there are between four and 13 neurologists per 100,000 people. Prof Deuschl: "This is barely enough even at this stage, and looking to the future we are increasingly heading towards a shortfall. Many neurological diseases such as stroke, dementia or Parkinson's are age-related, meaning that incidence increases as the population continues to age. And according to Eurostat, while the over-65 age group currently accounts for around a quarter of the total population, this is set to increase to 52 percent by 2060."
Neurology: specialisation moving at "warp speed"
However, modern neurology is in a position to counter this development to some extent. "As a specialisation, neurology is moving at warp speed - few other areas are moving forward so quickly. All of the subspecialties that are brought together under the umbrella of neurology are contributing to this progress," Prof Deuschl explained. "We are increasingly finding preventative, diagnostic, therapeutic and rehabilitative answers to the growing challenges posed by these diseases."
In his view, neurologists and health care policy makers have common aims: "Europe has to do more to combat neurological disease, that's clear enough," the EAN President emphasised. "An important first step would be to invest a sizeable chunk of the approximately eight billion euros made available for medical research by the EU's Horizon 2020 programme in neurological research and the neurosciences."
Neurological disease weighing on European economies
Securing sufficient funds for neurology is vital because many neurological diseases not only cause considerable human suffering, but also lead to loss of independence, not least through disabilities and need for longterm-care. And the cost of neurological disease is painfully high, with the direct and indirect economic burden amounting to more than 336 billion euros per year - more than the entire German national budget. The top three culprits are dementia (105 billion), followed by stroke (64 billion) and headache and migraine (43 billion). 122 billion euros is accounted for by treatment costs and direct non-medical costs, respectively, while a further 93 billion euros is attributable to indirect costs such as sick leave or early retirement.
Neurological disease also has a significant impact in terms of DALYs, a measure used to determine the years lost through disease and premature death. In the EU alone, 2.2 million DALYs are attributable to dementia, 1.6 million to strokes, 640,000 to Parkinson's disease and 260,000 to epilepsy. According to the WHO, worldwide DALYs due to neurological disease will rise from 95 million in 2015 to 103 million in 2030, an increase of more than nine percent. Alzheimer's and other forms of dementia (up 37 percent), and cerebrovascular disease (up 13 percent) will be among the main factors behind the increase.
EAN: major contribution towards research and health care
The European Academy of Neurology is well placed to make a major contribution to high-quality neurological health care in Europe, as its President confirmed: "This includes playing a coordinating role in neurological practice, education and training and defining uniform diagnostic and therapeutic standards for patient care in Europe, as we increasingly move towards greater harmonisation of the different health care systems. The EAN also has enormous potential for promoting scientific research in neurology as well as the neurosciences in general. This is reflected in the broad range of new discoveries being presented at the EAN Congress."
In the EAN President's view, the decision to merge the continent's two leading neurological societies has put European neurology in pole position. "Together we are much better placed to tackle the important tasks ahead of us. We provide a framework for bringing all neurological subspecialties together under one roof and representing their common interests. The outcome is that all of the specialists are pulling together in the same neurological direction."