Supplementary Material for: Estimates of Global Needs for Neurorehabilitation: A Systematic Analysis Based on the GBD-WHO Rehabilitation Database 2021

Abstract
Background: Neurological disorders affect approximately 3.4 billion people worldwide and are the leading cause of disability. We conducted this study to explore global neurorehabilitation requirements and project trends from 2022 to 2036.
Methods: The data on health conditions that may benefit from neurorehabilitation were sourced from the World Health Organization Rehabilitation Need Estimator. Prevalence and years lived with disability (YLDs) of neurorehabilitation needs were analyzed overall and by sex, age, region, country, and health condition. Estimated annual percentage changes (EAPCs) were calculated to quantify trends in age-standardized rates. A decomposition analysis was conducted to identify drivers of changes in neurorehabilitation needs. Projections of neurorehabilitation needs were made until 2036 using Bayesian age–period–cohort analysis (BAPC).
Results: Globally, in 2021, neurological disorders requiring rehabilitation affected 225.38 million (95% UI 215.84–235.21) individuals, contributing to 52.35 million (95% UI 37.57–67.46) YLDs. The age-standardized prevalence rate (ASPR) and YLD rate (ASYR) were 2,758.37 (95% UI 2,644.02–2,878.23) and 640.5 (95% UI 459.39–824.44) per 100,000 persons, respectively. From 1990 to 2021, neurorehabilitation needs increased significantly, with prevalent cases and YLDs rising by 97.5% and 96.4%, respectively. This trend was reflected in a significant annual increase in both ASPR and ASYR, with an EAPC of 0.17 (95% CI 0.15–0.19) and 0.13 (95% CI 0.11–0.15), respectively, and is expected to continue increasing by 2036. Furthermore, decomposition analysis identified population growth and aging as the primary drivers of this increase. Most neurorehabilitation needs occur in low- and middle-income countries (LMICs). From 2021 to 2036, the highest contributors to the global need for neurorehabilitation will remain stroke, cerebral palsy, and Alzheimer's disease and dementia.
Conclusions: Our findings reveal a large and escalating global burden of neurological disorders requiring rehabilitation, driven by demographic aging and population growth. It is essential to expand rehabilitation services and integrate them into primary healthcare systems, particularly in LMICs.