More patients in Malta die of stroke than in the EU, highlighting the need for brain health initiatives to improve outcomes and reduce the number of deaths, Mater Dei Hospital’s neuroscience department has said.

Malta’s acute 30-day mortality rate for stroke stands at 15.7%, slightly higher than the average EU rate of 14%, and the figure may rise even further at the 90-day benchmark, said consultant neurologist Malcolm Vella.

To improve patient care and inform public health strategies, the neuroscience department, which Vella chairs, has now started to compile a detailed stroke register.

It will systematically collect and analyse data on stroke cases, treatments and outcomes, he said.

Malcolm Vella: “As a nation, we need to plan ahead to reduce the incidence of brain disease.”

Despite advancements in technology and expanding medical knowledge, the mortality rate for strokes remains significantly high, Vella pointed out.

Deaths are higher in the elderly population but they span a wide age range, with some young patients succumbing to the condition even when they are only 45 years old, he noted.

Stroke care is a major component of the department of neuroscience’s work and “consumes” significant inpatient and outpatient resources, said its chairman.

Between January and May, 332 patients were admitted to hospital with a diagnosis of acute ischemic and haemorrhagic stroke, he said, as real-time data is being compiled in Malta for the first time.

Vella was speaking ahead of World Brain Day on Monday, which aims to raise awareness about the importance of brain health and to highlight the challenges faced by those with neurological disorders.

Initiated by the World Federation of Neurology in collaboration with various health organisations, the global day is designed to promote education, research and advocacy in neurology.

The theme chosen for World Brain Day 2024 is Brain Health and Prevention.

'40% of dementia, 25% of epilepsies preventable'

The human brain, the most complex organ in the body, remains one of the least understood and is afflicted by many diseases, some of which can be prevented, Vella said.

Scientific evidence suggests that up to 50% of all strokes, 40% of dementia and up to 25% of epilepsies are preventable.

One in three individuals worldwide will suffer from a neurological disease – such as stroke, Alzheimer’s and other dementias, Parkinson’s, multiple sclerosis and epilepsy – sometime during their lifetime, he pointed out.

According to the World Health Organisation, neurological disorders are the leading cause of disability-adjusted life years and premature deaths and the second leading cause of deaths globally.

Sufferers in Malta expected to more than double from 6,552 in 2018 to 14,117 in 2050

In 2011, a systematic European study assessed the costs of brain conditions and found these were estimated at around €300 billion, with dementia, stroke, headache and sleep disorders being the main drivers of cost.

“This expenditure is much higher than the cost of other common disorders such as diabetes, cancer and cardiovascular disease,” Vella pointed out.

The burden of neurological diseases is expected to rise dramatically due to the ageing global population, given that the elderly are particularly vulnerable to these disorders, even though they can affect people of all ages.

“This reality underscores the urgent need for enhanced research, better diagnostic tools and more effective treatments,” Vella continued.

Zooming in on dementia, Vella quoted data published in the National Dementia Strategy for the Maltese Islands 2024-2031, which says the overall number of sufferers in Malta was expected to more than double from 6,552 in 2018 to 14,117 in 2050.

According to a study, the increase is due to a significant rise in the number of people aged over 75 and, particularly, those over 85, which is expected to more than triple between 2018 and 2050.

“This equals to a rise in the prevalence of dementia from 1.38% of the population in 2018 to an estimated 3.31% by the next 25 years,” Vella pointed out. “As a nation, we need to plan ahead to reduce the incidence of brain disease.

This is the remit of policymakers and should include access to education and ensuring that everyone everywhere has the same access to preventative neurological care,” he urged.

Environmental factors such as air pollution, research strategies and socio-economic conditions also play a part.

According to the National Dementia Strategy the overall number of dementia sufferers in Malta is expected to more than double from 6,552 in 2018 to 14,117 in 2050. File photo: Shutterstock

How to preserve brain health

Sticking to a healthy diet, getting sufficient and good quality sleep, maintaining social interactions and promoting adaptive coping strategies could help in preserving brain health.

Protection from diseases that affect the brain, by avoiding excessive alcohol consumption, not smoking, reducing sugar intake and controlling cholesterol levels, is also important.

Hypertension, excessive weight, depression, diabetes, hearing impairment and cataracts are also factors that can have a significant impact on brain health, Vella advised.

Compelled to spread awareness, share healthy behaviours to prevent brain disorders and create a world with less brain disease, the Malta Association for Neurologists and Neurosurgeons, together with the department of neurosciences, are joining the European Academy of Neurology and other partner organisations on World Brain Day in promoting the Brain Health Mission to enhance the public understanding of brain health across all life stages.

“It is important to emphasise that brain health does not equate to mental health. It includes mental health but also incorporates the physical and social well-being of the individual,” Vella said.

“World Brain Day is more than just an observance; it is a call for action. It reminds us of the importance of brain health and the impact of neurological disorders on individuals and society,” he continued.

On the occasion, the Malta Association for Neurologists and Neurosurgeons will deliver a talk about brain health in the hospital foyer on Monday (July 22) at 11am and a team of professionals will connect with the public to promote practical measures.

“As neurologists and neurosurgeons, we really hope that this day's message reaches everyone to highlight the importance of taking care of our brain health and to implement the necessary changes in our lifestyles and take preventative measures to lessen the risks of acquiring brain disease.”