Burden and determinants of non-communicable neurological disorders among adults in a coastal region of South India: a community-based cross-sectional study

Abstract Background Non-communicable neurological disorders (NCNDs) are a major and growing contributor to global morbidity and disability, particularly in low- and middle-income countries undergoing rapid epidemiological transition. However, community-based evidence on their burden and determinants in India remains limited. This study aimed to estimate the prevalence and identify risk factors of NCNDs among adults in a coastal region of South India. Methods A community-based cross-sectional study was conducted among 2,633 adults in Udupi taluk, Karnataka, between 20 January 2024 and 30 November 2024. A total of 1,118 households were approached and 2,633 eligible adult residents consented to participate. Participants were screened for neurological disorders using the validated NIMHANS protocol, followed by specialist confirmation. Data on socio-demographic, behavioural, and health-related factors were collected using a structured questionnaire. Univariate logistic regression identified variables with a p value less than 0.20, which were entered into a multivariable logistic regression model to identify independent predictors of NCNDs. Results The overall prevalence of NCNDs was 7.06%. Stroke (32.2%), migraine (28.0%), and neuropathic pain (17.7%) were the most common conditions. In multivariable analysis, unemployment (AOR 2.29; 95% CI 1.28–4.11), hypertension (AOR 1.53; 95% CI 1.02–2.30), tobacco use (AOR 1.98; 95% CI 1.01–3.88), sedentary lifestyle (AOR 5.74; 95% CI 1.91–17.2), moderate to severe stress, poor sleep quality, and suboptimal dietary practices were independently associated with increased odds of NCNDs. Unmarried individuals had lower odds of NCNDs (AOR 0.35; 95% CI 0.13–0.92). Conclusions NCNDs impose a substantial and under-recognised public health burden in South India, driven by modifiable behavioural and metabolic risk factors. Strengthening community-based screening and integrating neurological health into existing non-communicable disease programs could improve early detection and prevention strategies.