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ObjectivesA population‐based controlled study to determine whether adult (55‐74 years) neurological disease deaths are continuing to rise and are there significant differences between America and the twenty developed countries 1989‐91 and 2012‐14.MethodTotal Neurological Deaths (TND) rates contrasted against control Cancer and Circulatory Disease Deaths (CDD) extrapolated from WHO data. Confidence intervals compare USA and the other countries over the period. The Over‐75's TND and population increases are examined as a context for the 55‐74 outcomes.ResultsMale neurological deaths rose >10% in eleven countries, the other countries average rose 20% the USA 43% over the period. Female neurological deaths rose >10% in ten counties, averaging 14%, the USA up 68%. USA male and female neurological deaths increased significantly more than twelve and seventeen countries, respectively. USA over‐75s population increased by 49%, other countries 56%. Other countries TND up 187% the USA rose fourfold. Male and female cancer and CDD fell in every country averaging 26% and 21%, respectively, and 64% and 67% for CDD. Male neurological rates rose significantly more than Cancer and CCD in every country; Female neurological deaths rose significantly more than cancer in 17 countries and every country for CDD. There was no significant correlation between increases in neurological deaths and decreases in control mortalities.ConclusionsThere are substantial increases in neurological deaths in most countries, significantly so in America. Rises in the 55‐74 and over‐75's rates are not primarily due to demographic changes and are a matter of concern warranting further investigation.

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Introduction: Multiple Systematic Atrophy (MSA) whose incidences virtually doubled within a decade, coinciding with major rises in total neurological mortality in the developed world. Aetiology of neurological diseases is linked to various `Possible Occupations Linked' (POL) to neurological disease-Electronics and IT; Engineering, Chemicals, Solvents. Two inconsistent findings-electric shock and head injury have been reported by many MSA patients. This pilot study analyses differences between MSA patients and general population in regard to occupation and incidence of electric shock and head injury. Methodology: Two-year cohort of MSA patients attending support groups completed a one page self-administered questionnaire. It explored age, sex, occupation and electric shock and head injury, contrasted with estimates in the General Public, occupations were determined from ONS data, from which odds ratios of patients and general population were calculated. Results: Of 88 patients, 34% were aged under 60;56% occupations were POL compared to 24% in regional population; one in 1.52 MSA patients reported head injury and 1:3.26 electric shock. This yielded odd ratios of patients to general population of 1:91.4 and 1:589.9 respectively. Patents with Other occupations had significantly more trauma than POL patients. Discussion: Despite the limits of the study 34% of the cohort were relatively young for neurological disease, double the `possible occupational links' to neurological disease than the general population and substantially higher trauma incidence. This pilot study indicates the need for a more focused analysis of possible tripping contributory factors in the aetiology of MSA.

Background: The IMF fears the COVID-19 pandemic will create an economic down-turn matching the Great Depression. More recent recessions have led to physical and mental health problems including suicide deaths of young adults (15 -34). We aim to identify risk patterns of mortality by age from influenza and suicide mortality in peak years from 1979 to 2016 to see if there are lessons to be learned for policy makers and psychiatric services. Method: Using WHO mortality data for 1979-2016 peak years of influenza deaths and suicides are identified in ten Western countries. Death rates per million in each age-band are calculated for both sexes and the percentage of the total deaths accruing in each of five age-bands for influenza and suicides. Ratios of influenza to suicide by age in regard to rates and percentages of deaths indicate differential risk mortality and morbidity patterns. Results: Of the ten country's average Influenza deaths, 95% occurred in people over 55, including 80% -85% for the over 75's. Conversely it was 59% of suicides occurred in peoples aged <55 years. Young adults (15 -34) influenza to suicide ratios were 1:12.1 and 35 -54 years ratio 1:9.3. Discussion: IMF predicts major unemployment, which is likely to create mental health problems, including suicide as well as worsening child health outcomes linked to relative poverty. These wider inter-related factors should be considered by policy-makers and mental health services. The age patterns of risk of mortality point towards a cumulative summation of morbidity and mortality risks of the socio-economic consequences of the COVID pandemic.