Finally, stroke, which is often listed as the most common cause of disability (unpublished data from http://www.selleckchem.com/products/pf-562271.html National Heart, Lung, and Blood Institute. Unpublished tabulation of the NHANES, 1971–1975, 1976–1980, 1988–1994, 1999–2004, and 2005–2008 and extrapolation to the U.S. population, 2008), is likely second to both arthritis and back pain in its

impact on functional limitations. This is consistent with evidence from the United Kingdom.90 Back pain and arthritis make their impact by sheer numbers in the population. Even if affected individuals miss just a few days of work on average, or have their productivity slightly impaired, the cumulative results across the affected population can amount to tens of billions of dollars in lost wages and reduced work capacity each year. Conversely, interventions that make small improvements in the onset and progression of these chronically disabling diseases may result in significant overall health care cost savings. Other conditions may affect fewer people but can severely limit their ability to work, ambulate, or take care of themselves. In conditions

CB-839 like spinal cord injury or limb loss, the degree of each person’s specific impairments results in widely differing costs of care and levels of disability. Because conclusions are relatively difficult to make about conditions such as spinal cord injury and amputation as an aggregate group, it is important for future research to focus on the evaluation of, and creation of specific interventions for, thoughtfully delineated subsets of these populations. The high direct and indirect costs of disability are likely related

to the chronic nature of functional loss. A comparison of the rates of first-time versus recurrent stroke, or the incidence versus prevalence rates of spinal cord injury and TBI highlight the continual burden of these conditions beyond their Phosphoglycerate kinase initial impact. Although direct medical costs tend to be highest in the first year after event onset, they can remain high throughout a patient’s lifetime. Without a comprehensive view of the lifelong costs of chronic disability, medical costs may continue to account for most bankruptcies in this country. This article has several limitations. First, while we searched for the latest and best available research, some of the data we examined are more than a decade old. Inflation adjustments over this period may be less accurate. In addition, the costs were not estimated in a uniform fashion, raising the possibility that there might be differential error between diagnostic groups. We also used a single inflation adjustment metric, and there is no question that inflation may have been different for different conditions.