Pre-COVID life expectancy, mortality, and burden of diseases for adults 70 years and older in Australia: a systematic analysis for the Global Burden of Disease 2019 Study
- PMID: 38911261
- PMCID: PMC11190477
- DOI: 10.1016/j.lanwpc.2024.101092
Pre-COVID life expectancy, mortality, and burden of diseases for adults 70 years and older in Australia: a systematic analysis for the Global Burden of Disease 2019 Study
Abstract
Background: The Australian population aged 70 and above is increasing and imposing new challenges for policy makers and providers to deliver accessible, appropriate and affordable health care. We examine pre-COVID patterns of health loss between 1990 and 2019 to inform policies and practices.
Methods: Using the standardised methodology framework and analytical strategies from GBD 2019 methodologies, we estimated mortality, causes of death, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs), life expectancy at age 70 and above (LE-70), and healthy life expectancy (HALE-70) in Australia comparing them globally and with high socio-demographic index (SDI) groups.
Findings: DALY rates have been improving steadily over the past 30 years among Australians aged 70 and above. Decreases in DALY rates were primarily attributed to a fall in YLLs attributable to cardiovascular diseases (60%) and chronic respiratory disorders (30.2%) and transport injuries (56.9%), while the non-fatal burden remained stable from 1990 to 2019. According to the DALY rates, the top five leading causes are ischemic heart disease, Alzheimer's disease, COPD, stroke, and falls, where falls exhibited the largest increase since 1990.
Interpretation: This study provides an in-depth report on the main causes of mortality and disability in Australia's population aged 70 and above. It sheds light on the shifts in burden over three decades, emphasising the need for the Australian health system to enhance its readiness in addressing the escalating demands of an ageing population. These findings establish pre-COVID baseline estimates for Australia's population aged 70 and above, informing healthcare preparedness.
Funding: Bill & Melinda Gates Foundation.
Keywords: Aged 70 and above; Australia; GBD 2019; Global Burden of Disease Study.
© 2024 The Authors.
Conflict of interest statement
SC was supported by Janssen-Cilag Australia and Lundbeck Otsuka grants paid to institution (The University of Adelaide). B Angell reports a grant from the National Health and Medical Research Council (Australia) (Investigator Grant–GNT GNT2010055), outside the submitted work. P Atorkey reports infrastructure support for the present manuscript from the Australian College of Applied Professions, Discipline of Psychological Sciences, and the School of Medicine and Public Health, University of Newcastle. S Bhaskar reports grants or contracts from Japan Society for the Promotion of Science (JSPS), Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT) for the Grant-in-Aid for Scientific Research (KAKENHI) and from the JSPS and the Australian Academy of Science for a JSPS International Fellowship; leadership or fiduciary roles in other board, society, committee or advocacy group, paid or unpaid, with Rotary District 9675 as District Chair, Diversity, Equity & Inclusion, Global Health & Migration Hub Community, Global Health Hub Germany, Berlin, Germany as Chair and Manager, PLOS One, BMC Neurology, Frontiers in Neurology, Frontiers in Stroke, Frontiers in Public Health & BMC Medical Research Methodology as Editorial Board Member, and College of Reviewers, Canadian Institutes of Health Research (CIHR), Government of Canada as Member; all outside the submitted work. A M Briggs reports research grants paid to their institution from AO Alliance, Asia Pacific League of Associations for Rheumatology, Australian Rheumatology Association, Pan American League of Associations for Rheumatology, World Federation of Chiropractic, Australian Government Department of Health Grant, National Health and Medical Research Council (Australia) Medical Research Future Fund Grant, Western Australian Government Department of Health Grant, Bone and Joint Decade Foundation (Sweden), Institute for Bone and Joint Research (Australia), Canadian Memorial Chiropractic College, Arthritis and Osteoporosis Western Australia, and Arthritis Australia; consulting frees as a senior consultant to World Health Organization for technical advice and technical products development related to ageing and musculoskeletal health, from OneSpace Health for services as a consultant physiotherapist, and from WorkSafe Victoria for work in reviewing management pathways for injured workers in the state of Victoria; honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from the American College of Rheumatology for a presentation in 2022 and the Austrian Institute for Health Technology Assessment for independent reviews of their policy documents in 2021; support for attending meetings and/or travel from WHO for travel to work at the Headquarters in Geneva for technical work, the University of Otago to attend the New Zealand Osteoarthritis Summit in 2023 (Dunedin, New Zealand), and the World Federation of Chiropractic to attend their scientific meeting in 2023 (Gold Coast, Australia); leadership or fiduciary roles in other board, society, committee or advocacy group, unpaid, as a member of the International Coordinating Council for the Global Alliance for Musculoskeletal Health (G-MUSC); all outside the submitted work. S R Clark reports grants or contracts from Janssen Cilag Australia Investigator Initiated paid to the University of Adelaide; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Lundbeck Otsuka for speakers fees and manuscript writing paid to the University of Adelaide; participation on an Advisory Board with Lundbeck Otsuka paid to the University of Adelaide; all outside the submitted work. R C Franklin reports Support for attending meetings and/or travel from the Australasian College of Tropical Medicine (ACTM)—Tropical Medicine and Travel Medicine Conference 2022, 2023, and the International Society of Travel Medicine (ISTM)—Travel Medicine Conference, Basel 2023; leadership or fiduciary roles in other board, society, committee or advocacy group, paid or unpaid, with Kidsafe as President/Director, Farmsafe as Director, Auschem as Director, PHAA Injury Prevention SIG Convener, ISASH as Governance Committee member, and ACTM as Vice President; all outside the submitted work. S M S Islam reports support for the present manuscript from the National Health and Medical Research Council (Australia) through an Investigator Grant and the Heart Foundation of Australia through a Vanguard Grant. P B Mitchell reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Janssen (Australia) outside the submitted work. A E Peden reports support for the present manuscript from the National Health and Medical Research Council (Australia) (Grant Number: APP2009306). P S Sachdev reports grants or contracts paid to their institution from National Health and Medical Research Council (Australia) and National Institutes of Health (USA); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Alkem Labs for a lecture as part of the Frontiers of Psychiatry 2023 seminar, Mumbai, India, June 2023; participation on a Data Safety Monitoring Board or Advisory Board with Biogen Australia on the Medical Advisory Committee in 2020 and 2021 and Roche Australia on the Medical Advisory Committee in 2022; leadership or fiduciary roles in other board, society, committee or advocacy group, unpaid, with VASCOG Society Executive Committee and the World Psychiatric Association Planning Committee; all outside the submitted work. S Sharma reports support for the present manuscript paid to their institution from the John J. Bonica Postdoctoral Fellowship from the International Association for the Study of Pain (2021–2023); payment outside the submitted work for an online lecture on pain to compensate for time in January 2023; support outside the submitted work from the International Association for the Study of Pain to offset travel for the World Congress on Pain in Toronto in 2022. H Slater reports grants or contracts paid to their institution from Australian Government, Department of Health Grant, Medical Research Future Fund Grant, Western Australian Government Department of Health Grant, Bone and Joint Decade Foundation (Sweden) Grant, Curtin University (Australia), Institute for Bone and Joint Research (Australia), Canadian Memorial Chiropractic College (Canada): Grants; support for attending meetings and/or travel from the Australian Pain Society; all outside the submitted work. A G Thrift reports grants for research projects paid to their institution from the National Health & Medical Research Council (Australia), Heart Foundation (Australia), and Stroke Foundation (Australia); a leadership or fiduciary role in other board, society, committee or advocacy group, unpaid, with the Stroke Foundation Board (Australia); all outside the submitted work.
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