Global burden of disease and its risk factors for adults aged 70 and older across 204 countries and territories: a comprehensive analysis of the Global Burden of Disease Study 2021

Abstract

Background: The global older population has been rapidly increasing in recent decades, presenting substantial economic and social challenges.

Aims: This study aims to examine the global disease burden and the associated risk factors among the population aged 70 and older across different regions.

Methods: Data from the Global Burden of Disease Study (GBD) database were used to analyze global deaths, disability-adjusted life years (DALYs), and average annual percentage changes to assess disease burden and associated risk factors.

Results: In 2021, the global population aged 70 and older reached 494.4 (95%UI 482.1-508.2) million. Death and DALY rates have declined by 9.2% (95%CI 5.3-12.7) and 11.0% (95%CI 7.7-14.0) from 1990 to 2021, respectively. However, the global death rate increased to 7,062 per 100,000 population, with DALY rates rising to 125,042 per 100,000. A strong correlation exists between socio-demographic index (SDI) and DALY rates. Regions with lower SDI levels, particularly low and low-middle SDI regions, showed higher DALY rates, reaching 189,563 and 165,080 per 100,000, respectively. The leading causes of death among the older included ischemic heart disease, stroke, COVID-19, and chronic obstructive pulmonary disease. The primary risk factors contributing to DALYs were high systolic blood pressure, air pollution, and tobacco use.

Conclusions: The global disease burden among adults aged 70 and older has shown declines in death and DALY rates, yet remains a significant challenge exacerbated by population growth, especially in less developed regions. Implementing preventive strategies that target primary risk factors early and enhancing treatment of underlying conditions are crucial.

Keywords: Aging; Causes of death; Global disease burden; Older population; Risk factors.

Fig. 1

Global and regional burdens of disease in adults aged ≥ 70 in 2021. Abbreviations: DALYs, deaths and disability-adjusted life years

Fig. 2

Death and DALY rates of adults aged ≥ 70 among 204 countries and territories in 2021: (A) Death rates; B DALY rates. Abbreviations: DALYs, deaths and disability-adjusted life years

Fig. 3

Temporal changes in the top 15 causes of total DALYs rates globally among adults aged ≥ 70 between 1990 and 2021. This figure illustrates the evolution of the top 15 causes contributing to DALY rates among adults aged 70 and older globally, comparing data from 1990 and 2021. Each health condition is ranked based on its DALY rates per 100,000 population in these respective years. The color scheme indicates whether the DALY rates were higher in 2021 (red) or 1990 (blue), determined by whether the 95% uncertainty interval of the absolute difference in DALY rates includes zero. The transparency of the bars and lines reflects the distribution of DALYs between Years of Life Lost (YLL) and Years Lived with Disability (YLD) for each cause. Abbreviations: DALY, disability-adjusted life-year; YLD, years lived with disability; YLL, years of life lost

Fig. 4

Five leading causes of total DALYs rates in 2021 by region and sex for adults aged ≥ 70. Abbreviations: DALY = disability-adjusted life-year; AD, Alzheimer's disease and other dementias; COPD, chronic obstructive pulmonary disease; CKD, chronic kidney disease; DM, diabetes mellitus; HHD, hypertensive heart disease; IHD, ischemic heart disease

Fig. 5

Temporal changes in the top 15 risk factors of total DALYs rates among adults aged ≥ 70 between 1990 and 2021. This figure illustrates the temporal shifts in the top 15 risk factors contributing to DALY rates among adults aged 70 and older globally, comparing data from 1990 and 2021. The list of risk factors is ranked based on their DALY rates per 100,000 population in these respective years. Bars and lines are color-coded to indicate whether DALY rates were higher in 2021 (pink) or 1990 (green), determined by whether the 95% uncertainty interval of the absolute difference in DALY rates includes zero. The transparency of each bar and line reflects the composition of DALYs between Years of Life Lost (YLL) and Years Lived with Disability (YLD) for each risk factor. Abbreviations: DALY, disability-adjusted life-year; YLD, years lived with disability; YLL, years of life lost

Fig. 6

Five leading risk factors of total DALYs rates in 2021 by region and sex for adults aged ≥ 70. Abbreviations: DALYs, deaths and disability-adjusted life years; FPG, fasting plasma glucose; LDL-C, low-density lipoprotein cholesterol; SBP: systolic blood pressure