07 September 2022

Old and sick humanity

By 2050, the proportion of people over 70 will grow to 16%

"Scientific Russia" based on the materials of the MIPT press service

An international team of scientists conducted a global study on the burden of diseases, injuries and risk factors of the population over the age of 70 for the period from 1990 to 2019 in 204 countries. It was found that in 2019, the world population lived significantly longer than in 1990, due to a decrease in mortality from cardiovascular diseases and chronic respiratory diseases. However, the burden of disability is not decreasing, which indicates the need for further improvement of public health. The co-authors of the work included employees of the Laboratory for the analysis of public health indicators and digitalization of healthcare at MIPT. The results of the study are published in the journal BMJ (Global, regional, and national burden of diseases and injuries for adults 70 years and older: systematic analysis for the Global Burden of Disease 2019 Study).

For the population over the age of 70, an increase in life expectancy was recorded by almost two years, while almost one and a half years — without diseases. Thus, for the first time in world history, life expectancy has crossed the 70-year mark. Moreover, people aged 70 to 90 are the fastest growing population group in Europe, Asia and the USA. Consequently, the health and well-being of the aging population is becoming a priority area of public health. In 1950, the share of elderly people was 5% of the total world population, it is projected that by 2050 it will grow to 16%. That is why in 2015 the World Health Organization declared the growth of chronic diseases among the elderly a global epidemic.

"The world's population is aging — everyone wants to live longer. This requires the adaptation of the healthcare system: it is necessary to treat other diseases and do it by methods more suitable for the population. For an elderly person, going to a polyclinic can be a real epic. This means that telemedicine services will be developed in the future, which allow you to provide assistance remotely," explained Nikita Otstanov, a researcher at the laboratory and one of the co-authors of the work.

During the study period, the age group of 70-79 years increased by 115.4% (168.3 million people), 80-94-year-olds increased by 164.7% (90.1 million people). The population aged 95 and over has grown by 363.7% (3.7 million people).  At the same time, the indicators of life with disabilities increased slightly (by only 0.7%).

Women tend to live longer, but they have a higher proportion of years spent in poor health. Life expectancy was higher for women by an average of 1.89 years than for men in 195 out of 204 countries. The only exceptions were Afghanistan, Algeria, Egypt, Jordan, the Marshall Islands, Mauritania, Qatar, the Syrian Arab Republic and Tokelau, where the figure was higher for men. The greatest increase in life expectancy was observed among the male population in Singapore, South Korea, Bermuda, Maldives and Luxembourg. On the contrary, in Uzbekistan, Tajikistan, Nicaragua, Honduras and Azerbaijan, there was a decrease in the indicator for at least two years.

Russia, whose indicators in this study are within the group of Eastern European countries, was no exception to the general conclusions. Life expectancy on average increased by 1.5 years over 30 years, while the proportion of healthy years of life remained at the same level. The probability of death between the ages of 70 and 90 is over 80%, but this is 8% less than in 1990. The main causes remain the same: cardiovascular and respiratory diseases. The main reasons for reducing the number of years of healthy life in old age for our country are loss of vision and hearing, lower back pain and depressive disorders.

"People expect rapid changes in medicine that will solve all problems at once. Unfortunately, it doesn't work that way: the profile of diseases changes very slowly. They began to cope with strokes a little better — people began to live up to the moment of symptoms of neurodegenerative diseases. And so on," says Nikita Otstanov.

Almost all regions showed a decrease in the probability of death between the ages of 70 and 90, with the exception of Central Asia (83.2% probability of death in 1990 compared to 89.0% in 2019) and southern regions, sub-Saharan Africa (81.6% probability of death in 1990 versus 83.5% in 2019 At the global level, the probability of death decreased mainly due to a decrease in the incidence of cardiovascular diseases, chronic respiratory diseases, respiratory infections and tuberculosis, intestinal infections (total -13.6%), and increased due to an increase in the number of neoplasms, neurological disorders, diabetes mellitus and kidney diseases (+4.3%).

Alzheimer's disease and other types of dementia were in the top five in 51 countries, osteoarthritis — in 28 countries, oral diseases — in 29 countries and chronic obstructive pulmonary disease — in 50 countries.

The top five risk factors for disability included high blood pressure, high glucose levels, smoking, high cholesterol and high body mass index. Thus, bad habits continue to reduce the standard of living of the elderly population of the Earth.

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