The burden of disease among Brazilian older adults and the challenge for health policies: results of the Global Burden of Disease Study 2017

Population Health Metrics

Valéria Maria de Azeredo Passos¹  Maria Fernanda Furtado Lima-Costa²  Ana Paula Silva Champs³  Bruno Ramos Nascimento⁴  Mohsen Naghavi⁵  Ewerton Cousin⁶  Maria Inês Schmidt⁶  Bruce Bartholow Duncan⁶  Fatima Marinho Souza⁷  Renato Teixeira⁷  Renata Kirkwood⁸  Renato Veras⁹  Ana Maria Nogales^1,10 

[1] Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil;Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil;Fundação Oswaldo Cruz, Belo Horizonte, Brazil;Hospital Sarah, Belo Horizonte, Brazil;Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil;Institute for Health Metrics and Evaluation, University of Washington, Washington, USA;Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil;Postgraduate Program on Public Health, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil;School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil;Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Brazil;Universidade de Brasília, Brasília, Brazil;

关键词: Older adults;    Burden of disease;    Life expectancy;    Mortality;    DALY;    Brazil;   

DOI  :  10.1186/s12963-020-00206-3

来源: Springer

【 摘 要 】

BackgroundBrazil is the world’s fifth most populous nation, and is currently experimenting a fast demographic aging process in a context of scarce resources and social inequalities. To understand the health profile of older adults in Brazil is fundamental for planning public policies.MethodsThe estimates were derived from data obtained through the collaboration between the Brazilian Ministry of Health and the Institute of Health Metrics and Evaluation of the University of Washington. The Brazilian Institute of Geography and Statistics provided the population estimates. Data on causes of death came from the Mortality Information System. To calculate morbidity, population-based studies on the prevalence of diseases in Brazil were comprehensively searched, in addition to information obtained from national databases such as the Hospital Information System, the Outpatient Information System, and the Injury Information System. We presented the Global Burden of Disease (GBD) 2017 estimates among Brazilian older adults (60+ years old) for life expectancy at birth (LE), healthy life expectancy (HALE), cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs), from 2000 to 2017.ResultsLE at birth significantly increased from 71.3 years (95% UI to 70.9-71.8) to 75.2 years (95% UI 74.7-75.7). There was a trend of increasing HALE, from 62.2 years (95% UI 59.54-64.5) to 65.5 years (95% UI 62.6-68.0). The proportion of DALYs among older adults increased from 7.3 to 10.3%. Chronic noncommunicable diseases are the leading cause of death among middle aged and older adults, while Alzheimer’s disease is a leading cause only among older adults. Mood disorders, musculoskeletal pain, and hearing or vision losses are among the leading causes of disability.ConclusionsThe increase in LE and the decrease of the DALYs rates are probably results of the improvement of social conditions and health policies. However, the smaller increase of HALE than LE means that despite living more, people spend a substantial time of their old age with disability and illness. Preventable or potentially controllable diseases are responsible for most of the burden of disease among Brazilian older adults. Health investments are necessary to obtain longevity with quality of life in Brazil.

【 授权许可】

CC BY