Abstract
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.
Highlights
Brazil 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
The smaller increase of healthy life expectancy (HALE) than life expectancy at birth (LE) means that despite living more, people spend a substantial time of their old age with disability and illness
It is noteworthy that about one quarter of this time will be lost to disability, HALE equal to 15.7 years (95% 95% uncertainty intervals (UI) 14.4-16.9) in 2000 and 17.0 years (95% II 15.6-18.3) in 2017 (Table 1)
Summary
Brazil 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. Since NCDs are more frequent among older adults, their health tends to be substantially worse, among the poorest populations [2] While it took a century for the proportion of older adults to increase from 7 to 14% in the population of the developed countries, like France, this same demographic charge is expected to occur in Brazil between 2011 and 2031. This fast aging process increases the financial pressure on health and welfare [3]. The amount of health expenditures will depend essentially on the burden of disease, which can be reduced by investments in the prevention and treatment of people throughout their lives, in late life [3, 4]
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