Older adults aged 75 and over
Figure 1: Contribution of disease groups to total (DALY), non-fatal (YLD) and fatal (YLL) burden, First Nations adults aged 75 and over, 2022
Stacked bar chart showing proportions of burden by disease group. For this age group, most YLL comes from cancer, while most YLD comes from musculoskeletal conditions.
Two-thirds of the burden (66% or 16,329 YLL) among First Nations adults aged 75 and over was due to premature death (fatal burden) (figures 2 and 5). Cancer & other neoplasms (26%), cardiovascular diseases (24%) and neurological conditions (12%) were the main contributors to fatal burden in this age group.
The remaining burden (34% or 8,290 YLD) was due to living with disease or injury (non-fatal burden) (figures 2 and 5), with musculoskeletal conditions (21%), respiratory diseases (17%), and neurological conditions (17%) the main contributors to non-fatal burden in this age group (Figure 1).
Among First Nations adults aged 75 and over the contribution of fatal burden and non-fatal burden to total burden differed greatly for each disease group (Figure 2). Among the highest burden disease groups:
- The burden from cardiovascular diseases, cancer & other neoplasms, and neurological conditions was mostly fatal.
- The burden from musculoskeletal conditions was mostly non-fatal.
- The burden from respiratory diseases was almost evenly split between fatal and non-fatal.
Figure 2: Fatal (YLL) and non-fatal (YLD) burden as a proportion (%) of total burden (DALY), leading 10 disease groups, First Nations adults aged 75 and over, 2022
Source: AIHW First Nations Burden of Disease Database
How does burden differ by sex?
Among First Nations adults aged 75 and over, females experienced a higher proportion of the total burden (56% compared with 44%), non-fatal burden (59% compared with 41%) and fatal burden (55% compared with 45%) than males. These differences may in part be due to there being a considerably greater number of females (57%, or 9,298 people) than males (43%, or 7,093 people) of this age in the population.
Cancer & other neoplasms and cardiovascular diseases were the 2 leading contributors to total burden and fatal burden for both First Nations males and females in this age group, although their rankings and the amount they contributed varied by sex (Figure 3).
Musculoskeletal conditions was the leading disease group contributor to non-fatal burden for First Nations females in this age group, and ranked third for males. Neurological conditions was the leading contributor for First Nations males, and ranked third for females (Figure 3).
Figure 3: Contribution of disease groups to total (DALY), non-fatal (YLD) and fatal (YLL) burden, by sex, First Nations adults aged 75 and over, 2022
Stacked bar chart showing proportional burden splits by sex. For males, cancer was the largest contributor to DALY, while for females it is cardiovascular diseases.
Figure 4: Top 5 specific causes of total (DALY), non-fatal (YLD) and fatal (YLL) burden, by sex, First Nations adults aged 75 and over, 2022
Tile map showing the top specific causes by sex and burden type. For males, coronary heart disease was the largest contributing individual cause of total burden, while for females, it was dementia.
To further explore the top specific causes across all stages of life, see the following interactive data visualisation:
- Dashboard 8: Top specific causes across the stages of life: This visualisation provides the top 5 causes contributing to burden for each age group, by sex.
Changes over time
Overall, the health of First Nations adults aged 75 and over improved slightly over the period 2011 to 2022 (Figure 5).
There was a 3.2% decline in the age-specific rate of total burden between 2011 and 2022 (from 1,552 to 1,502 DALY per 1,000 people). Most of this decline was observed between 2011 and 2018, with an increase from 2018 to 2022.
The decrease in total burden was driven by small reductions in the rate of both fatal burden (3.6% decrease) and non-fatal burden (2.5% decrease) between 2011 and 2022.
Figure 5: Change between 2011 and 2022 in the age-specific total (DALY), non-fatal (YLD) and fatal (YLL) burden rates (per 1,000 people), First Nations adults aged 75 and over
Source: AIHW First Nations Burden of Disease Database
Changes by disease group
Over the period 2011 to 2022, among First Nations adults aged 75 and over, there was a decrease in the age-specific total burden rate for cardiovascular diseases (109 DALY per 1,000 people, or 27%).
Increases in the age-specific total burden rates were observed for:
- infectious diseases, where the rate doubled (an increase of 50 DALY per 1,000), with most of this increase due to the emergence of COVID-19
- respiratory diseases (increase of 21 DALY per 1,000, or 13%)
- neurological conditions (increase of 20 DALY per 1,000, or 10%).
Changes by specific causes
In both 2011 and 2022, the leading causes of total burden remained largely the same among First Nations adults aged 75 and over, although there were changes in the rankings and age-specific burden rates for each cause (Figure 6).
There were decreases in the age-specific burden rate and ranking for:
- coronary heart disease (27% decrease)
- stroke (45% decrease)
- type 2 diabetes (34% decrease)
There were increases in the burden rate and ranking for:
- dementia (14% increase)
- COPD (27% increase)
- chronic kidney disease (28% increase)
COVID-19 was the 7th leading cause of burden among First Nations adults aged 75 and over in 2022.
Figure 6: Changes in ranking and age-specific DALY rate (DALY per 1,000 people), leading specific causes of burden, First Nations adults aged 75 and over, 2011 and 2022
COPD chronic obstructive pulmonary disease.
Notes
- Rheumatoid arthritis was ranked 9th in 2022 with an age-specific rate of 51.7 DALY per 1,000 people.
- An increase in rank over time does not always mean the disease or injury has increased in the population, and vice versa. Therefore, changes in ranking of causes of deaths and disease burden over time should be interpreted with caution.
- Causes are presented in descending order, from highest age-specific rate to lowest age-specific rate, with arrows indicating either an increase (orange) or decrease (blue) in the age-specific rate over time.
- Cause rankings exclude ‘other‘ residual conditions from each disease group; for example, ‘other musculoskeletal conditions’.
- There were changes in practices of coding deaths due to dementia; therefore, caution is recommended when interpreting changes over time for dementia burden.
- For information on colours used for each specific cause, see disease group colours for FNBDS 2022 colour legend.
Source: AIHW First Nations Burden of Disease Database
How big is the gap, and what causes it?
First Nations adults aged 75 and over experienced disease burden at 1.5 times the rate for non-Indigenous adults of this age in 2022 (1,502 compared with 982 per 1,000 people).
For adults aged 75 and over, respiratory diseases was the greatest disease group contributor to the gap (representing 22% of the gap among adults aged 75 and over). Cancer & other neoplasms, cardiovascular diseases and neurological conditions were also important contributors to the gap (representing 16%, 13% and 10% of the gap among adults aged 75 and over, respectively) in this age group (see Figure 5 in Gap in disease burden section).