Older Australia at a glance

In Australia between 2014 and 2016, there were over 380,000 deaths of people aged 65 and over (82% of all deaths). Only 1 in 5 (19%) of these deaths were of people aged 65–74 (32% aged 75–84, 41% aged 85–94 and 8% for people aged 95 and over). The leading cause of death for all older Australians was coronary heart disease—51,600 deaths between 2014 and 2016, followed by dementia and Alzheimer disease (37,400 deaths), cerebrovascular disease (29,800), chronic obstructive pulmonary disease (19,500) and lung cancer (19,200) [1].

Coronary heart disease was also the leading cause of death in each age group, except for those aged 65–74, whose leading cause of death was lung cancer (Figure 1). Dementia and Alzheimer disease featured as the second leading cause of death among people aged 75 and older.

Coronary heart disease

Coronary heart disease (CHD) is the leading cause of death of older Australians; it accounted for 13% of all deaths in people aged 65 and over between 2014– 2016 [1]. The sex distribution for older Australians who died from CHD changes dramatically between age groups.

Nearly three-quarters (75%) of older Australians who died of CHD aged 65–74 were men. This reduced to 62% for those aged 75–84, 45% for those aged 85–94 and 29% for those aged 95 years and over [1].

Dementia

Dementia is not a single specific disease. It describes a syndrome linked with over 100 different diseases that exhibit impaired brain function [2]. The most common types of dementia are:

• Alzheimer disease (up to 50–75% of cases, although only half of these are thought to be ‘pure’ Alzheimer disease—mixed types of dementia are also common)
• vascular dementia (20–30% of cases), with frontotemporal dementia and dementia with Lewy bodies accounting for around 5% of cases [2].

The type and severity of dementia vary. Dementia is usually of gradual onset, progressive and irreversible. Studies consistently show that people with dementia have an increased risk of death, due to complications and causes directly or indirectly related to dementia [2]. Between 2014–2016, 10% of deaths of people aged 65 and over were due to dementia, with the number of deaths increasing with age, although there was a decline in deaths due to dementia for people aged 95 years and over [1].

AIHW analysis of a range of national and international sources estimates there were 354,000 people with dementia in Australia in 2016, almost all of whom were aged 65 and over (328,000 or 93%). This number is predicted to rise markedly in future—projected to more than double by the year 2046 to around 833,000. As a leading cause of death and burden of disease, the demand that dementia places on health and aged care services is expected to increase considerably over time [2].

Dementia deaths—sex distribution

The sex distribution of the proportion of deaths attributed to dementia in older Australians changed across age groups. In those aged 75 and over, woman have a higher number of deaths from dementia and Alzheimer’s disease than men.

• For people aged 65–74, there was a similar sex distribution for dementia related deaths- 53% of deaths were men and 47% were women
• For people aged 75–84, the proportions were 44% for men and 56% for women
• For those aged 85–94 and those aged 95 and over—in line with the gender differences on life expectancy— fewer deaths were attributed to dementia for men than for women (33% and 67% respectively for those aged 85–94 and 19% and 81% for those aged 95 and over) [1].

Cerebrovascular disease

Cerebrovascular disease is any disorder related to the blood vessels that supply the brain and covering membranes. Stroke is the most common cause of death from cerebrovascular disease. In 2014–2016, 7.8% of all deaths of people aged 65 and over were due to cerebrovascular disease [1].

As expected, the sex distribution for deaths attributed to cerebrovascular disease changes as people age. For those aged 65–74, more deaths were attributed to cerebrovascular disease for men than women (59% for men), and there were similar proportions of deaths attributed to cerebrovascular disease for men and women aged 75–84 (48% for men and 52% for women). For those aged 85–94 and those aged 95 years and over, more deaths were attributed to cerebrovascular disease for women than men. For those aged 85–94, 66% of cerebrovascular attributed deaths were women and for those aged 95 years and over 79% of cerebrovascular attributed deaths were for women [1].

Cancer

Cancer is a diverse group of diseases in which some of the body’s cells can become defective, multiply out of control, and damage tissues around them.

• In 2014, people aged 65 and over were estimated to account for half (58%) of new cancer cases diagnosed (74,393 new cases) [3]
• In 2015, people aged 65 and over accounted for three-quarters (76%) of cancer related deaths (35,153) [3].

Between 2014-16, lung cancer was the most common cause of death from cancer for people aged 65 and over , followed by colorectal, unknown cancers, prostate, pancreatic and breast cancer [1].

The most common type of cancer causing death varies with sex.

Cancer in older men

In 2014–16, the most common types of cancer causing death in older men were lung cancer (around 11,700 deaths), prostate cancer (9,900 deaths) and colorectal cancer (nearly 4,500 deaths) [1]. Deaths from the 6 most common cancers causing death in older men accounted for 19% (35,300) of all deaths of men aged 65 and over (Figure 5).

Cancer in older women

In 2014–16, the most common types of cancer causing death in older women were lung cancer (around 7,500 deaths), breast cancer (5,500 deaths) and unknown or ill-defined cancer (4,800 deaths) [1]. Deaths from the 6 most common cancers causing deaths in older women accounted for 14% (27,100) of all deaths of women aged 65 and over (Figure 5).

Generally, the number of new cases of all types of cancer per 100,000 Australians aged 65 and over have increased over time, peaking in 2008–2009; since then, there has been some decline (Figure 6).

References

1. Australian Institute of Health and Welfare (AIHW) 2018. Deaths in Australia. Canberra: AIHW.
2. Australian Institute of Health and Welfare 2012. Dementia in Australia. Cat. no. AGE 70. Canberra: AIHW.
3. AIHW 2017. Australian Cancer Incidence and Mortality (ACIM) books: All cancers combined. Canberra: AIHW. Viewed March 2018.