leading causes of death in older persons (60+)
Changing health profiles related to changing age structure profiles
As populations age, there are usually changes in the health profiles of those populations as well. In a relatively young population, infectious, parasitic and nutritional disease tend to predominate. As the population ages, however, the health profile changes to one where chronic conditions due to degenerative and non-communicable disease become more of a burden.1
As individuals age, the process is often associated with increased disease and disability. This is supported by morbidity and cause of death statistics, showing that disease and disability are usually more common among older than younger people, and that the prevalence of disability and chronic disease increases with advanced age.2
Large mortality burden from non-communicable disease in older ages
While the total South African population is affected by a combination of injuries, HIV/AIDS, other communicable diseases and non-communicable diseases, the major cause of death in the older population is non-communicable (or chronic) diseases. These diseases were responsible for an estimated 84% of older person deaths in the year 2000. Figure 1 below, which shows the leading 20 causes of death in older men and women, highlights the significant chronic disease burden in the older population.
Single causes of death
Ischaemic heart disease and stroke were the two leading single causes of death, with the order for men and women reversed. These two conditions accounted for almost a third of deaths in the older population. Whereas hypertensive heart disease was responsible for more than double the proportion of deaths among women compared to men, chronic obstructive pulmonary disease accounted for almost double the proportion of deaths among men compared to women.
Large numbers of death were from malignant neoplasms or cancers, and the ranking for specific cancers differed between men and women. In men, lung cancer was the leading cause of cancer deaths, followed by prostate, oesophageal, stomach, liver and colo-rectal cancer. In women, breast cancer was the leading cause of cancer deaths, followed by lung, cervix, oesophageal and colorectal cancer.3
When grouping these single causes of death together in disease categories, cardiovascular disease is the primary cause of death, accounting for 43% (over 62 000) of the deaths in persons 60+. Malignant neoplasms (16%) is the second-largest category, followed by respiratory disease (10%), infectious/parasitic diseases excluding HIV/AIDS (8%) and diabetes mellitus (6%). Unintentional and intentional injuries are respectively the 9th and 11th largest categories.
- Omran A. The epidemiological transition: A theory of the epidemiology of population change. Milbank Memorial Fund Quarterly, 1971; 49: 509-538.
- Joubert JD, Bradshaw D. Population ageing and its health challenges in South Africa. Forthcoming chapter in an MRC Technical Report, 2006.
- Joubert JD, Bradshaw D. Health of older persons. In: Ijumba P, Day C & Ntuli A. (Eds). South African Health Review 2003/04. Durban: Health Systems Trust; 2004.