The Most Prevalent Causes of Deaths, DALYs, and Geriatric Syndromes in Iranian Elderly People Between 1990 and 2010: findings from the Global Burden of Disease study 2010.
BACKGROUND
The substantial increase in life expectancy during recent decades has left all countries with a high number of elderly people that have particular health needs. Health policy-makers must be aware of the most prevalent causes of deaths and DALYs in this age group, as well as geriatric syndromes, in order to provide appropriate care and allocate resources in an equitable manner.


METHODS
The Global Burden of Disease study 2010 (GBD 2010), conducted by the institute for Health Metrics and Evaluation team, estimated the worldwide burden of diseases from 1990 to 2010. Its estimations were conducted on the basis of the proportion of deaths, the duration of symptoms and disability weights for sequelae, years lived with disability (YLDs), years of life lost (YLLs), and disability adjusted life years (DALYs) attributable to different diseases. In the present study, we extracted the data regarding the top five most prevalent causes of deaths, DALYs, and geriatric syndromes in the elderly based on the aforementioned GBD 2010, discussed the results using some tables and figures, reviewed the results, described the limitations of GBD 2010, and finally provided some recommendations as potential solutions.


RESULTS
According to GBD 2010, the total number of deaths in Iran in 1990 was 321,627, of which 116,100 were in elderly people (those aged 60 years and above), meaning that 36.10% of all deaths occurred in the elderly. Among all diseases in this year, the first to third ranked causes of death were ischemic heart disease (IHD; 29.44%), neoplasms (13.52%), and stroke (7.24%). In comparison, the total number of deaths in Iran increased to 351,814 in 2010, with 213,116 of these occurring in the elderly (60.58% of deaths), but the most prevalent causes of death remained the same as in 1990. The highest 1990 DALYs rates were the result of IHD (21.56%), neoplasms (10.70%), and stroke (4.85%). IHD (22.77%), neoplasms (9.48%), and low back pain (LBP; 5.72%) were the most prevalent causes of DALYs in older Iranian adults in 2010. The fourth and fifth ranked causes of deaths and DALYs in both 1990 and 2010, both in Iran and globally, were different diseases and geriatric syndromes in the elderly Iranian population.


CONCLUSIONS
The aged population of Iran is growing steadily, and there is a need for health policy-makers to create appropriate programs to meet the health needs of elderly people. Although GBD 2010 results are useful in providing burden estimations at regional and national levels, each individual country should estimate its burden of diseases, injuries, and risk factors at a sub-national level to obtain further details regarding the health status of its people. As no comprehensive study regarding elderly people in Iran has previously been conducted, our study will be a major source for identifying the important causes of deaths, DALYs, and geriatric syndromes among this population.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Alireza
A
Namazi Shabestari
2)Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.3)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Sahar
S
Saeedi Moghaddam
4)Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.3)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Farshad
F
Sharifi
Iranian Research Center on Aging, The University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran.
Reza
R
Fadayevatan
Physiology Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Fatemeh
F
Nabavizadeh
Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Alireza
A
Delavari
School of Medicine, Department Of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Hamid Reza
HR
Jamshidi
3)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.9)Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute,Tehran University of Medical Sciences, Tehran, Iran.
Shohreh
S
Naderimagham
D000058:Accidental Falls / Q000401:mortality; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003704:Dementia / Q000401:mortality; D003920:Diabetes Mellitus / Q000401:mortality; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007492:Iran / Q000453:epidemiology; D017116:Low Back Pain / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality; D009369:Neoplasms / Q000401:mortality; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality; D020521:Stroke / Q000401:mortality