Archives of gerontology and geriatrics · 2026
Trends in the burden of decubitus ulcers among individuals aged 70 years and above in low- and middle-income countries, 1990-2023.
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Huang Jianmin, Lei Dongyan, Yi Xiaying, Wang Zichao
Аннотация
BACKGROUND: Decubitus ulcers significantly impair older adults' health, with the burden escalating in low- and middle-income countries (LMICs) due to rapid population aging. Previous studies have lacked in-depth analysis of long-term trends and socioeconomic impacts specifically for adults aged ≥70 years in these regions.
METHODS: Using Global Burden of Disease 2023 data, we analyzed the incidence, mortality, prevalence, and disability-adjusted life years (DALYs) for decubitus ulcers in adults aged ≥70 years across 129 LMICs (1990-2023). Trend, health inequality, and decomposition analyses, alongside an autoregressive integrated moving average (ARIMA) model, were employed to assess burden drivers and project trends to 2050.
RESULTS: The burden rose markedly from 1990 to 2023. Mortality and DALYs showed the steepest increases, with deaths exhibiting a percentage change (PC) of 370% (estimated annual percentage change [EAPC]=1.17) and DALYs a PC of 330% (EAPC=0.88). Regional heterogeneity was evident: upper-middle-income countries within LMICs (GNI-UM countries) saw the largest increases in cases, whereas low-income countries within LMICs (GNI-L countries) experienced the steepest rises in mortality and DALY rates. Demographic factors were the primary burden driver. ARIMA projections indicated declining incidence and prevalence rates (2024-2050), but rising mortality (7.13 to 8.89 per 100,000; 24.68% PC) and DALY rates (98.90 to 130.37 per 100,000; 31.82% PC).
CONCLUSION: The burden of decubitus ulcers among older adults in LMICs is intensifying, driven mainly by population aging with notable regional variations. Stratified interventions based on economic development are recommended, shifting the focus from reducing incidence to alleviating severity and mortality risk.
METHODS: Using Global Burden of Disease 2023 data, we analyzed the incidence, mortality, prevalence, and disability-adjusted life years (DALYs) for decubitus ulcers in adults aged ≥70 years across 129 LMICs (1990-2023). Trend, health inequality, and decomposition analyses, alongside an autoregressive integrated moving average (ARIMA) model, were employed to assess burden drivers and project trends to 2050.
RESULTS: The burden rose markedly from 1990 to 2023. Mortality and DALYs showed the steepest increases, with deaths exhibiting a percentage change (PC) of 370% (estimated annual percentage change [EAPC]=1.17) and DALYs a PC of 330% (EAPC=0.88). Regional heterogeneity was evident: upper-middle-income countries within LMICs (GNI-UM countries) saw the largest increases in cases, whereas low-income countries within LMICs (GNI-L countries) experienced the steepest rises in mortality and DALY rates. Demographic factors were the primary burden driver. ARIMA projections indicated declining incidence and prevalence rates (2024-2050), but rising mortality (7.13 to 8.89 per 100,000; 24.68% PC) and DALY rates (98.90 to 130.37 per 100,000; 31.82% PC).
CONCLUSION: The burden of decubitus ulcers among older adults in LMICs is intensifying, driven mainly by population aging with notable regional variations. Stratified interventions based on economic development are recommended, shifting the focus from reducing incidence to alleviating severity and mortality risk.