Global Burden of Alcoholic Cardiomyopathy in Adults Aged 60 and Older From 1990 to 2021: A Secondary Analysis of Global Burden of Disease 2021 Data.

BACKGROUND

Alcoholic cardiomyopathy (ACM) poses a significant global health challenge, yet its impact on elderly populations across regions remains underexplored.

METHODS

Using Global Burden of Disease (GBD) 2021 data sourced from the official visualization platform, we analyzed ACM burden among individuals aged ≥ 60 years across 204 countries (1990-2021). Age-standardized rates (ASR) for prevalence, mortality, and disability-adjusted life years (DALYs) were calculated. Trends were assessed via estimated annual percentage change and Joinpoint regression. Future burden (2022-2050) was projected using Bayesian age-period-cohort models. Inequalities were measured using Slope and Concentration Indices, while frontier analysis identified optimization potential.

RESULTS

In 2021, global age-standardized prevalence, mortality, and DALY rates were 19.33, 2.64, and 58.55 per 100,000, respectively, declining since 1990. Eastern Europe exhibited the highest burden (ASDR: 645.87), notably in Hungary, Russia, and Latvia. Males experienced 3-5 times higher rates than females. While Southern Latin America saw substantial declines, the Caribbean observed increases. A positive correlation existed between the Socio-demographic Index (SDI) and ASRs. Decomposition analysis indicated population growth drove prevalence increases, whereas epidemiological improvements reduced mortality. Projections suggest a slight prevalence rise by 2050. Alcohol consumption remained the primary risk factor, especially in high-SDI regions.

CONCLUSION

Although age-standardized ACM burden decreased among the elderly from 1990 to 2021, absolute numbers rose due to population aging and growth. Targeted interventions are needed, particularly in high-burden regions and among males.