The burden of premature mortality among older adults: a population-based study in Malaysia

Background The populations of many countries-including Malaysia-are rapidly growing older, causing a shift in leading causes of disease and death. In such rapidly ageing populations, it is critical to monitor trends in burden of disease and health of older adults by identifying the leading causes of premature mortality and measuring years of life lost (YLL) to these. The objective of this study, therefore, is to describe the burden (quantified by YLL) associated with major causes of premature mortality among older adults in Malaysia in 2019. Methods All deaths that occurred in older adults aged 60 and above in Malaysia in the year 2019 were included in this study. YLL was calculated by summing the number of deaths for the disease category at 5-year age intervals, multiplied by the remaining life expectancy for the specific age and sex group. Both life expectancy and mortality data were obtained from the Department of Statistics Malaysia. Results In 2019, older adults accounted for 67.4% of total deaths in Malaysia (117,102 out of 173,746). The total number of YLL among older adults in Malaysia in 2019 was estimated at 1.36 million YLL, accounting for 39.6% of the total YLL (3.44 million) lost to all premature deaths in that year. The major causes of premature mortality among older adults were ischaemic heart disease (29.5%) followed by cerebrovascular disease (stroke) (20.8%), lower respiratory infections (15.9%), diabetes mellitus (8.1%) and trachea, bronchus and lung cancers (5.0%). Conclusions Non-communicable diseases (NCD) remained the largest contributor to premature mortality among older adults in Malaysia. Implementation of population-level NCD health promotion programmes, screening programmes among high-risk groups and holistic intervention programmes among populations living with NCD are critical in reducing the overall burden of premature mortality.