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Special Article - Deaths of Older Persons (Dec, 1999)
(b) Projections are based on Series K from the ABS Population Projections 1997-2051(Cat. no. 3222.0).
(c) Age-standardised using the Australian total estimated resident population at 30 June 1991 as standard
TRENDS IN DEATH RATES
Driving the increase in life expectancy of older males and females since the early 1970s has been the marked and sustained decrease in death rates of older persons. There has been a 2% annual average decline in death rates of older persons since 1968. Around 70% of this decline can be attributed to reductions in death rates from ischaemic heart disease and stroke, which have in turn resulted from improved medical treatments and reductions in certain risk factors (AIHW, 1999).
Sex and age
As in all other age-groups of the population, older males have a higher death rate than females. In 1998, the older male death rate was 56% higher than for females (50 male deaths and 32 female deaths per 1,000 population). However, the male-female differential tends to narrow progressively with age. In 1998, males aged 65–69 years had death rates 92% higher than females at the same ages, while males aged 85 years and over had deaths rates only 23% higher than those for females.
The improvement in mortality rates for older people over the last 30 years was most marked at the younger ages within this population. Death rates for those aged 65–69 years decreased by 54% (from 33 to 15 deaths per 1,000 population) between 1968 and 1998, while the for persons aged 85 and over declined by 39% (from 240 to 146 deaths per 1,000 population). Reductions in ischaemic heart disease deaths produced around 54% of the decline in 65–69 years deaths, with a further 20% coming from reductions in deaths from stroke. In contrast, among the oldest old population reductions in stroke deaths and ischaemic heart disease deaths have each contributed around 29% of the total decrease in death rates.
Leading causes of death
Cancer and ischaemic heart disease each accounted for a quarter of all deaths of older people in 1998. On an age standardised basis however, cancer was the leading cause with 1033 deaths per 100,000 population, while ischaemic heart disease followed with 970 deaths. Cancer was the major cause of death at ages less than 80 years, while ischaemic heart disease was dominant at ages 80 years and over.
Among older males, lung cancer was the most common cancer-type death in 1998 with 359 deaths per 100,000 males, down from 410 deaths in 1988. This was followed by prostate cancer deaths which declined from 251 to 241 deaths per 100,000 males.
Breast cancer deaths, the most common cancer cause of death among older females, declined from 116 to 99 deaths per 100,000 females over the 1988–98 period. In contrast, female lung cancer deaths have been increasing rapidly, from 21 deaths to 93 deaths per 100,000 females over the 1968–98 period. In 1998, female lung cancer overtook colon cancer as the second most common cancer-type death.
Deaths from respiratory disease and stroke were the third and fourth leading causes of death for older persons in 1998, each contributing 11% of deaths, while diseases of the digestive system was the fifth leading cause with 3% of deaths.
The latest ABS mortality projections assume that the SDRs of older persons will decline a further 27% by 2051. This would produce a gain in life expectancy of almost three years for 65 year olds at that time. The projected increase in life expectancy, combined with low levels of future fertility are projected to double the proportion of persons aged 65 years and over, from 12% in 1998 to around 24% in 2051. While death rates are projected to decline, the number of deaths of elderly people is projected to be around 270,000 or 2.8 times higher than the number in 1998.
For further information on deaths of older persons and deaths in general see Deaths, Australia, 1998 (Cat. no. 3302.0) released on 29 November 1999.
Australian Institute of Health and Welfare (AIHW) 1999. Heart, stroke and vascular diseases, Australian facts. AIHW Cat. No. CVD 7. Canberra.
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