Global, regional, and national trends in dengue incidence, mortality, and disability burden among adults aged 70 years and above: an analysis from the global burden of disease study 2021

BACKGROUND: Dengue remains a significant public health threat, yet the disease burden among the elderly has remained poorly quantified. This study aims to analyse the spatiotemporal trends in the dengue burden among the elderly at global, regional, and national levels from 1990 to 2021. METHODS: Data on the dengue burden were obtained from the Global Burden of Disease (GBD) 2021 study. This study described the incident cases, deaths, disability-adjusted life years (DALYs), and corresponding rates for dengue among adults aged 70 years and above in 1990 and 2021 by sex, age, socio-demographic index (SDI), GBD region, and country. Joinpoint regression analysis was employed to assess the temporal trends in dengue burden from 1990 to 2021. RESULTS: Between 1990 and 2021, the global incidence and DALYs rate of dengue among the elderly were lower than those in the entire population, whereas the mortality rate remained consistently higher. During this period, the incident cases, deaths, and DALYs for dengue worldwide increased by 372.69%, 439.15%, and 404.06%, respectively. In 2021, the global incidence, mortality, and DALYs rates of dengue among the elderly were 666.10, 1.28, and 23.92 per 100 000 population, respectively. From 1990 to 2021, the incidence, mortality, and DALYs rates of dengue showed an overall upward trend, with average annual percentage changes of 2.11 (95% confidence interval [CI]: 1.88-2.35), 2.58 (95% CI: 2.02-3.14), and 2.35 (95% CI: 2.20-2.69), respectively. Regionally, the highest incidence, mortality, and DALYs rates occurred in low-middle SDI regions. The highest dengue burden was primarily concentrated in Tropical Latin America, South Asia, and Southeast Asia. CONCLUSIONS: The dengue burden among adults aged 70 years and above has significantly increased over the past three decades, with substantial variations across SDI levels, regions, and countries. Targeted measures, including developing clinical management guidelines, enhancing vaccine research, and conducting community education, are urgently needed to reduce the burden in this vulnerable population.