The silent burden of non‐alcoholic fatty liver disease in the elderly: A global burden of disease analysis

Abstract

SummaryBackgroundNon‐alcoholic fatty liver disease (NAFLD) represents a significant health threat worldwide. The growing trend towards an aging population, along with an alarming rise in obesity and diabetes, may have significant implications for the burden of NAFLD.AimTo assess the impact of NAFLD on the elderly.MethodsWe utilised data from the Global Burden of Disease study between 2010 and 2019 to conduct a comprehensive analysis of the prevalence, mortality, and disability‐adjusted life years (DALYs) associated with NAFLD in the elderly (65–89 years), stratified by region, nation, sociodemographic Index and sex.ResultsGlobally, there were an estimated 228 million cases, 87,230 deaths and 1.46 million DALYs attributed to NAFLD in the elderly. Geographically, the Western Pacific region had the highest burden of NAFLD in the elderly. From 2010 to 2019, there was an increasing prevalence rate in all areas, with the most pronounced change observed in the Western Pacific region (annual percentage change (APC) +0.95%, p < 0.001). Over the study period, there was a more rapid increase in NAFLD prevalence in men (APC +0.74%, p < 0.001) than in women (APC +0.63%, p < 0.001). In most regions, death and DALYs rates have declined, with the exception of the Americas, where there was a slight increase (APC +0.25%, p = 0.002 and 0.38%, p < 0.001, respectively).ConclusionOver the past decade, the burden of NAFLD in the elderly has been increasing, necessitating immediate and inclusive measures to tackle the rising burden.

The Surreptitious Burden of Nonalcoholic Fatty Liver Disease in the Elderly in the Asia-Pacific Region: An Insight from the Global Burden of Disease Study 2019

“…In terms of gender differences, our study found that the NAFLD burden was higher in elderly males, consistent with a prior study using the same global database [2]. However, several prior investigations have suggested that in elderly populations, the burden of NAFLD in females either equals or exceeds that in males, potentially due to the protective effects of estrogen waning after menopause [18,19].…”

“…Nonalcoholic fatty liver disease (NAFLD) has been considered a public health concern globally [1,2]. It significantly contributes to the burden of liver cirrhosis, hepatocellular carcinoma, and liver transplantation necessities, subsequently imposing a substantial financial burden on the healthcare system [3].…”

Global and regional burden of alcohol-associated liver disease and alcohol use disorder in the elderly

“…Drawing upon the GBD 2019 data, first, this study acknowledged the inherent limitations tied to the unavailability of MASLD with increased alcohol intake, the attribution of only one etiology for cirrhosis and cancer, and possible confounders that could affect the burden of ALD. 6 , [46] , [47] , [48] , [49] Second, it is critical to recognize that the data from the GBD 2019 preceded the onset of the COVID-19 pandemic, which has been associated with a rise in alcohol consumption worldwide. [50] , [51] , [52] Third, the interpretation of decline in mortality should be considered, as GBD initially calculates total liver mortality and then divides these into five specific causes.…”

From Shadows to Spotlight: Exploring the Escalating Burden of Alcohol-Associated Liver Disease and Alcohol Use Disorder in Young Women

“…Fifth, regarding analyzing ALD-related mortality using the GBD data, it is vital to consider etiology-specific liver deaths within the broader context of total liver deaths. GBD initially calculates the total liver deaths and then allocates them into 5 etiology-specific categories, which include MASLD, ALD, viral hepatitis B, viral hepatitis C, and other causes, using proportional models (13,53,70). According to limited data availability concerning etiological proportions and the decreasing trend in overall liver deaths, primarily due to improved viral hepatitis treatment, there is a possibility that a worsening trend in ALD-related liver mortality might not be fully captured and could be concealed (71).…”