Global and regional burden of alcohol-associated liver disease and alcohol use disorder in the elderly
Pojsakorn Danpanichkul,
Kanokphong Suparan,
Cheng Han Ng,
Disatorn Dejvajara,
Siwanart Kongarin,
Nuttada Panpradist,
Nathorn Chaiyakunapruk,
Mark D. Muthiah,
Vincent L. Chen,
Daniel Q. Huang,
Luis Antonio Díaz,
Mazen Noureddin,
Juan Pablo Arab,
Karn Wijarnpreecha
Affiliations
Pojsakorn Danpanichkul
Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Corresponding authors. Addresses: Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, USA; Department of Internal Medicine, Banner University Medical Center, Phoenix, AZ, 85004, USA. Tel.: +1 602 521 5800 (K. Wijarnpreecha); Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand. Tel.: +1 385 220 4590 (P. Danpanichkul)
Kanokphong Suparan
Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Cheng Han Ng
Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
Disatorn Dejvajara
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Siwanart Kongarin
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Nuttada Panpradist
Global Center for Integrated Health for Women, Adolescents, and Children (Global WACh), Department of Global Health, University of Washington, Seattle, WA, USA
Nathorn Chaiyakunapruk
Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA; IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA
Mark D. Muthiah
Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
Vincent L. Chen
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
Daniel Q. Huang
Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
Luis Antonio Díaz
Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
Mazen Noureddin
Houston Methodist and Houston Research Institute, Houston, TX, USA
Juan Pablo Arab
Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile; Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, ON, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, ON, Canada
Karn Wijarnpreecha
Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, USA; Department of Internal Medicine, Banner University Medical Center, Phoenix, AZ, USA; BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA; Corresponding authors. Addresses: Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, USA; Department of Internal Medicine, Banner University Medical Center, Phoenix, AZ, 85004, USA. Tel.: +1 602 521 5800 (K. Wijarnpreecha); Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand. Tel.: +1 385 220 4590 (P. Danpanichkul)
Background & Aims: Alcohol-associated liver diseases (ALDs) and alcohol use disorder (AUD) pose a global health risk. AUD is underrecognized in the elderly, and the burden of AUD complications, including ALD, may increase with aging populations and rising alcohol intake. However, there is a lack of epidemiological evidence on AUD and ALD in the elderly. Methods: Using the Global Burden of Disease Study 2019, we analyzed the prevalence, mortality, disability-adjusted life years (DALYs), age-standardized rates (ASRs), and temporal change from 2000 to 2019 of ALD and AUD in the overall population and the elderly (65–89 years). The findings were categorized by sex, region, nation, and sociodemographic index. Results: The prevalence rates of ALD in the elderly were higher than those in adolescents and young adults, whereas AUD levels were lower than those in adolescents and young adults. In 2019, there were 9.39 million cases (8.69% of cases in the overall population) of AUD, 3.23 million cases (21.8% of cases in the overall population) of alcohol-associated cirrhosis, and 68,468 cases (51.27% of cases in the overall population) of liver cancer from alcohol among the elderly. ASRs of the prevalence of ALD and AUD in the elderly increased in most regions; on the contrary, ASRs of death and DALYs decreased in most regions. Nevertheless, ASRs of death and DALYs from liver cancer from alcohol increased in many areas. Conclusions: Our findings highlighted the increased prevalence of ALD in the elderly, with a burden of AUD comparable with that in the overall population. Public health strategies on ALD and AUD targeting the elderly are urgently needed. Impact and implications: The burden of alcohol-associated liver disease (ALD) and alcohol use disorder (AUD) is increasing. Advances in healthcare and education have resulted in a remarkable spike in life expectancy and a consequential population aging. Nevertheless, little is known about the epidemiology of ALD and AUD in the elderly. Our study indicates the increasing burden of ALD and AUD in the elderly population, necessitating early detection, intervention, and tailored care to the unique needs and complexities faced by older individuals grappling with these conditions.
