Burden of Chronic Obstructive Pulmonary Disease for 70-Year-old Adults and Older in Iran During 1990-2021

Objectives: To comprehensively examine the burden of chronic obstructive pulmonary disease (COPD) among Iranians aged 70 and above, with a focus on gender, age, and provincial differences from 1990 to 2021. Design: Systematic analysis. Outcome measures: Data were derived from the Global Burden of Disease study 2021. Estimates were provided as numbers and age-standardized rates per 100000, accompanied by their 95% uncertainty intervals (UIs). Results: In 2021, COPD had an age-standardized prevalence of approximately 16 thousand per 100000 among Iranians aged 70 and older (95% UI: 13–19 thousand per 100000). This rate increased by 65.2% compared to 1990, which was statistically significant. COPD also accounted for 8,084 deaths in the elderly population of Iran in 2021. Furthermore, the disability-adjusted life year (DALY) rate was 3834.7 per 100000 individuals, reflecting a 6.4% increase from 1990 to 2021. Tehran and Ilam recorded the highest and lowest point prevalence per 100000, at 116000 and 3400, respectively. From 1990 to 2021, every province in Iran experienced a statistically significant increase in age-standardized prevalence rates. In 2021, although men experienced slightly higher deaths and DALYs and women had more prevalent cases, the overall prevalence, mortality, and DALYs related to COPD demonstrated no significant differences between the sexes. Additionally, in 2021, the age-standardized prevalence, mortality, and DALYs attributable to COPD increased with advancing age. Conclusions: The burden of COPD among the elderly in Iran has increased since 1990, paralleling the growth of the elderly population and an increase in COPD-related risk factors. Implementing preemptive measures, raising public awareness, and enacting risk management policies can effectively curb the ongoing rise of COPD in Iran.