Global, Regional, and National Sexual Violence Prevalence and Disease Burden in Older Adults from 1990 to 2021: A Systemic Analysis for the Global Burden of Disease 2021 Study

Backgrounds Sexual violence (SV) in older adults is an underrecognized public health issue. As populations continue to age globally, comprehensive evidence on the magnitude, trends, and distribution of SV remains scarce.Objectives We aimed to assess the global, regional, and national burden of SV among adults aged 60 years and older from 1990 to 2021.Methods Data were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) across 204 countries and territories. We examined the prevalence and disability-adjusted life years (DALYs) of SV for older adults aged 60–95 from 1990 to 2021. The estimated annual percentage changes (AAPC) in the age-standardized prevalence rate (ASPR) and DALY rate (ASDR) of SV were calculated to evaluate the temporal trends by sex and Socio-Demographic Index (SDI).Results In 2021, an estimated 20.8 million older adults globally experienced SV, resulting in approximately 134,000 DALYs. The burden increased steadily over the past three decades, with both prevalence and DALYs showing persistent upward trends. Women consistently experienced substantially higher prevalence rates than men. Moreover, the highest burdens were observed in regions with lower SDI, such as parts of Southeast Asia, Oceania, and sub-Saharan Africa, whereas high-SDI regions reported the lowest burdens. A significant inverse correlation between SDI and SV burden was confirmed (ρ = −0.72 for prevalence; ρ = −0.68 for DALYs; both P < 0.001).Conclusions SV among older adults is increasing globally, with women and populations in socioeconomically disadvantaged regions bearing the greatest burden. Targeted prevention, screening, and support strategies are urgently needed to reduce these inequalities and address this growing public health challenge.