Sex-specific global, regional and national burden of dysthymia and major depression disorder in older adults from 1990 to 2021: a systematic analysis of the global burden of disease 2021 study.

Dysthymia and major depression disorder impair the wellbeing of older adults, their families, and communities. Understanding its global disease burden and trends in older adults over 60 is fundamental for policy making. Therefore, we obtained data from Global Burden of Diseases Study 2021 in 204 countries and territories from 1990 to 2021. We calculated the age-standardized prevalence, incidence, disability-adjusted life years (DALYs) rates, and estimated annual percentage change by age, sex, and socio-demographic index (SDI) to assess burden and quantify the temporal trends. We then used spearman correlation analysis to examine the relationship between age-standardized rates and SDI, and adopted a Bayesian age-period-cohort model to predict trends to 2030. In 2021, there were over 67.6 million cases of dysthymia and major depression disorder in older adults globally, with an age-standardized prevalence rate of 6203.2 per 100,000 (95% Uncertainty Interval: 5128.4-7464.5). Age-standardized prevalence, incidence, and DALY rates increased in high-income Asia Pacific and East Asia. Disease burden negatively correlated with SDI levels. A heavier burden was observed in older females consistently across all regions and age groups. Disease burden in older adults peaked at age 60-64 and declined with aging in most but low SDI regions, where an increasement preceded the decline. By 2030, the age-standardized prevalence, incidence, and DALY rates are predicted to increase globally, with a higher projected burden in older females. In conclusion, the allocation of health resources should focus on addressing regional disparities, with special attention to vulnerable groups such as older females in economically disadvantaged regions.