Visualizing the Cost of Age-Related Disease as Disability Adjusted Life Years
Disability adjusted life years (DALYs) are a statistical construct used in epidemiology to assess the harms caused by disease, particularly the chronic diseases of aging, as these are by far the greatest burden of disease that is inflicted upon the population as a whole. The costs of aging are huge, however they are measured. It is the greatest single cause of human suffering and death, and the economic effects of this constant destruction of human lives and capabilities are sized to match. The greatest good any of us can do in the world as it stands today is to work towards bringing aging under medical control.
Disability-adjusted life years (DALYs) are used globally to quantify the number of healthy years of life lost from the presence of a disease, disability, or injury. The burden of chronic, non-fatal health loss and early mortality is evaluated separately and compared across populations. More studies are needed for understanding how aging is linked with disease. Calculating the years lived with a disease (YLDs) and years of life lost (YLLs) from premature mortality will provide insights into the burden of common health conditions for the growing aging adult population. This information can help to identify which health conditions contribute most to the number of healthy years of life lost for aging adults, thereby informing how healthcare providers and interventions prioritize treatment and prevention efforts. The purpose of this study was to determine the burden of 10 common health conditions for a nationally-representative sample of middle-aged and older adults in the United States.
The principal findings of this investigation revealed that over 1-million years of healthy life were lost for middle-aged and older Americans from the 10 health conditions evaluated over the 16 year study period. Although aging adults were impacted by each health condition, hypertension accounted for the greatest burden; whereas, hip fractures had the lowest number of DALYs. There were 30,101 participants included. Sex stratified DALY estimates ranged from 4092 (fractured hip) to 178,055 (hypertension) for men and 13,621 (fractured hip) to 200,794 (hypertension) for women. The weighted overall DALYs were: 17,660 for hip fractures, 62,630 for congestive heart failure, 64,710 for myocardial infarction, 90,337 for COPD, 93,996 for stroke, 142,012 for cancer, 117,534 for diabetes, 186,586 for back pain, 333,420 for arthritis, and 378,849 for hypertension. In total, there were an estimated 1,487,734 years of healthy life lost from the 10 health conditions examined over the study period.
It is well past time that someone did this, but more needs to be done. There is a demographic disaster awaiting the West unless something is done, and efforts to increase fertility rates have largely failed. My sense is that this study captured less than 10% of the damage to the economy caused by aging. Still, it is an important piece that can be added to more comprehensive models.