Global burden of aortic aneurysm in adults aged 60 and older from 1990 to 2021 and projections to 2040: based on the Global Burden of Disease Study 2021

Background Aortic aneurysm (AA) represents a serious health threat to human survival, especially affecting older adults. Despite its substantial disease burden, AA remains understudied in the global elderly population. This study aims to characterize this demographic group to elucidate temporal trends in AA-related disease burden. Methods Leveraging data from the Global Burden of Disease Study 2021 (GBD 2021), this investigation assessed epidemiological metrics of aortic aneurysms (AA), encompassing: the number of deaths, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR). We assessed AA-related disease burden across geographical regions, Social Development Index (SDI) quantiles, age groups, gender, and temporal trends. Additionally, Future disease burden trajectories of AA were forecasted via the Bayesian age-period-cohort (BAPC) model. Results In 2021, the number of deaths, ASMR, DALYs and ASDR, were 130, 159.84 (95% UI: 114,175.98 to 141,843.38), 12.65 per 100,000 population (95% UI: 11.03 to 13.80), 2,120,661.13 (95% UI: 1,904,410.65 to 2,303,247.25) and 199.66 per 100,000 population (95% UI: 178.72 to 217.24). During 1990–2021, global deaths and DALYs attributable to AA showed increasing trends, whereas ASMR and ASDR demonstrated significant declines. The calculated estimated annual percentage changes (EAPCs) were − 1.39 (95% confidence interval: -1.50 to -1.29) for the ASMR and − 1.52 (95% CI: -1.63 to -1.42) for the ASDR. Among the 5 SDI regions, the most pronounced declines in ASMR and ASDR occurred in high SDI regions, whereas low-middle SDI regions exhibited the most substantial increases. Stratified by age and gender, males aged over 60 years exhibited declines in ASMR and ASDR across all age groups, whereas females showed similar reductions except in the 95 + age group. The BAPC model predicts increased ASMR and ASDR for the elderly AA by 2040. Conclusions From 1990 to 2021, the global burden of AA among the elderly has declined overall, particularly in high SDI regions and among males. However, future projections suggest a potential reversal of this trend under the current model assumptions. These findings highlight the importance of considering the development and implementation of targeted screening and early intervention strategies for high-risk populations.