Dementia to become Australia’s biggest killer

Death from heart disease is at its lowest since records began in the 1960s. But dementia is shaping up to be Australia’s biggest killer.

The Australian Bureau of Statistics (ABS) recently released its data on the causes of death in Australia. The median age at death was 82.0 years (79.6 for men, 84.6 for women).

The top five leading causes of death are:

1. Ischaemic heart disease remains the leading cause of death (9.2%). However, it is the lowest standardised death rate for the disease since death statistics were collected in 1968.
2. Dementia.
3. Cerebrovascular disease.
4. Lung cancer.
5. Chronic lower respiratory diseases.

These account for approximately one-third of all registered deaths in 2023.

Back in 2022, COVID-19 was the third-ranked cause of death and has now dropped down to ninth.

Dementia

While mortality rate for ischaemic heart disease has decreased by 87.9% over the past 50 years, the rate of death from dementia has increased by a staggering 842% over this time period. The ABS states that it will become the leading cause of death in coming years.

Dementia, including Alzheimer’s disease, was 250 deaths behind heart disease and accounted for 9.1% of deaths. The median age of people who died from dementia was relatively high at 88.7 years.

“Improved health care and medical interventions for ischaemic heart disease, such as coronary artery bypass grafts and treatment of risk factors such as hypertension and high cholesterol have contributed to reduced mortality,” the ABS said.

With Australia’s ageing population, there are more people aged over 65 years and that is the most common age group to be diagnosed with dementia.

The ABS also noted that there have been changes in the way dementia deaths are certified.

“Dementia is now more likely to be certified by a doctor as having caused death (pneumonia, aspiration pneumonia and urinary tract infections are the most common terminal causes leading to death, which are a result of dementia),” the ABS said.

“This means that dementia is more likely to be tabulated by the ABS as an underlying cause of death.”

“Some of the change in certification may be related to enhanced knowledge of the disease and diagnosis in the community,” the ABS reported.

Accidental falls causing death have risen sharply

Over the last decade, deaths by accidental falls have increased by 70.3%, becoming the 11th leading cause of death, rising from 16th place a decade ago. The median age of death due to accidental falls is 87.4 years. The most common complications resulting from falls include hip fractures, immobility and pneumonia.

Suicide

Suicide was the 16th highest cause of death with a low median age of death at 45.5 years. It causes the highest number of potential years lost compared to any other disease.

The overall median age at death due to suicide was 45.8 years for men and 44.4 years for women.

The ABS reports 83.3% of people who died by suicide had at least one risk factor. The data come from National Coronial Information System — police, pathology, toxicology and coroners’ reports.

“For suicide, a risk factor can be one of many factors including mental health conditions, lifestyle factors, or chronic diseases that can interact and increase the ‘risk’ of suicide,” the ABS said.

The ABS states that a risk factor may have been present in the life of a person who died by suicide but it may not be a direct cause.

Psychosocial risk factors were involved in 67.4% of deaths by suicide.

The ABS reported different risk factors for different age groups, but overall mood disorders (including depression) were the most common risk factor overall for people aged 25–84 years. Suicidal ideation was involved in one in four suicides across all age groups.

Most common risk factors according to age group:

• Overall, mood disorders (including depression) were the most common risk factors overall and in those aged between 25-84 years.
• Under 25 years: suicidal ideation;
• 25 –64 years: problems with employment, relationships and legal circumstances;
• 85 years and above: limited activities due to illness and disability.

Drug and alcohol use

• People aged 25–44 years are most likely to have psychoactive substance use mentioned as a risk factor. It was present in 24.5% of suicides as acute use and intoxication and 28.2% as chronic use and a more common risk factor than acute or chronic alcohol use.
• 37 years was the lowest median age for death due to suicide with acute psychoactive substance use.

If this article has caused you or someone you know distress, please contact Lifeline on 13 11 14 or Beyond Blue on 1300 22 46 36.

Further resources for medical practitioners who need support:

Doctors’ Health in Queensland: https://dhq.org.au/

Doctors’ Health New South Wales: https://doctorshealth.org.au/

Victorian Doctors’ Health Program: https://vdhp.org.au/

Doctors’ Health Advisory Service Western Australia: https://www.dhaswa.com.au/

Doctors’ Health South Australia: https://doctorshealthsa.com.au/

Drs4Drs Tasmania: https://www.ama.com.au/drs4drs/tas

Drs4Drs ACT: https://www.ama.com.au/drs4drs/act

Doctors’ Health Northern Territory: https://doctorshealthnt.com.au/confidential-support