What do the very old die from?
Australia has one of the highest life expectancies at birth in the world (OECD 2023). The median age of death in 2022 was 79.7 years for males and 85.0 years for females (AIHW 2024). About 4 in 10 deaths (41%) in 2022 occurred at age 85 or over and this proportion has been slowly increasing over time. Older Australians (85 years or more) die from more chronic disease and age-related conditions and events than younger Australians.
Among older Australians:
- dementia and coronary heart disease were the 2 most common causes involved in causing death, and the 2 most common underlying causes.
- infections, cardiac/respiratory arrest, and heart failure were consistently common direct causes.
- hypertension and dementia were the 2 most common causes contributing to death (Figure 7.1).
The high prevalence of comorbidity with cardiovascular diseases in Australia is recognised (AIHW 2023), and in 2022 half of the leading contributory causes of death at ages 85 and over were cardiovascular-related. In these age groups, diabetes and dementia were also among the most common contributory causes and dementia was among the 10 leading direct causes. This highlights the different roles that these conditions play in causing death.
Figure 7.1: Most common causes of death, persons aged 85 years or more, by cause type and age group, 2022
Cardiovascular conditions make up 5 of the 10 most common causes involved in deaths across all older age groups. Other cardiovascular conditions also commonly contributed to death across all age groups. These include coronary heart disease, atrial fibrillation, cerebrovascular disease, and heart failure. Diabetes was also mentioned cross all age groups as a contributory cause of death.
Notes
- Deaths registered in 2022 are based on the preliminary version and are subject to further revision by the Australian Bureau of Statistics.
- Each death can involve one or more multiple, direct or contributory cause. As a result, the total percentage by a cause type can be greater than 100.
- See Psychosocial factors contribute to death for a description of circumstances included in psychosocial factor groups.
Source: AIHW National Mortality Database; Table S7.1.
‘Old age’ is a common cause of centenarian deaths
‘Old age’
The use of terminology such as ’old age’, ‘frailty’ and ‘senility’ written alone on the medical death certificate should be used in limited circumstances as these terms do not provide insight into the medical cause of death and can be viewed as ageist (WHO 2022). To better align with the WHO Healthy Ageing framework, senility has been replaced with ‘Ageing associated decline in intrinsic capacity’ in the next revision to the International Classification of Diseases (ICD) (Rabheru et al. 2022).
People in the oldest age groups frequently have ill-defined age-related causes including senility (a proxy for ‘old age’) or frailty as a cause of death.
Among centenarians, senility was involved in causing 17% of deaths, was the most common direct cause (in 11% of deaths) and was a leading underlying and contributory cause. Frailty was also most commonly involved in deaths at older ages: as a leading contributor and as a leading direct cause from age 90 or over.
AIHW (Australian Institute of Health and Welfare) (2023) General Record of Incidence of Mortality (GRIM) books, AIHW, Australian Government, accessed 10 April 2024.
AIHW (2023) Heart, stroke and vascular disease: Australian facts, AIHW, Australian Government, accessed 11 April 2024.
Organisation for Economic Cooperation and Development (2023) Health at a Glance 2023: OECD Indicators, OECD Data website, accessed 08 April 2024.
Rabheru K, Byles JE and Kalache A (2022) ‘How “old age” was withdrawn as a diagnosis from ICD-11’, The Lancet Healthy Longevity, 3(7): E457–E459, doi:10.1016/S2666-7568(22)00102-7.
WHO (World Health Organization) (2022) Fact sheet: Ageing and health, WHO, accessed 19 April 2024.