Dual Health and Economic Burden of Multimorbidity in Aging Populations
13 affiliations
- 1Department of Pharmacy Administration, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- 2Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- 3Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- 4School of Public Health and Management, Ningxia Medical University, Yinchuan, China
- 5Department of Medicine, National University of Singapore, Singapore
- 6Health Policy and Management, School of Public Health, Yale University, New Haven, Connecticut
- 7Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia
- 8Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- 9Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore
- 10Department of Economics, College of Social Science, University of Birmingham, Birmingham, United Kingdom
- 11China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
- 12Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- 13for the Global Aging Multimorbidity Collaboration
Abstract
Importance: Population aging is contributing to rising multimorbidity across physical, psychological, and cognitive domains, yet global evidence integrating health and economic burdens in older adults remains limited.
Objectives: To quantify the global health and economic burden of multimorbidity among adults aged 60 years or older and to assess trends from 2000 to 2023.
Design, Setting, and Participants: This economic evaluation used observational modeling of Global Burden of Disease study 2023 estimates as health inputs and integrated them with macroeconomic, health expenditure, and population data from World Bank Open Data, the World Health Organization Global Health Expenditure Database, and United Nations population data. Health burden analyses covered adults aged 60 years or older in 204 countries and territories from 2000 to 2023, and economic burden analyses covered 180 countries and territories. Data analyses were performed from January 27 to July 22, 2026.
Exposures: Cross-domain multimorbidity spanning physical conditions, psychological disorders, and cognitive disorders, operationalized as 78 multimorbidity combinations.
Main Outcomes and Measures: The main outcomes were years lived with disability (YLDs) per 100 000 population and economic losses. All economic indicators are reported in 2021 international dollars (USD) adjusted for purchasing power parity. Joinpoint regression characterized 2000 to 2023 trends.
Results: From 2000 to 2023, total YLDs increased from 2367.81 (95% uncertainty interval [UI], 1067.67-4969.59) to 2941.68 (95% UI, 1252.99-6816.95) per 100 000 population, while economic losses increased from $80.10 billion (95% UI, 59.60−104.69 billion) to $363.25 billion (95% UI, 264.04−502.74 billion). The highest 2023 YLD rate was observed for osteoarthritis and Alzheimer disease and other dementias (369.87 [95% UI, 163.86-752.23] per 100 000 population), whereas the largest 2023 economic loss was observed for osteoarthritis and anxiety disorders ($48.51 billion [95% UI, 31.68−76.57 billion]). The fastest-growing combination was diabetes, anxiety disorders, and Parkinson disease, with a YLD average annual percentage change (AAPC) of 3.94% (95% CI, 3.79%-4.08%) and an economic loss AAPC of 9.92% (95% CI, 9.69%-10.13%).
Conclusions and Relevance: In this economic evaluation of the global health and economic burden of multimorbidity among adults aged 60 years or older, multimorbidity burden increased worldwide, with economic losses growing faster than YLDs. Heterogeneity across sex, country income groups, and disease combinations, together with divergence between disability and economic burden, suggest that policy priorities for aging populations should consider both health burden and economic vulnerability.
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BibTeX
@article{ji2026dual,
title = {{Dual Health and Economic Burden of Multimorbidity in Aging Populations}},
author = {Wenjing Ji and Jiacheng Zheng and Suzhen Guan and Yang Liu and Xi Chen and Zhuoer Lin and Joan Costa-Font and Reshma Aziz Merchant and Alessandra Guariglia and Chenyan Wang and Sen Xu and Caijun Yang and Mingwang Shen and Minghuan Jiang and Duolao Wang and Yu Fang and Global Aging Multimorbidity Collaboration and Amy Lastuka},
journal = {JAMA Network Open},
year = {2026},
month = oct,
doi = {10.1001/jamanetworkopen.2026.33002},
url = {https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2855576},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Dual Health and Economic Burden of Multimorbidity in Aging Populations
AU - Wenjing Ji
AU - Jiacheng Zheng
AU - Suzhen Guan
AU - Yang Liu
AU - Xi Chen
AU - Zhuoer Lin
AU - Joan Costa-Font
AU - Reshma Aziz Merchant
AU - Alessandra Guariglia
AU - Chenyan Wang
AU - Sen Xu
AU - Caijun Yang
AU - Mingwang Shen
AU - Minghuan Jiang
AU - Duolao Wang
AU - Yu Fang
AU - Global Aging Multimorbidity Collaboration
AU - Amy Lastuka
PY - 2026
DA - 2026/10/21
JO - JAMA Network Open
DO - 10.1001/jamanetworkopen.2026.33002
UR - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2855576
AB - Importance: Population aging is contributing to rising multimorbidity across physical, psychological, and cognitive domains, yet global evidence integrating health and economic burdens in older adults remains limited. Objectives: To quantify the global health and economic burden of multimorbidity among adults aged 60 years or older and to assess trends from 2000 to 2023. Design, Setting, and Participants: This economic evaluation used observational modeling of Global Burden of Disease study 2023 estimates as health inputs and integrated them with macroeconomic, health expenditure, and population data from World Bank Open Data, the World Health Organization Global Health Expenditure Database, and United Nations population data. Health burden analyses covered adults aged 60 years or older in 204 countries and territories from 2000 to 2023, and economic burden analyses covered 180 countries and territories. Data analyses were performed from January 27 to July 22, 2026. Exposures: Cross-domain multimorbidity spanning physical conditions, psychological disorders, and cognitive disorders, operationalized as 78 multimorbidity combinations. Main Outcomes and Measures: The main outcomes were years lived with disability (YLDs) per 100 000 population and economic losses. All economic indicators are reported in 2021 international dollars (USD) adjusted for purchasing power parity. Joinpoint regression characterized 2000 to 2023 trends. Results: From 2000 to 2023, total YLDs increased from 2367.81 (95% uncertainty interval [UI], 1067.67-4969.59) to 2941.68 (95% UI, 1252.99-6816.95) per 100 000 population, while economic losses increased from $80.10 billion (95% UI, 59.60−104.69 billion) to $363.25 billion (95% UI, 264.04−502.74 billion). The highest 2023 YLD rate was observed for osteoarthritis and Alzheimer disease and other dementias (369.87 [95% UI, 163.86-752.23] per 100 000 population), whereas the largest 2023 economic loss was observed for osteoarthritis and anxiety disorders ($48.51 billion [95% UI, 31.68−76.57 billion]). The fastest-growing combination was diabetes, anxiety disorders, and Parkinson disease, with a YLD average annual percentage change (AAPC) of 3.94% (95% CI, 3.79%-4.08%) and an economic loss AAPC of 9.92% (95% CI, 9.69%-10.13%). Conclusions and Relevance: In this economic evaluation of the global health and economic burden of multimorbidity among adults aged 60 years or older, multimorbidity burden increased worldwide, with economic losses growing faster than YLDs. Heterogeneity across sex, country income groups, and disease combinations, together with divergence between disability and economic burden, suggest that policy priorities for aging populations should consider both health burden and economic vulnerability.
SN - 2574-3805
ER -