Spatiotemporal Analysis of the Burden of Lower Respiratory Infections in the Elderly Population Due to Air Pollution: Trends from 1990 to 2021 and Predictions for the Next 30 Years

Zheng Lei ¹ Ziguo Sun ² Huiyu Li ¹ Ji Luo ¹ Li Zhang ¹ Yuanjun Zhang ^1*

• ¹ ziyang central hospital, Ziyang, China
• ² BaZhong Center Hospital JingKai District Branch, BaZhong, China

Background: Lower respiratory infections (LRI), caused by various pathogens, have significant impacts on global health. Air pollution is a major environmental factor in the development of LRI, and with ongoing urbanization and industrialization, it has become a critical public health concern. The elderly population, with declining immune function and physiological capabilities, exhibits reduced resistance to air pollution, making them a high-risk group for LRI. However, the spatiotemporal trends of LRI burden in the elderly and their association with air pollution remain understudied. This study analyzes the trends in LRI burden from 1990 to 2021 in relation to air pollution and predicts future trends from 2022 to 2050.Using data from the Global Burden of Disease (GBD 2021) database, this study examines mortality rates and disability-adjusted life years (DALY) at global, regional, and national levels from 1990 to 2021. Age-standardized rates (ASR) and estimated annual percentage changes (EAPC) were used to compare burdens across regions and time periods. A Bayesian age-period-cohort (BAPC) model was applied to predict future trends. Data analysis was conducted using R programming to explore differences in burden across genders, age groups, and socioeconomic levels.Results: From 1990 to 2021, the global burden of LRI due to air pollution generally declined, with the largest reduction in household air pollution from solid fuels. Regional differences were observed, with Asia and Africa showing increasing LRI burden from ambient particulate matter, especially in regions with lower socioeconomic development. Gender and age-specific analysis revealed that men and older populations face a higher burden, with the gap widening with age. The burden was negatively correlated with socioeconomic development. Predictions indicate a continued decrease in LRI burden due to secondhand smoke, while the LRI burden caused by ambient particulate matter and household air pollution may experience a rebound around 2035.While the global burden of air pollution-related LRI in older adults has decreased, regions with lower economic development, particularly in parts of Asia and Africa, continue to face high and rising burdens. Efforts should focus on strengthening the resilience of high-risk groups and implementing targeted interventions.