Changing Patterns of Digestive Disease Mortality in Older Adults in Poland, 2000-2022: Age- and Sex-Specific Trends in Liver Disease Mortality.

Background: The aim of this study was to assess long-term trends in mortality due to digestive diseases among older adults in Poland. Methods: Mortality data for the years 2000-2022 were analyzed for individuals aged ≥65 years. Age-standardized death rates (SDRs) were calculated. Particular attention was paid to liver cirrhosis-related mortality, operationalized according to the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) joined categories K70 and K74. Temporal trends were assessed using joinpoint regression to estimate annual percentage change (APC) and average annual percentage change (AAPC) stratified by sex and age groups (65-74 and ≥75 years). The total number of deaths included in the statistical analysis was 6,645,408. Results: In early old age (65-74 years), the proportion of deaths due to digestive diseases increased in both men (from 3.6% to 5.0%) and women (from 4.1% to 4.5%), while a decrease was observed in late old age (≥75 years). The combined K70/K74-coded liver disease category represented an important component of digestive disease mortality. Among women aged 65-74 years, a significant upward trend in SDR was observed after 2015 (APC 3.5%, p < 0.05), with an increase from 54.7 to 70.8. In men of the same age, SDR remained relatively stable overall (160.5 to 171.6), although mortality due to liver-related diseases increased significantly after 2015 (APC 6.7%, p < 0.05). In older age groups, declining trends were observed until the late 2010s, followed by recent non-significant increases. Conclusions: Mortality patterns for alcohol-related liver disease and hepatic fibrosis/cirrhosis showed particularly unfavorable recent trends in adults aged 65-74 years. These findings highlight the need for continued surveillance and prevention of chronic liver disease in ageing populations.