The aging population in Sweden: can declining incidence rates in MI, stroke and cancer counterbalance the future demographic challenges?
- 458 Downloads
It is often taken for granted that an ageing population will lead to an increased burden for the health care sector. However, for several diseases of big public health impact the rates have actually come down for a substantial period of time. In this study we investigate how much the incidence rates for myocardial infarction (MI), stroke, and cancer will have to decline in order to counterbalance future demographic changes (changes in population size and age structure) and compare these figures with observed historical trends. Information on incidence rates were obtained from the National Board of Health and Welfare and referred to the total Swedish population. Population projections were obtained from Statistics Sweden. We projected the number of MI events to increase 50–60% between 2010 and 2050. The decline in incidence rates that is required to keep the number of events constant over time is, on average, 1.2%/year for men and 0.9%/year for women, somewhat higher than the trend for the past 10 years. For stroke the corresponding figures were 1.3% (men) and 1% (women), well in line with historical trends. For cancer the results indicate an increasing number of events in the future. Population ageing is more important than population growth when projecting future number of MI, stroke and cancer events. The required changes in incidence rates in order to counterbalance the demographic changes are well in line with historical figures for stroke, almost in line regarding MI, but not in line regarding cancer. For diseases with age dependence similar to these diseases, a reduction of incidence rates in the order of 1–2% is sufficient to offset the challenges of the ageing population. These are changes that have been observed for several diseases indicating that the challenges posed by the ageing population may not be as severe as they may seem when considering the demographic component alone.
KeywordsMyocardial infarction Stroke Cancer Projections Demography Incidence trends Sweden
KM and AA conceived and designed the original protocol. TA and KM analyzed data, KM wrote the first draft to which all authors contributed. No specific funding has been provided for the study. No funders had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Conflict of interest
The authors declare that they have no conflict of interest.
The study has been approved by the regional Ethics committee in Stockholm, Protocol 2011/5:3.
- 2.Bengtsson T, Scott K. The ageing population. In: Bengtsson T, editor. Population ageing—a threat to the welfare state? The case of Sweden. Heidelberg: Springer; 2010.Google Scholar
- 6.Lindgren B, Lyttkens CH. Financing healthcare: a gordian knot waiting to be cut. In: Bengtsson T, editor. Population ageing—a threat to the welfare state? Heidelberg: Springer; 2010.Google Scholar
- 7.National Board of Health and Welfare. Official Statistics of Sweden. Hjärtinfarkter 1987–2008 samt utskrivna efter vård för akut hjärtinfarkt 1987–2009/myocardial infarcions in Sweden 1987–2008. 2010.Google Scholar
- 8.Swedish National Board of Health and Welfare. Official Statistics of Sweden. Cancer incidence in Sweden 2009. http://www.socialstyrelsen.se/publikationer2010/2010-12-17, 2010.
- 9.Statistics Sweden. The future population of Sweden 2009–2060. In: BE51 demographic reports. Stockholm, Sweden; 2009.Google Scholar
- 10.Modig K, Andersson T, Ahlbom A. Sjukdomspanoramat i Stockholm—idag och i framtiden. Rapport nr 2010:25. Stockholm; 2010.Google Scholar
- 12.The Joint European Society of Cardiology/American College of Cardiology Committee. Myocardial infarction redefined–a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. Eur Heart J. 2000;21(18):1502–13.Google Scholar
- 13.National Board of Health and Welfare. Official Statistics of Sweden. Hjärtinfarkter 1987–2007 samt utskrivna efter vård för akut hjärtinfarkt 1987–2008. http://www.socialstyrelsen.se/Lists/Artikelkatalog/Attachments/17858/2009-12-7.pdf.
- 17.Isaksson R-M, Jansson J-H, Lundblad D, Näslund U, Zingmark K, Eliasson M. Better long-term survival in young and first middle-aged women than in men after first myocardial infarction between 1985 and 2006. An analysis of 8630 patients in the Northern Sweden MONICA study. BMC Cardiovasc Disord. 2006;2011(11):1.Google Scholar
- 19.Dudas K, Lappas G, Rosengren A. Long-term prognosis after hospital admission for acute myocardial infarction from 1987 to 2006. Int J Cardiol. 2010.Google Scholar