Abstract
INTRODUCTION: Aortic aneurysm (AA) is a life-threatening vascular disease that primarily affects older adults and represents a major global health challenge. However, the global burden of AA among the older adult population and the contribution of environmental lead exposure remain insufficiently characterized. METHODS: Using data from the Global Burden of Disease (GBD) 2021 study, we analyzed the burden of AA among individuals aged ≥60 years. Secondary analyses were conducted for deaths, disability-adjusted life years (DALYs), the age-standardized death rate (ASDR), and the age-standardized DALYs rate at the global level, across five Socio-demographic Index (SDI) groups, 21 GBD regions, and 204 countries. The contribution of lead exposure to AA burden was assessed, and future trends in ASDR and age-standardized DALYs rate were projected for the next 15 years based on trends from 1990 to 2021. RESULTS: Between 1990 and 2021, the global burden of AA among adults aged ≥60 years decreased modestly, although substantial regional heterogeneity persisted, particularly in less-developed regions. Lead exposure contributed disproportionately to the AA burden among older men. Projections based on historical trends indicate that both ASDR and the age-standardized DALYs rate will continue to decline steadily over the next 15 years, with a more pronounced decrease in males than in females. DISCUSSION: Despite overall improvements, the burden of AA among older adults remains unevenly distributed worldwide. Given the notable contribution of lead exposure-especially among older men-region-specific strategies that integrate vascular risk management with environmental lead control are needed to mitigate the impact of population aging and address geographic and sex-related disparities in AA burden.