Leading causes of death in older people and old age according to medical certificates of death in Moscow

Abstract

The purpose of the study: to identify and discuss the leading causes of death from diseases in the elderly and senile age based on data from medical death certificates (MCC).
 Materials and methods. From the electronic database of the Main Department of the Civil Registry Office of the Moscow Region (the USR registry office system), all cases were selected in which diseases were indicated as the initial cause of death (PPD) (all codes of external causes, injuries and poisoning were excluded). A total of 109126 cases, aged 60 and older - 90269 (82.7%). 18 groups of PPP were formed (95.2% of deaths from diseases). 40442 (44.8%) MCCs were issued by the Bureau of Forensic Medicine (BSME).
 Results. In total, 50% died in the hospital, 35.7% died at home, and 14.3% died elsewhere. With age, the proportion of MCAs issued by the BSME is growing. 5 leading groups of causes of death 1) COVID-19 - 24.2% (7% MSS issued by BSME), 2) a group of pathologies associated with cognitive impairment and dementia (21.15%; minimum at the age of 60-69 years - 6.02 %, maximum - 100 years and older - 63.5%); 73.8% of MCAs were issued by BSME; 3) HIHD - 18.6% (62.9% of MSIs were issued by BSME), 4) ZNO - 10.7%, 5) CVA - 6.2%. In old age, compared with the elderly, the contribution of such causes as acute forms of coronary artery disease, stroke, hypertension, diabetes mellitus, COVID-19 and others is less. Only 30% of the MSS have part II of the MSS completed. The probability of filling out part II of the MSS is affected by age, place of death and place of issuance of the MSS (in BSME less than in other medical organizations), as well as teaching staff.
 Conclusions: The contribution of individual causes of death changes with age. The results indicate the need for a multidisciplinary consensus in the definition of PPP, especially the leading causes of death, and the participation of attending physicians in the formation of the final diagnosis.