# Trend Analysis of Respiratory Disease Mortality in the Population Aged 65 and over in Poland: Results from a Registry Study (2000–2022)

## TL;DR

Respiratory disease mortality in Poland's elderly population shows increasing pneumonia/influenza deaths and sex-specific trends in chronic respiratory diseases.

## Contribution

This study provides detailed sex- and age-specific respiratory mortality trends in Poland from 2000–2022, revealing patterns missed by aggregated international data.

## Key findings

- Pneumonia and influenza mortality increased across all sex and age subgroups in Poland's elderly population.
- Chronic lower respiratory disease mortality declined in older men but increased in women.
- Respiratory mortality trends show distinct sex-specific and age-specific patterns not captured by international aggregated data.

## Abstract

What are the main findings?
Mortality from pneumonia and influenza increased markedly among adults aged ≥65 years in Poland across all sex and age subgroups, despite improvements in chronic respiratory disease management.Mortality from chronic lower respiratory diseases declined among older men but increased among women, reflecting persistent sex-specific epidemiological differences.

Mortality from pneumonia and influenza increased markedly among adults aged ≥65 years in Poland across all sex and age subgroups, despite improvements in chronic respiratory disease management.

Mortality from chronic lower respiratory diseases declined among older men but increased among women, reflecting persistent sex-specific epidemiological differences.

What are the implications of the main findings?
Rising mortality from acute respiratory infections highlights major gaps in vaccination coverage and infection prevention strategies among older adults.Strengthening influenza and pneumococcal vaccination uptake and integrating respiratory care within chronic disease management are essential to reduce avoidable respiratory deaths.

Rising mortality from acute respiratory infections highlights major gaps in vaccination coverage and infection prevention strategies among older adults.

Strengthening influenza and pneumococcal vaccination uptake and integrating respiratory care within chronic disease management are essential to reduce avoidable respiratory deaths.

Background: Respiratory diseases remain a major contributor to mortality in Europe, yet national long-term analyses rarely explore sex- and age-specific temporal patterns in detail. Large international datasets provide aggregated estimates but may obscure country-specific trend changes relevant for public health planning. The aim of the study was to assess long-term trends in mortality from chronic lower respiratory diseases (ICD-10: J40–J47) as well as pneumonia and influenza. (ICD-10: J10–J18) in Poland, with particular emphasis on sex- and age-specific trajectories and joinpoint-defined changes over time. Methods: All deaths among Polish residents aged ≥65 years were analysed using nationwide mortality registry data. Age-standardised death rates (SDRs) were calculated, and temporal trends were assessed using joinpoint regression models to estimate annual percentage changes (APC) and average annual percentage change (AAPC). Results: The proportion of deaths attributable to respiratory diseases increased in both men and women across early (65–74 years) and late (≥75 years) old age. Mortality from chronic lower respiratory diseases declined throughout the study period among men, with the most pronounced reductions observed in the early 2000s, particularly among those aged ≥75 years, while trends among women remained largely stable or showed only gradual declines. In contrast, mortality from pneumonia and influenza rose markedly across all sex and age subgroups, with distinct trend reversals observed after 2008–2009. Conclusions: Long-term respiratory mortality trends in Poland exhibit marked sex- and age-specific differences that are not fully captured by aggregated international analyses. These findings highlight the importance of country-level, stratified assessments when interpreting respiratory mortality patterns and underscore the need for caution when relying on single time-point indicators for risk assessment and policy planning.