Regional and sex-based trends in brain and CNS cancer mortality, DALYs, and YLLs among adults aged 70+ years: A Global Burden of Disease 1980-2021 analysis.

250 Background: Older adults face a growing burden from chronic and age-related diseases. This study examines global and regional trends in mortality and disease burden due to brain and central nervous system (CNS) tumors among adults aged 70 and older. Methods: Data were extracted from the Global Burden of Disease Study (1980-2021). Metrics included age-standardized death rates (ASDR), disability-adjusted life years (DALYs), and years of life lost (YLL). Analyses were stratified by World Bank regions and sex. Linear regression models were used to calculate average annual percentage change and assess temporal trends. Results: Between 1980-2021, ASDRs among individuals aged 70+ increased globally by 6.3% (from 137.5 to 146.2 per 100,000). The largest increase occurred in Europe & Central Asia (+1.36% annually across sexes, p < 0.001), followed by Latin America & the Caribbean (+1.17% in males and +1.22% in females, p < 0.001). Whereas ASDRs declined the most in South Asian females (−0.26% per year, p = 0.012), with other groups showing minor/non-significant trends. DALYs, measured as a percentage of total disease burden, rose steadily worldwide (+1.75% per year, p < 0.001), with the steepest increases in Europe & Central Asia (+2.65% annually), followed by Latin America & Caribbean (+2.44%). Moderate but significant gains were seen in the Middle East & North Africa, East Asia & Pacific, and North America (+1.93%, +1.75%, and +1.34% respectively). North American and South Asian females showed the least increase (+1.04% and +1.08%) (p < 0.001). Given the high fatality of brain and CNS tumors in this age group, YLL trends mirrored those of DALYs across all regions and sexes, reflecting the contribution of premature mortality to the disease burden. Conclusions: Despite greater healthcare resources, high-income regions had the sharpest increase in brain/CNS tumor burden, especially among older men. Slower but rising trends in lower-income regions, with some stability among women, highlight the need for equity-driven, gender-aware strategies to improve care quality and outcomes globally. Key findings. Region Income Group ASDR Annual % Change (Both Sexes) DALY Annual % Change (Both Sexes) YLL Annual % Change (Both Sexes) Sex Difference in Trends Europe & Central Asia High 1.37 2.65 2.65 M > F Latin America & Caribbean Upper-Middle 1.18 2.44 2.44 F > M Middle East & North Africa Upper-Middle 0.52 1.93 1.93 M > F East Asia & Pacific Upper-Middle 0.39 1.75 1.75 F > M North America High -0.11 1.34 1.34 M > F South Asia Lower-Middle -0.36 1.16 1.16 F decline, M flat Sub-Saharan Africa Low -0.23 1.14 1.14 F decline, M flat