After the epidemiologic transition: a reassessment of mortality from infectious diseases among over-65s in France and Italy

Objectives To assess more accurately the contribution of infectious diseases (IDs) to mortality at age 65 and over. Methods We use cause-of-death data for France and Italy in 2009. In addition to chapter I of the 10th International Classification of Diseases (ICD-10), our list of IDs includes numerous diseases classified in other chapters. We compute mortality rates considering all death certificate entries (underlying and contributing causes). Results Mortality rates at age 65 and over based on our extended list are more than three times higher than rates based solely on ICD-10 chapter I. IDs are frequently contributing causes of death. In France, the share of deaths at age 65? involving an ID as underlying cause increases from 2.1 to 7.3 % with the extended list, and to 20.8 % when contributing causes are also considered. For Italy, these percentages are 1.4, 4.2 and 18.7 %, respectively. Conclusions Publicly available statistics underestimate the contribution of IDs to the over-65s’ mortality. Old age is a risk factor for IDs, and these diseases are more difficult to treat at advanced ages. Health policies should develop targeted actions for that population.