Epidemiological analysis of infectious diseases in older people in China from 2014 to 2022: a population-based study.

Background: The whole world is undergoing an unprecedented rapid population aging, and the accompanying threat of infectious diseases epidemic among the older people will pose a serious challenge to the national public health. Methods: We extracted individual data on 21 notifiable infectious diseases (NIDs) among individuals aged ≥60 years from the Chinese Infectious Disease Surveillance and Control Project (CISDCP) from 2014 to 2022 in the mainland of China. We comprehensively analyzed the epidemiological characteristics of NIDs in older people and estimated the impact of age, year, and the COVID-19 pandemic. Findings: A total of 8,604,064 cases of 21 major NIDs were reported, with an overall annual incidence of 362·10/100,000. Sexually transmitted or bloodborne diseases (STBDs, 45·23%) were the most common diseases. Notably, ranking of syphilis rose from fourth to third, while HIV/AIDS moved from eighth to seventh; respiratory diseases (34·88%) showed sustained declines. Tuberculosis remained the most common respiratory diseases despite a 6·4% annual decline (APC, P < 0·001); gastrointestinal or enteroviral diseases (GEDs, 18·35%) showed sustained declines, except for infectious diarrhea and hepatitis E; vector-borne or zoonotic diseases (VBZDs, 1·54%) remained low, though brucellosis increased during COVID-19 pandemic. Inflection point analysis revealed that 13 diseases, such as tuberculosis, infectious diarrhea, hepatitis B, and others, exhibited a quadratic distribution (inverted "V" shape) in age-specific incidence as age increased. Difference was noticeable between regions, with the older people in Inner Mongolia-Xinjiang region and South China region continuing to carry a disproportionate burden from NIDs. Interpretation: Although China's success in infectious disease control in older people. Effective prevention and control strategies are needed for highest incidence diseases, such as tuberculosis, hepatitis B, and infectious diarrhea, especially in high-incidence regions and among critical age points. Funding: National Major Research & Development Program of China (2022YFC2604000).