Global, regional, and national burden of major depressive disorders in adults aged 60 years and older from 1990 to 2021, with projections of prevalence to 2050: Analyses from the Global Burden of Disease Study 2021

To estimate the burden of major depressive disorder (MDD) among older adults and project its prevalence through 2050. Using data from the Global Burden of Disease Study 2021, we calculated age-standardized rates (ASRs) for the incidence, prevalence, and years lived with disability (YLDs) of MDD among people aged ≥60 years from 1990 to 2021. Trends were analyzed using average annual percentage changes (AAPCs). Polynomial regressions were utilized to assess the relationship between economic levels and MDD burden. Prevalence of MDD was forecasted to 2050 using a mixed-effects model with Socio-demographic Index as the predictor. Globally, the ASRs for incidence, prevalence and YLDs of MDD in older adults increased annually by 0.24 % (95 % CI: 0.18–0.31), 0.25 % (0.19–0.30), and 0.24 % (0.18–0.30), respectively. The fastest growth was observed in adults aged 60–69 years. The burden of MDD among females was approximately 1.5 times higher than males, although rates grew faster among males. Lower-income countries, particularly in sub-Saharan Africa, exhibited the highest burden and growth rates. By 2050, global MDD cases are projected to reach 97.04 million (95 % uncertainty interval [UI]: 71.27–129.85), with an ASR of 4.53 % (3.33–6.07). The global burden of MDD among older adults has increased since 1990 and its prevalence is projected to continue increasing through 2050. Increments were faster in males, younger-old adults and people living in lower-income countries. Comprehensive and integrated management systems at nation, community and individual levels for MDD among older adults are essential to mitigate this growing burden and promote healthy aging. •The major depressive disorder (MDD) burden in older adults has increased since 1990.•The prevalence of MDD in older adults is projected to be 4. 53 % by 2050.•Rise for the burden of MDD was faster in males, younger-old adults and lower-income countries.