Excess mortality in the elderly population of Russia under the COVID-19 pandemic

Russia met the twenty-first century as an actively aging country. Its population is aging more intensively than the residents of 159 countries. Despite the efforts being made to respond to the demographic challenge, the range of problems is quite broad. Russians experience a relatively early onset of diseases associated with old age; in the absence of early diagnosis and timely and effective treatment, they are a threat to disability and death. This situation has been exacerbated by COVID-19. Since the beginning of the pandemic during 2020, almost 90,000 scientific articles devoted to coronaviruses have been published worldwide. The greatest contribution to the number of publications was made by the United States and China, while the proportion of Russian publications was 0.5%. The impact of coronavirus infection not only on health status but also on mortality rates remains to be studied. The impact of coronavirus infection not only on health status but also on mortality rates remains to be studied. An overall view of the pandemic’s impact on these processes, not only by comparing deaths directly attributable to the virus but also by accounting for indirect mortality, can be obtained using the excess mortality rate. At the same time, it is relevant to consider the index depending on age. The purpose of the work was to assess excess mortality in the population of older age groups in Russia under the COVID-19 pandemic and to identify its determinants. Within the framework of the study we used methods of statistical analysis and empirical research (comparison), general logical and analytical methods. The main results of the work are that, based on the statistical data of Rosstat, we calculated the excess mortality for the age groups of the Russian population using the five-year average method, which takes into account the difference between the number of deaths during the pandemic with the average mortality for the previous five years, and provide a rationale for the results. It was found that excess mortality was most pronounced in the elderly population, where the proportion of deaths from coronavirus infection reaches maximum values of the total number of deaths, with rates not exceeding 10%. There is an exponential increase in the third and fourth age groups. The 60+ age group accounts for 83.4% of all deaths from COVID-19. The proportion of deaths from coronavirus infection in the total number of deaths is almost 1.5-2 times higher in the 60+ age group compared to the average age and more than 3.5-5 times higher in the young age group. There are a number of main determinants of increased mortality under the COVID-19 pandemic: all deaths directly related to the infection; delayed necessary medical care during the pandemic; increase in mental disorders; exacerbation of chronic diseases both during the course of COVID-19 and in the post-pandemic period.