Objective To evaluate the disease burden of pulmonary tuberculosis (TB) in the elderly in China from 1990 to 2019, and explore the prevention and treatment strategies of pulmonary TB in the elderly.

Methods According to the results of the Global Burden of Diseases Study 2019, the morbidity, mortality, disability-adjusted life year (DALY), years of lived with disability (YLD) and years of life lost (YLL) of pulmonary TB in the elderly aged 65-89 years in China from 1990 to 2019 were used to evaluate the time, gender and age specific burden of pulmonary TB in the elderly in China, and the results were compared with the data from different regions in the world.

Results From 1990 to 2019, the number of new cases of pulmonary TB in the elderly in China increased from 196300 to 204500 with a growth rate of 4.18%, and the number of deaths of pulmonary TB decreased from 67300 to 21100 with a decrease rate of 68.65%. The age-specific morbidity and mortality rates, the crude morbidity and mortality rates all showed decreasing trends. The age-standardized rate of YLD, YLL and DALYshowed decreasing trends, the average annual percentage change were –2.83%, –7.42% and –6.64%, P<0.05. The DALY rate was highest in age group 75–79 years, the morbidity and mortality rates were highest in age group 85–89 years. Disease burden in men was heavier than that in women. The age-specific morbidity, mortality and DALY rates of pulmonary TB in the elderly were at a moderate level in countries with different socio-demographic index (SDI), but the burden was still high compared with high SDI areas.

Conclusion From 1990 to 2019, the disease burden of pulmonary TB in the elderly in China was still relatively heavy. It is necessary to pay more attentions on the elderly men aged ≥75 years and take more effective prevention and treatment measures.