As Australians live longer, we are seeing changes in our leading causes of death. Diseases associated with old age are taking over from previous leading causes such as heart disease. Glenn Capuano investigates the connections between our changing age profile causes of death.
In October last year, the ABS released the number of deaths and cases data for the 2023 year. Notably, the death rate is at an all time low; life expectancy at birth is close to a record high of 81 for men and 85 for women. Long term this is continuing to increase, and our population forecasts now factor this in. (Expect to see large increases in the 85+ population in most areas as a greater share of population reach these age groups, and the baby boomers enter their senior years.)
Life expectancy has risen by about 4 years for females and 6 years for males since the 1990s, but women still live longer than men on average.
This change in life expectancy skews the main causes of death towards illnesses and conditions of old age. For many years, heart disease and cancer have been our leading causes of death in Australia. Just recently, Dementia (and Alzheimer's) has risen up the causes list, and likely will become our leading cause of death soon – perhaps as early as next year.
Top 20 causes of death
Below are the top 20 leading causes of death in 2023, adding up to the 183,000 deaths recorded in the year (down about 7,000 from the previous year).
| Cause of death and ICD-10 code |
2023 |
Median age at death |
| Ischaemic heart diseases (I20-I25) |
16,922 |
83.4 |
| Dementia, including Alzheimer's disease (F01, F03, G30) |
16,685 |
88.7 |
| Cerebrovascular diseases (I60-I69) |
9,359 |
85.4 |
| Malignant neoplasm of trachea, bronchus and lung (C33, C34) |
8,976 |
75.2 |
| Chronic lower respiratory diseases (J40-J47) |
8,359 |
80.2 |
| Diabetes (E10-E14) |
5,942 |
81.6 |
| Malignant neoplasm of colon, sigmoid, rectum and anus (C18-C21, C26.0) |
5,495 |
77.9 |
| Malignant neoplasms of lymphoid, haematopoietic and related tissue (C81-C96) |
5,121 |
79.1 |
| COVID-19 (U07.1-U07.2, U10.9) |
5,001 |
86.3 |
| Diseases of the urinary system (N00-N39) |
4,533 |
87 |
| Accidental falls (W00-W19) |
4,105 |
87.4 |
| Heart failure and complications and ill-defined heart disease (I50-I51) |
4,022 |
88.8 |
| Malignant neoplasm of prostate (C61) |
3,726 |
82.9 |
| Malignant neoplasm of pancreas (C25) |
3,724 |
75.6 |
| Malignant neoplasms of breast (C50) |
3,259 |
74.3 |
| Intentional self-harm [suicide] (X60-X84, Y87.0) |
3,214 |
45.5 |
| Influenza and pneumonia (J09-J18) |
2,886 |
88 |
| Cardiac arrhythmias (I47-I49) |
2,718 |
89.5 |
| Hypertensive diseases (I10-I15) |
2,684 |
88.3 |
| Cirrhosis and other diseases of liver (K70-K76) |
2,556 |
65.5 |
| All causes |
183,131 |
82 |
Source: Australian Bureau of Statistics, Causes of Death, 2023
This is not light reading – partly because of the difficult subject matter, and partly because some of the terms may not be immediately familiar if you're not a medical specialist. But it is important. They also use a rather complicated classification that you may need a medical degree to understand. Fortunately, the main titles are reasonably self evident. Less obvious is why certain things are grouped together and others are not.
You can see from this list, that dementia/Alzheimer's is only a few hundred deaths behind heart disease as our leading cause of death. Ten years ago, heart disease was responsible for about double the number of deaths of dementia; now, heart disease has fallen and dementia increased.
This change is clearly age-related. With our increased life expectancy, it's diseases of old age that are the main causes of death. (And there's no such thing as dying of "old age", of course – there's always an underlying cause.) Dementia has one of the highest ages at death of any of the primary causes: 88.7 years is the median, which is beyond life expectancy at birth. Of course, any of these diseases can have early onset, but the average is much older.
Dementia is also the most female-skewed of the main causes, with 63% female. This is because dementia is a disease primarily of old age, and females have a longer life expectancy.
Also worth mentioning is COVID-19. This was the 3rd largest cause of death in 2022, and dropped to 9th in 2023, with about half the number of deaths attributed to it as the previous year, and around double those attributed to influenza and pneumonia. As well publicised, COVID-19 is also mainly a killer of the elderly, with the average age of COVID-19 deaths being 86.3.
The only cause of death in the list with a significantly younger median age is "Intentional self-harm" (suicide), with a median age of 45.5. This entry always attracts a lot of attention and analysis because it is the most prevalent of the "preventable" causes of death (which also includes things like accidents and falls, motor vehicle crashes etc). Tragically, 3,214 deaths by suicide were recorded in 2023, and it was the leading cause of death among all people aged 15 to 44. It is also the most male-skewed of the causes of death, with 75% being males.
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What I'm not quite sure of (again, not being a medical specialist) is why the deaths from Cancer are split up into multiple categories. In the data these use the medical term "Malignant neoplasms", and the different types (eg. breast, lung, colon, prostate) - are all shown separately. If you add these all together the numbers come to over 30,000, which is nearly twice as many as heart disease (but also heart failure and cardiac arrhythmia are shown separately to heart disease as well). So that probably shows the limit of my knowledge of medicine, but also makes it hard to see what the leading causes of death are, as so much depends on the classification.
Australia's changing demographics
A look at the causes of death gives an insight into the impact of changing demographics in Australia. Overwhelmingly it shows the effect of an ageing population. .id's national population forecasts now show the population aged 85+ being the largest increasing age cohort, rising from about 530,000 people in 2021, to 1.3 million by 2041. Of course this is due to longer life expectancy, but it will also skew the causes of death further in to those diseases of old age, and have an impact on the services we need to provide as a society to the population with long-term health conditions related to age.
Learn more about our National Population Forecasting Program.
