Trend analysis on the disease burden among Chinese elderly population aged 60 and older from 1990 to 2019
WEI Xinyue and ZULIYAER Talifu contributed equally to this article
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摘要:
目的 分析1990―2019年中国≥60岁老年人疾病负担变化趋势。 方法 利用2019年全球疾病负担数据库提供的中国≥60岁老年人伤残调整寿命年数据，使用该数据库提供的世界人口数作为标准对其进行标化，采用Joinpoint对数线性回归模型计算平均年度变化百分比，检验其长期变化趋势，分析1990―2019年中国≥60岁老年人疾病负担变化趋势。 结果 1990―2019年中国≥60岁老年人一级病因疾病负担均呈下降趋势，其中传染病所造成的疾病负担下降幅度最大，从1990年的6 079.32/10万下降到2019年的2 056.84/10万；非传染性疾病是造成老年人疾病负担的首要原因，2019年为71 694.02/10万。在三级病因中，结核病疾病负担下降幅度最大；2019年，脑卒中、缺血性心脏病和慢性阻塞性肺疾病，下呼吸道感染和结核病，跌倒、道路伤害和自杀分别是造成非传染性疾病、传染病和伤害疾病负担的主要原因。 结论 非传染性疾病和伤害日益成为中国急需解决的公共卫生问题。应加强对重点疾病(心脑血管疾病、恶性肿瘤、肌肉骨骼疾病等)以及重点人群(男性、≥85岁人群)的防控，通过管理健康风险因素及可改变的行为生活方式预防疾病发生，降低疾病负担。 Abstract:Objective To analyze the trends in the disease burden among Chinese individuals aged 60 years and older from 1990 to 2019. Methods The disability-adjusted life year (DALY) data for Chinese individuals aged 60 and older from the Global Burden of Disease 2019 database, were standardized using world population figures. Long-term trends were assessed using the average annual percent of change calculated by the Joinpoint log-linear regression model to evaluate changes in disease burden among elderly in China over the study period. Results Between 1990 and 2019, the disease burden for all level 1 causes among the elderly in China showed a decreasing trend. The most significant decline was observed in communicable diseases, with the burden decreasing from 6 079.32 per 100 000 in 1990 to 2 056.84 per 100 000 in 2019. Non-communicable diseases (NCDs) were the primary contributors to the disease burden among the elderly, with a rate of 71 694.02 per 100 000 in 2019. Among level 3 causes, tuberculosis showed the most substantial decline. In 2019, stroke, ischemic heart disease, and chronic obstructive pulmonary disease were the leading causes of NCDs; lower respiratory infections and tuberculosis were the main causes of communicable diseases; and falls, road injuries, and suicide were the primary causes of injury-related disease burden. Conclusions Non-communicable diseases and injuries are increasingly becoming urgent public health issues in China. It is essential to strengthen the prevention and control of key diseases (such as cardiovascular diseases, malignancy, and musculoskeletal diseases) and focus on vulnerable populations (men and ≥85-year-olds). Managing health risk factors and modifying lifestyles are crucial for preventing disease onset and reducing the overall disease burden. -
Key words:
- Elderly /
- Burden of disease /
- Disability-adjusted life years /
- Trend analysis
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图 1 中国≥60岁老年人全病因和一级病因性别标化DALY率变化趋势
DALY，伤残调整寿命年。
Figure 1. Trends of standardized DALY rates of all cause and level 1 causes among Chinese people aged 60 years and older by gender
DALY, disability-adjusted life year.
图 2 中国≥60岁老年人全病因和一级病因年龄别标化DALY率变化趋势
DALY，伤残调整寿命年。
Figure 2. Trends of standardized DALY rates of all cause and level 1 causes among Chinese people aged 60 years and older by age group
DALY, disability-adjusted life year.
图 3 1990—2019年中国≥60岁老年人三级病因标化DALY率排名变化情况
DALY，伤残调整寿命年; 实线代表标化DALY率排名上升或不变，虚线代表标化DALY率排名下降。听力下降=与年龄相关的和其他听力下降。
Figure 3. Changes in rankings of standardized DALY rates of level 3 causes among Chinese people aged 60 years and older, 1990 to 2019
DALY, disabilit adjusted ife year; Solid lines are inreases or no changes in rank and dashed lies are decreases.Hearing loss =Age-related and other hearing loss.
表 1 中国≥60岁老年人疾病负担变化情况的性别Joinpoint回归分析
Table 1. Joinpoint regression analysis of changes in disease burden among Chinese people aged 60 years and older by gender
变量
Variable平均年度变化百分比 Average annual percent of change/%(95% CI) 全病因
All causes传染病、孕产妇和新生儿疾病、营养不良
Communicable, maternal, neonatal and nutritional diseases非传染性疾病
Non-commuicable diseases伤害
Injuries总体 Both -1.375①(-1.401~-1.350) -3.670①(-3.707~-3.630) -1.315①(-1.341~-1.290) -0.517①(-0.597~-0.445) 女性 Female -1.596①(-1.632~-1.560) -3.923①(-3.956~-3.887) -1.537①(-1.572~-1.502) -0.726①(-0.821~-0.619) 男性 Male -1.182①(-1.211~-1.154) -3.393①(-3.437~-3.346) -1.120①(-1.148~-1.092) -0.231①(-0.297~-0.173) 注：①P < 0.05。
Note: ① P < 0.05.
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表 2 中国≥60岁老年人疾病负担变化情况的年龄别Joinpoint回归分析
Table 2. Joinpoint regression analysis of changes in disease burden among Chinese people aged 60 years and older by age group
年龄组/岁
Age group/years平均年度变化百分比 Average annual percent of change/%(95% CI) 全病因
All causes传染病、孕产妇和新生儿疾病、营养不良
Communicable, maternal, neonatal and nutritional diseases非传染性疾病
Non-commuicable diseases伤害
Injuries60~ < 65 -1.594①(-1.625~-1.565) -3.909①(-3.947~-3.859) -1.537①(-1.562~-1.513) -0.903①(-0.987~-0.822) 65~ < 70 -1.555①(-1.593~-1.521) -3.923①(-3.959~-3.879) -1.502①(-1.542~-1.468) -0.682①(-0.776~-0.595) 70~ < 75 -1.487①(-1.514~-1.460) -4.009①(-4.057~-3.961) -1.176①(-1.631~-0.708) -0.536①(-0.603~-0.457) 75~ < 80 -1.383①(-1.411~-1.352) -3.859①(-3.896~-3.820) -1.319①(-1.345~-1.288) -0.400①(-0.477~-0.321) 80~ < 85 -1.185①(-1.237~-1.128) -3.568①(-3.631~-3.490) -1.109①(-1.154~-1.057) -0.137①(-0.254~-0.035) 85~ < 90 -0.912①(-0.949~-0.873) -3.040①(-3.097~-2.986) -0.844①(-0.878~-0.808) 0.322①(0.271~0.373) 90~ < 95 -0.940①(-0.991~-0.890) -2.701①(-2.759~-2.639) -0.904①(-0.946~-0.860) 0.779①(0.723~0.831) ≥95 -0.787①(-0.829~-0.742) -2.301①(-2.339~-2.258) -0.629①(-0.854~-0.399) 1.537①(1.493~1.577) 注：①P < 0.05。
Note: ① P < 0.05.
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