1990-2021 年中国 60 岁及以上人口应对非传染性疾病的优先事项：基于人口的研究。

IF 12.5 1区医学 Q1 CELL BIOLOGY

Ageing Research Reviews Pub Date : 2024-11-08 DOI:10.1016/j.arr.2024.102574

Yi Dai , Di Teng , Chengshuo Zhang , Haoyu Wang , Yaxin Lai , Shuangning Ding , Yang Han , Lei Dou , Shize Yang , Yue Ma , Bingyang Liu , Ziyu Gao , Liang He , Xu Han , Guofeng Zhang , Qiaobei Li , Qinghong Zeng , Hangjia Liu , Haoran Zhou , Siyu Wang , Yongze Li

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引用次数: 0

摘要

目标：预计到 2040 年，中国每三人中就有一人年龄在 60 岁及以上，超过其他中低收入国家。必须明确老年人的非传染性疾病（NCD）负担和趋势：在这项基于《2021 年全球疾病负担研究》的趋势分析中，我们报告了 1990-2021 年间中国 60 岁及以上老年人口中每 10 万人的非传染性疾病发病率，以及在《2021 年全球疾病负担研究》三个等级中按年龄亚组和性别划分的残疾调整生命年（DALYs）、死亡率和发病率的年均百分比变化（AAPCs）：结果：2021 年，中国老年人非传染性疾病的发病数为 3.82 亿例，导致 2.01 亿 DALYs 和 900 万人死亡。1990-2021 年间，虽然心血管疾病大大降低了残疾调整寿命年数（-1.2 %/年）和死亡率（-1.08 %/年），但 2021 年心血管疾病仍占残疾调整寿命年数（31000/10 万人口[95 % UI 26071-35908]）和死亡率（2025 [1678-2355]）的最大比例。1990-2021 年间，虽然非传染性疾病的总发病率有所下降（-0.01 %/年），但精神障碍的发病率（0.68 %/年）却迅速上升。在所有第 3 级病因中，抑郁障碍导致的残疾调整寿命年数增加最多（0.74%/年），而慢性呼吸道疾病在残疾调整寿命年数（-3.6%/年）和死亡率（-3.6%/年）方面的下降速度最快。每个年龄分组和性别的老年人在非传染性疾病控制方面的优先次序各不相同。2021 年，男性每 100,000 人的非传染性疾病 DALY 率高于女性（96409 [95 % UI 80625-112283] vs. 67112 [56878-77547]），但女性的非传染性疾病发病率高于男性（150276 [139285-163373] vs. 137571 [127439-148789]）。高收缩压已超过固体燃料造成的家庭空气污染，成为导致老年人残疾调整寿命年数的首要风险因素，并且仍然是导致该人群死亡的首要风险因素：结论：中国老年人的非传染性疾病总负担一直在下降和变化。结论：中国老年人的非传染性疾病总负担一直在下降和变化，心血管疾病和慢性呼吸系统疾病的负担大幅下降，而精神疾病的负担则迅速上升。政策需要更新，以反映不断变化的风险状况。目标干预措施应考虑到这一人群的年龄分组和性别差异。

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Priorities in tackling noncommunicable diseases among the population aged 60 years and older in China, 1990–2021: A population-based study

Objective

In China, it is expected that every one in three people will be aged 60 years and above in 2040, surpassing other low- and middle-income countries. The noncommunicable disease (NCD) burden and trends among elderly people must be clarified.

Methods

In this trend analysis based on the Global Burden of Diseases Study 2021, we reported NCDs per 100,000 people and average annual percentage changes (AAPCs) in disability-adjusted life-years (DALYs), mortality, and incidence at three levels of the GBD 2021 hierarchy by age subgroups and by sex in the older population aged 60 years and above in China during 1990–2021.

Results

In 2021, there were 382 million incident cases of NCDs among elderly individuals in China, leading to 201 million DALYs and 9 million deaths in the same year. During 1990–2021, although cardiovascular diseases substantially reduced both DALYs (-1.2 %/year) and mortality (-1.08 %/year), cardiovascular diseases still accounted for the greatest percentage of DALYs (31000 per 100,000 population [95 % UI 26071–35908]) and mortality (2025 [1678–2355]) in 2021. During 1990–2021, while the total incidence of NCDs decreased (-0.01 %/year), the incidence of mental disorders (0.68 %/year) rapidly increased. Among all level 3 causes, depressive disorder caused the greatest increases in DALYs (0.74%/year), while chronic respiratory diseases showed the most rapid decreases in both DALYs (-3.6 %/year) and mortality (-3.6 %/year). The priorities of NCD control in each age subgroup and sex among elderly individuals varied. In 2021, males had a greater DALY rate from NCDs per 100,000 people than females did (96409 [95 % UI 80625–112283] vs. 67112 [56878–77547]), but females had a greater incidence rate of NCDs than males did (150276 [139285–163373]) vs. 137571 [127439–148789]). High systolic blood pressure had surpassed household air pollution from solid fuels as the leading risk factor for DALYs among the elderly, and it continued to be the top risk factor for mortality in this population.

Conclusions

The total NCD burden among elderly people in China has been decreasing and changing. Substantial reductions in cardiovascular diseases and chronic respiratory disease have been observed, while rapid increases in mental disorders has also been found. Policies need to be updated to reflect the changing risk landscape. Target interventions should consider age subgroups and sex differences among this population.

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来源期刊

Ageing Research Reviews 医学-老年医学

CiteScore

19.80

自引率

2.30%

发文量

216

审稿时长

55 days

期刊介绍： With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends. ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research. The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.