2014—2019年武汉市老年人自杀死亡率与疾病负担分析

目的分析2014—2019年武汉市60岁及以上老年人自杀死亡率变化趋势,了解武汉市老年人群自杀死亡疾病负担,为开展老年人群自杀干预提供决策依据。方法利用武汉市死因监测信息系统收集的2014—2019年武汉市户籍居民死亡年龄≥60岁的老年人群自杀死亡个案资料。分别计算死亡率、标化死亡率、早死所致损失寿命年(YLL)和平均减寿年数(AYLL)。使用SPSS 26.0软件进行统计分析,采用χ^(2)检验对不同性别与地区间老年人群自杀死亡率进行比较,采用年度变化百分比(APC)进行趋势分析。结果2014—2019年武汉市60岁及以上老年人共报告自杀死亡1010例,自杀粗死亡率介于(7.60~10.77)/10万,老年男性自杀死亡率高于老年女性,农村老年人自杀死亡率高于城市老年人,农村老年人自杀死亡率呈下降趋势。武汉市老年人自杀死亡率整体上随年龄的升高而显著升高,2014—2019年老年男性和老年女性平均自杀死亡率各年龄组之间差异均具有统计学意义(P<0.01或P<0.05)。2014—2019年武汉市老年人自杀死亡YLL率呈先降低后升高的趋势,AYLL整体保持小幅波动,YLL率和AYLL变化趋势均无统计学意义。结论武汉市60岁及以上老年人自杀死亡率较高,尤其是农村老年男性,老年人自杀死亡导致的疾病负担较重,需采取多种针对性措施以预防和减少老年人自杀事件的发生。     

Ageing in the South-East Asian region

The increasing trend in the aging population of countries in the South-East Asia Region (SEAR) transforms these countries from "mature societies" to "aging societies.? The elderly population in this region would be increasing from 18.1% in 1995 to 21.4% of the world elderly population in 2025. Since women have a longer life expectancy than men, the proportion of elderly women in the region would increase to 13.2% by 2025, while the proportion of elderly men would be 11.6%. In SEAR, 11.8 million people reportedly suffered from blindness in 1998; 50-80% of these cases are caused by cataract, which is most common in those aged 60 years and above. Although the aged is one of the most vulnerable population groups, little attention is given to geriatric care. Health services in many countries still focus largely on communicable diseases, maternal care, and child care, rather than on the enormous needs of the elderly population. Care of the elderly should be a priority of the primary health care system, focusing on the promotion of a healthy old-age lifestyle and prevention of behaviors that are hazardous to health.     

Incidence and case fatality rates for acute appendicitis in California. A population-based study of the effects of age

In 1984, 24,794 appendectomies and abscess drainage procedures were performed for acute appendicitis in California hospitals. Analysis of hospital discharge abstracts revealed age- and sex-specific incidence rates and in-hospital case fatality rates for acute appendicitis lower than previously reported. In persons aged 60 years and older, the case fatality rate for nonperforating appendicitis with appendectomy was 0.7% and for perforating appendicitis and abscess 2.4%. Surgery was delayed beyond the day of admission in 21% of persons aged 40-59 years, 29% of persons aged 60-79 years, and 47% of persons aged 80 years and over. The proportion of cases with perforation increased from 22% to 75% between ages 20 and 80 years. The population incidence of perforating appendicitis changed little after age 20 years, while the incidence of nonperforating cases declined sharply. The high proportion of appendicitis cases with perforation among the elderly may be due to the decreased incidence of nonperforating appendicitis in the elderly and not to a greater propensity for perforation, as previously proposed. Most elderly in California receive timely surgery for appendicitis and tolerate it better than previously reported. Diminished tolerance for intra-abdominal infection may be the primary determinant of the increase in case fatality with age.     

UK and western European late-age mortality: trends in cause-specific death rates, 1960-1990

Age, sex and cause-specific death rates for the elderly population of 16 western European countries are examined for 1960, 1970, 1980 and 1990. Over the 30 years, the all-cause rates have fallen by around 23-41% depending on age and sex. Mortality from stroke has declined substantially and from cardiovascular disorders has recently fallen, but cancer health rates have increased among men. A comparison of the UK death rates with the west European and Swiss rates finds relative improvement in the UK for male mortality, but that female mortality at the younger ages has worsened sharply. Cardiovascular and stroke mortality is now exceptionally high in the UK among females aged 60-64 years and the 1980s trends for the 60-64 and 70-74 years age groups were unfavourable for several other causes of death.     

基于GIS的福建省60岁及以上不健康和生活不能自理二类老年人口空间分布特征研究

目的 研究福建省60岁及以上不健康和生活不能自理老年人口的地理空间分布特点,进而掌握人口老龄化的发展规律和趋势。 方法 利用2010 年第六次人口普查中的福建省各县市区的自评健康数据,结合空间自相关分析方法,研究分析了福建省60岁及以上不健康及生活不能自理老年人口的空间格局。 结果 2010年福建省60岁及以上不健康及生活不能自理老年人口占比具有显著的空间正相关性和潜在的空间依赖性,且其空间分布都存在较明显的空间分异,其中60岁及以上不健康老年人口占比整体呈现“东北部热,东南部冷”的空间分布格局。60岁及以上生活不能自理的老年人口占比整体呈现“东北部和西南部热,东南部冷”的空间分布格局。 结论 60岁及不健康及生活不能自理的老年人口有明显的聚集区域,且这些聚集区域均呈现了团状集聚且连续分布的现象。经济发展水平对2010年福建省60岁及以上老年人口健康状况存在较大的影响。     

The evolving demography of aging in the United States of American and the former USSR.

In the United States of America and in the republics of the former USSR, the elderly (persons aged 60 and over) will comprise the same proportion of their respective societies by the year 2000, namely 17%. In both countries, this population subgroup is growing at a faster rate than the rest of the population and living longer, although there are now more differences than similarities between the two countries in respect of the elderly, as summarized below. Similarities. In both countries today, the age group 50 years and over represents 26% of the total population, and by the year 2000 it is expected that 17% of the population will be 60 years and over. Diseases of the circulatory system and neoplasms are the major causes of death in both countries. Life expectancy beyond retirement age (i.e. the number of years a person is expected to live after having retired) is about the same in both, but this is due to the statistical fact that in the former USSR women are expected to have an extra year of life expectancy compared to their United States counterparts, while men are expected to live 2.5 years less beyond retirement than their United States counterparts. Differences. Mortality rates in the former USSR are higher than those in the United States. Life expectancy for men in the former USSR is 6.5 years below the figure for United States males. By age 65, the differences are 2.7 years for women and 2.4 years for men. Today, the proportion of the population having reached retirement age is larger in the former USSR than in the United States (17% vs 15%) because of lower retirement age in the former USSR. By the year 2000, these figures are expected to be 19% and 25%, respectively. Men make up 27% of the pension-age population in the former USSR against 41% in the United States. Life expectancy at birth could increase by 4 years for men in the former USSR if they had the same mortality rates from diseases of the circulatory and respiratory systems as their United States counterparts. Similarly, women in the former USSR would gain 4 years of life from these two causes alone. Older women are more likely to be married in the United States than in the former USSR, and this difference increases with age: at age 65, 25% of the former USSR's women are married versus 41% in the United States.     

2008—2019年无锡市跌倒死亡的疾病负担及对期望寿命的影响分析

目的 分析江苏省无锡市2008—2019年跌倒死亡导致的疾病负担及对期望寿命的影响,为制定干预措施提供依据。方法 利用2008—2019年无锡市全人群死因监测数据,计算跌倒死亡率和早死所致寿命损失年(years of life lost,YLL),以平均年度变化百分比(average annual percent change, AAPC)分析变化趋势及对期望寿命增量的贡献。结果 2008—2019年无锡市居民跌倒粗死亡率AAPC为7.0%(95%CI:4.8～9.4)(P<0.05)和标化死亡率AAPC为3.7%(95%CI:1.4～6.0)均呈上升趋势(P<0.05)。2008—2019年因跌倒死亡中,女性占比达到57.62%,略高于男性,且60岁及以上老年人占比达到89.98%。2008—2019年因跌倒死亡导致的期望寿命平均下降了0.11岁(6.43%),且对女性影响大于男性。2008—2019年全人群和60岁及以上老年人因跌倒死亡导致的YLL率均呈上升趋势,AAPC分别为3.3%(95%CI:1.2～5.5)(P<0.05)和4.5%(95%CI:2.0～7...     

Socio-demographic differentials in the functional decline among the elderly in Brazil

There is a positive reversion in the expectations regarding the health condition of the elderly population, possibly due to the progresses in medical technology; behavioural changes; development of special programmes for the elderly; improvements in the socio-economic status; decrease of infectious diseases. This study aims analyzing differentials in the prevalence rates of mobility disability among elderly people in Brazil. The data used were from 'The 1998 and 2003 National Household Survey (PNAD)', conducted by the Brazilian Institute of Geographic and Statistics (IBGE). The two samples were nationally representative, including approximately 30 thousand individuals aged 60 years or more respectively. "Difficulty to walk more than 100 meters" was the variable selected as the indicator of disability. Socio-demographic status measures were sex, age group, region of residence and family income per capita. Comparison of the PNAD results of 1998 and 2003 showed that over that period in Brazil the elderly disability rates decreased among all socio-demographic groups considered. Public policies directed to the elderly must focus on reducing mobility disability.     

Malnutrition mortality in the elderly,southeast Brazil, 1980-1997

OBJECTIVE: To assess the frequency of nutritional disturbances as cause of death in elderly. METHODS: Female and male subjects aged 60 years and more were selected from municipalities of the southeastern region between 1980 and 1997. Data was collected from death certificates provided by the Death Data System (1980-1998) and the population size was estimated using data provided by the Center for Regional Development and Planning (Cedeplar). Death categorization was performed using the ICD-9 (260 to 263.9) for the period 1980 to 1995 and ICD-10 (E40 to E46) for recent years. RESULTS: In Brazil, between 1980 and 1997, there were 36,955 deaths associated to malnutrition among elderly. The southeast region concentrates the largest number of deaths, 23,968 (64.9%). In the state of S?o Paulo, there were 11,067 deaths caused by malnutrition in elderly and in the state of Rio de Janeiro, 7,763. These two regions are responsible for the highest values observed for the region. There are higher death proportions and mortality rates among subjects aged 70 years and more than in subjects of any sex of the age group 60 to 69 years. CONCLUSION: The preliminary results of the study raise some issues as follows: the role of malnutrition as an associated cause of death; the trend of increased number of deaths for malnutrition among elderly people; distinctive death characteristics among states in the same geographic region. Statistical analysis such as time series analysis might explain better these issues. There is a need to further study the role of malnutrition among elderly aged 60 years and more to establish adequate intervention programs.     

湖北省麻城市1 984--2008年自杀死亡水平长期趋势分析

目的 探讨1984-2008年湖北省农村人口自杀死亡水平的特征及其长期变化趋势.方法 利用湖北省麻城市1984-2008年居民死因监测资料,回顾性分析不同性别、不同年龄人群的自杀死亡水平、自杀死亡占伤害的死因构成比及其变化趋势.结果 1984-2008年间该地人群的自杀死亡率呈下降趋势,自杀标化死亡率由1984年的113.29/10万降至2008年的20.11/10万,下降幅度为82.25%.自杀死亡占伤害死亡的构成比下降幅度不明显,自杀仍是该地人群伤害死亡的首要死因.自杀死亡者中,女性人数始终多于男性,女性所占的构成比在50%～60%之间波动;≥65岁老年人口所比例近年来明显增加,2008年老年人的构成比达46.81%.结论 自杀仍居该地人群,特别是女性人群伤害死因谱的首位.农村地区自杀预防的重点人群是女性和≥65岁老年人.

Abstract：

Objective To explore the characteristics and the long-term trend of suicidal deaths among the rural population in Hubei province. Methods Data on suicide deaths from 1984 through 2008 were released from Macheng Death Registration System and analyzed by year, gender and age. Results The suicidal death rates were decreasing during the last 25 years in Macheng city, with the standardized suicide mortality rapidly decreasing from 113.29/100 000 in 1984 to 20.11/100 000 in 2008. The proportion of suicide deaths in the total deaths caused by injuries were declining but not obviously. Suicide was still the leading cause of deaths among all the deaths due to injuries.Number of suicidal deaths among females was outnumbered the males during the last 25 years,representing 50%-60% in total suicide deaths annually. The proportion of suicide deaths among the elderly aged 65 and over had significantly increased in the recent years, which accounting for 46.81% of all the suicidal deaths in 2008. Conclusion Suicide remained the leading cause of injury deaths among the population in this area, especially in females. Attention should be paid to the females and the elderly aged 65 and over,in the rural areas.     

Efficient antioxidant capacity against lipid peroxide levels in healthy elderly of Mexico City

We evaluated antioxidant activity against lipid peroxide levels (LPO) in healthy elderly and adults of Mexico City in comparison with a population of a rural area. The study included free-living subjects: 38 adults aged <60 years and 129 older subjects aged > or = 60 years of urban Mexico City in addition to 37 adults aged <60 years and 88 older subjects aged > or = 60 years of rural area (Actopan, Hidalgo State, Mexico). LPO were observed as higher in adults and elderly of the urban area than among rural subjects (P<0.01), although LPO levels were similar in rural adults and elderly (P>0.05); conversely, in urban area levels were higher in the elderly than in adults (P<0.01). On the other hand, the superoxide dismutase in urban elderly was higher than that in rural elderly (P<0.05) but similar between urban adults and urban elderly (P>0.05). Total oxidant status in urban elderly was higher than that in rural elderly (P<0.01). Our findings allow us to conclude that the urban elderly (residents of Mexico City) have higher oxidative stress than the rural-dwelling elderly, though the urban elderly have efficient antioxidant capacity as a response to elevated LPO.     

2010 - 2016年江苏省老年人群意外跌倒死亡流行特征

目的 了解江苏省≥60岁老年人群意外跌倒死亡的流行特征和寿命损失情况,为制定我省预防跌倒伤害干预措施提供科学依据。方法 收集全国疾病监测系统中2010 - 2016年江苏省死因监测数据,计算城乡、不同性别、不同年龄的意外跌倒死亡率及疾病负担指标:潜在减寿年数（Potential Years of Life Lost, PYLL）、潜在减寿率（Potential Years of Life Lost Rate, PYLLR）和平均减寿年数（Average Years of Life Lost, AYLL）。年度变化百分比用于检验死亡率的时间变化趋势。结果 2010 - 2016年,江苏省60岁以上老年人口比例逐年增加。意外跌倒是我省老年人群因意外死亡的首位原因。老年人意外跌倒死亡率随年龄增加而升高。男、女和农村居民意外跌倒死亡率都呈逐年上升趋势（标化t男 = 9.260,t女 = 11.161,t农村 = 13.931,三者P＜0.001）。男性意外跌倒死亡的PYLL、PYLLR和AYLL都高于女性,农村居民总体高于城市居民。结论 老年跌倒已成为江苏省不容忽视的公共卫生问题,在农村更为严峻。应将跌倒干预工作作为江苏省老年人伤害防控的优先领域。     

Sexual behavior in healthy married elderly men

Sexual behavior was evaluated in 81 men aged 60–71 years (34 men aged 60–65 years and 47 men aged 66–71 years). All subjects were married, physically healthy, and with no psychopathology or marital problems. Sexual function was evaluated by a self-report three-point rating scale. Thirty-six percent of the whole study population reported impotence, with no significant difference between the two age groups. About half of the total population reported regular masturbatory activity. A decline in frequency of sexual intercourse and an increase in frequency of masturbation in subjects aged 66–71 years as compared to subjects aged 60–65 indicates that the interest in sexuality continues in elderly men although the form of sexual expression changes from active sexual intercourse to a self-pleasuring/autoerotic form. Evaluation of sexual activity in advanced age is recommended and appropriate therapy in case of sexual dysfunction should be offered to elderly men.     

2012-2017年阆中市60岁及以上老年人伤害死亡分析

目的了解阆中市60岁及以上老年人伤害死亡情况、构成特点及其影响因素,为制定防治对策提供科学依据。方法对人口死亡信息登记管理系统中报告的阆中市2012-2017年60岁及以上老年人伤害死亡数据进行描述性统计分析。结果2012-2017年阆中市因伤害死亡2870人,粗死亡率为55.25/10万,其中60岁及以上老年人伤害死亡1317人,平均粗死亡率为143.84/10万,标化率为153.34/10万,占全人群伤害死亡45.89%。男性死亡率(157.98/10万)高于女性(129.39/10万),差异有统计学意义(χ^2=13.029,P<0.01)。意外跌落居老年人伤害死亡原因首位(占30.98%),其次是自杀、机动车辆交通事故、淹死、意外中毒,前5位伤害原因占总伤害死亡的87.93%。结论阆中市60岁及以上老年人伤害死亡率较高,且呈逐年上升趋势。应根据主要伤害死亡的类型、特点制定综合防治措施,降低伤害死亡率。     

Population ageing: the implications for Africa

Aging of the population will present formidable challenges to countries struggling with underdevelopment. Nigeria is expected to have one of the largest populations of elderly in the world (over 16 million people over the age of 60 years by 2025). The task ahead is to alert the population to aging and public health concerns. There are difficulties in the lack of definition of aging as a point in time or in terms of function. In a rural community, many agricultural workers or high parity mothers may be functionally aged by the time they are 40. The problems faced by the elderly in rural areas are different from urban elderly due to differences in resource allocation. The needs of the elderly change with age and morbidity. Self-sufficiency is a requirement for the elderly regardless of housing arrangements. The elderly may appear to be in secure settings caring for grandchildren and receiving remittances, while in fact migrating parents may experience cost of living constraints, which prevent sending much money home. The elderly may have chronic health conditions or disabilities, which would make a long walk to a health unit difficult or impossible. Treatment for the elderly may be limited by a lack of pensions or trained personnel. The elderly may potentially be in a difficult emotional adjustment from independence to dependence. Trained health professionals, who understand chronic diseases, must dispense western scientific medicine with sensitivity and careful communication. Most health services are not prepared for services specific to the unique needs of the elderly but rather are more concerned with maternal and child health. Life expectancy has increased, and elderly people are the main users of health services.     

A comparative appraisal of the relationship of education, income and housing tenure with less than good health among the elderly in Europe

The objective of this study was to determine the strength of various socio-economic indicators for predicting less than good health among elderly people aged 60-79 years. Data were obtained from national health surveys from 10 European countries. Education, income and housing tenure were examined in relation to less than good health using standardised prevalence rates and (multiple) logistic regression analyses. The results illustrated that there are substantial health differences among the elderly according to education and income in each country. Both education and income (with men) showed a strong independent relationship with health status. Health differences according to housing tenure were generally somewhat smaller. However, in Great Britain and the Netherlands housing tenure demonstrated large health differences, even after adjustment for education and income. It is recommended that more refined socio-economic measures are developed and that in the meantime both education and income are used when studying socio-economic health differences among the elderly. In some countries, like Great Britain and the Netherlands, however, housing tenure has an additional value.     

The diabetes epidemic in the elderly population in Western Europe: data from population-based studies

Valid epidemiologic data on type 2 diabetes in the elderly population are scarce in the European Region despite its enormous human and economic burden. The aim was to assess population-based data on type 2 diabetes and impaired glucose regulation (IGR) from surveys carried out in Western Europe since 1990 using oral glucose tolerance tests, and to discuss the possible impact of risk factors on geographic variation, in particular, obesity and physical activity. In the decade below 60 years of age, about 10 % of the population had known or newly diagnosed diabetes in European surveys. In the age group 70 to 79 years, average total diabetes prevalence was about one quarter. IGR prevalences also increased with age, reaching a maximum of 25 % (men) to 30 % (women) above 70 years of age. There was a wide variation of total diabetes prevalence in the elderly population in Western European countries, however, without clear geographical pattern. Whereas age- and sex-specific prevalences for total diabetes in the German KORA Survey S4 (1999/2001) (Augsburg) were comparable to the European average, IGR prevalences were higher in Augsburg (60-69 years: KORA: men: 30.2 %, women: 22.4 % Europe: men: 21.2 %, women: 19.0 %). Thus, there is a huge reservoir for future diabetes cases in the elderly population in Germany. Differences at the population level were found for obesity, nutrition, and sedentary lifestyle in Western Europe. Comparative studies on the predictive values of obesity, physical activity, and nutrition and possible interactions with genetic markers in European populations are of interest in the future.     

Mortalidad general y por causas en la población autóctona e inmigante en Andalucía

Objective

To compare mortality rates between immigrant and native-born residents of Andalusia between 2006 and 2010, and to characterize mortality by cause.

Material and methods

The data consisted of deaths from mortality statistics by cause, and the aggregated populations registered in the lists of inhabitants by country of birth in the case of native-born individuals and immigrants (with immigrants grouped into six geographical areas of origin). Crude rates and age-standardized mortality rates (0-39, 40-65 and 65 years and above) were calculated by cause of death separately for men and women.

Results

In the group aged 0-39 years, mortality due to external causes was higher in immigrants than in the native-born population, especially in African immigrants, with standardized rates of 142 and 145 deaths per 100,000 persons/year in women and men, respectively. Deaths due to maternal-related factors were particularly high among Africans. In the group aged 40-64 years, mortality rates were higher in immigrant women than in native-born women but were lower in immigrant men than in native-born men; in this age group, mortality was particularly high in African women and men from Europe and North America. In the group aged 65 years and over, mortality was higher in the native-born population of both genders than in immigrants due to cancer and cardiovascular disease.

Conclusions

The differences in mortality between immigrants and native-born residents varied depending on age, gender, cause of death and birthplace. Notable findings were the higher mortality among elderly native-born residents, due to chronic degenerative diseases, and the high mortality in the Sub-Saharan population at younger ages due to accidents.     

Tetanus in Italy 2001–2010: A continuing threat in older adults

Despite being a completely preventable disease, tetanus cases continue to occur in Italy and notification and hospitalization rates have been reported to be higher with respect to European and other industrialized countries. We examined statutory notification, hospitalization, mortality and seroprevalence data to describe tetanus epidemiology in Italy from 2001 to 2010. A total of 594 tetanus cases were notified, with an average annual incidence of 1.0/1,000,000 population. Most cases were unvaccinated or incompletely vaccinated. Eighty percent of cases occurred in subjects aged >64 years and a higher proportion of females with respect to males were reported in this age group. The annual number of hospital admissions was 1.4–1.7 times greater than the number of notifications in the same year. The mean annual number of reported deaths was 21. Seroprevalence data show progressively higher susceptibility levels with increasing age. Over 50% of persons aged 45–64 years and over two thirds of subjects ≥65 years had tetanus antibody levels <0.01 IU/ml. Results show that tetanus is a continuing problem in Italy and, as in other countries, most cases occur in older adults, especially elderly women. The observed differences in notification and hospitalization rates suggest underreporting by physicians. In recent years, Italy has accounted for most cases reported annually in the European Union (EU) but different case definitions are used. In Italy, a confirmed case is one that meets the clinical case definition while the EU case definition classifies confirmed cases as those with laboratory confirmation of disease. The incidence of clinical tetanus in Italy is ten-fold higher than in other industrialized countries, like Australia and Canada, likely due to higher susceptibility levels in Italy. In view of the low prevalence of tetanus antibodies in adults ≥45 years, strategies to improve vaccine uptake in this population group need to be implemented.     

昆明市官渡区2000～2009年糖尿病早死所致生命损失年分析

目的分析昆明市官渡区2000~2009年糖尿病早死所致疾病负担的时间趋势。方法以早死所致生命损失年(yearsoflifelost,YLL)作为糖尿病疾病负担的测量单位,采用3%的贴现率但不采用年龄权重分年份、性别、年龄组和文化程度比较糖尿病的标化每千人口YLL率。结果从2000～2009年间,糖尿病的死亡率和YLL率随时间起伏波动,但2009年糖尿病的死亡率和YLL率均明显高于2000年。连续10年来,女性的糖尿病死亡率和YLL率均高于男性;糖尿病早死所致疾病负担以60岁及以上人群组和小学及以下文化程度者为主,且小学及以下文化程度者糖尿病每千人口YLL率所占的比例随时间呈上升趋势,而60岁及以上人群组糖尿病每千人口YLL率所占的比例则随时间起伏波动。结论应重点加强该地区女性、文化程度较低者以及老年人糖尿病的防治工作,以降低糖尿病的早死疾病负担。