1990-2019年江苏省老年人群跌倒疾病负担分析

目的  分析1990-2019年江苏省老年人群跌倒疾病负担及其变化趋势，为制定老年人群跌倒预防控制策略提供科学依据。方法  基于2019全球疾病负担研究结果，分析1990-2019年江苏省不同性别和年龄老年人群跌倒的死亡率、伤残调整寿命年(disability adjusted life year，DALY)、DALY率、伤残损失寿命年(years lived with disability，YLD)、YLD率、早死损失寿命年(years of life lost，YLL)、YLL率等指标的变化趋势。应用Joinpoint 4.9.0.0软件计算各指标的平均年度变化百分比(average annual percentage of change, AAPC)和95% CI。结果  2019年，江苏省60岁及以上老年人因跌倒造成的死亡率、DALY率、YLD率、YLL率分别是54.609/10万、1 584.374/10万、646.922/10万、937.451/10万，较1990年分别增加93.019%、27.164%、46.419%、16.584%。1990-2019年江苏省老年人群因跌倒死亡率、DALY率、YLD率、YLL率呈增长趋势(AAPC=2.235%、0.837%、1.647%、0.545%，均P＜0.05)。1990-2019年，不同性别、年龄组老年人疾病负担变化不同，老年女性跌倒疾病负担指标增幅普遍高于老年男性；60~＜65岁年龄组老年人跌倒的DALY率呈明显下降趋势，而80岁及以上年龄组老年人群所有的疾病负担指标均呈明显上升趋势。结论  跌倒给江苏省老年人造成了沉重的疾病负担，特别是80岁及以上老年人，疾病负担逐年增长。因此，应加强80岁及以上老年人群跌倒的预防工作，降低其疾病负担。

Disease burden on falls among older adults in Jiangsu Province, 1990-2019

Objective To analyze the temporal trends of the disease burden of falls in the elderly in Jiangsu Provincee from 1990 to 2019, and to provide a scientific basis for developing fall prevention and control strategies in the elderly. Methods Based on the results of the Global Burden of Disease Study 2019, we analyzed the trends of the mortality, disability-adjusted life year (DALY), DALY rate, years lived with disability loss (YLD), YLD rate, years of life lost (YLL)and YLL rate of falls in the elderly by sex and age in Jiangsu Province from 1990 to 2019. The Joinpoint 4.9.0.0 was used to analyze the time trends from 1990 to 2019 by calculating the average annual percentage of change (AAPC) and corresponding 95% CI. Results In 2019, the mortality, DALY rate, YLD rate, and YLL rate contributed by falls among people aged ≥60 years in Jiangsu Province were 54.609/100 000, 1584.374/100 000, 646.922/100 000, and 937.451/100 000, respectively. There was an increase of 93.019%, 27.164%, 46.419%, and 16.584%, respectively, compared with 1990. The mortality, DALY rate, YLD rate, and YLL rate contributed by falls among the elderly in Jiangsu Province from 1990 to 2019 showed an increasing trend, with average annual percent change (AAPC) of 2.235%, 0.837%, 1.647%, and 0.545%, respectively (all P < 0.05). During 1990-2019, the changes in disease burden among the elderly across sex and age groups were different, and the increase of disease burden indicators of falls among elderly women was generally higher than that of elderly men. And the DALY rate of falls among the elderly aged 60- < 65 years showed a significant decreasing trend. However, all disease burden indicators of falls among the elderly aged ≥80 years showed a significant increasing trend. Conclusions Falls cause a heavy disease burden for the elderly in Jiangsu Province, especially those aged ≥80 years, and the disease burden is increasing yearly in this age group. Therefore, the prevention of falls among the elderly aged ≥80 should be strengthened to reduce the disease burden.