2004-2018年中国老年居民慢性非传染性疾病死亡水平与变化趋势

目的分析2004-2018年中国≥65岁老年居民慢性非传染性疾病(慢性病)死亡水平及变化趋势,预测2019-2023年慢性病年龄标化死亡率。方法利用2004-2018年中国死因监测数据集中老年居民死亡数据,分析不同性别、城乡、地区的慢性病粗死亡率、年龄标化死亡率、构成比及变化趋势。采用2010年第六次全国人口普查的人口构成计算年龄标化死亡率;采用加权最小二乘法拟合Joinpoint回归模型,计算全时间段内平均年度变化百分比(AAPC)及95%可信区间;采用对数线性模型预测年龄标化死亡率。结果2004-2018年我国老年居民慢性病年龄标化死亡率从4697.05/10万降至3555.35/10万,平均每年下降2.0%(95%CI:-2.7%~-1.3%)。不同性别、城乡、地区间年龄标化死亡率呈下降趋势。东部地区(AAPC=-2.1%,95%CI:-2.8%~-1.3%)、中部地区(AAPC=-2.8%,95%CI:-3.4%~-2.1%)下降速度均快于西部地区(AAPC=-0.8%,95%CI:-1.8%~0.2%)。慢性病死亡构成比从89.82%上升至91.41%,平均每年上升0.1%(95%CI:0.1%~0.2%)。预计至2023年,男性年龄标化死亡率(3906.23/10万)仍高于女性(2708.43/10万);农村年龄标化死亡率(3283.20/10万)与城市(3250.01/10万)相接近;西部地区(3782.48/10万)与东部地区(3037.01/10万)、中部地区(3249.24/10万)的年龄标化死亡率的差距将进一步拉大。结论2004-2018年我国老年居民慢性病年龄标化死亡率呈下降趋势,死亡构成比呈上升趋势,建议以老年人群中男性居民和西部地区居民作为今后慢病防控关注的重点人群。

Chronic and non-communicable disease mortality and trends in Chinese elderly, 2004-2018

Objective To analyze the mortality level and trend of chronic and non-communicable diseases(NCDs)among elderly residents aged 65 and over in China from 2004 to 2018,and predict the age-standardized mortality rate of NCDs from 2019 to 2023.Methods Data on resident death was collected from the National Mortality Surveillance data set and used to analyze the unstandardized mortality rates,age-standardized mortality rates,composition ratios and changing trends of NCDs among different genders,urban and rural areas,and geographical regions in China during 2004 to 2018.The age-standardized mortality rates were calculated based on the Year 2010 Population Census of China.The Joinpoint Regression Models were fitted by the weighted least squares method.The average annual percent change(AAPC)and its 95%confidence interval for the entire time period were calculated.Log-linear models were used to predict age-standardized mortality rates.Results From 2004 to 2018,the age-standardized mortality rates of NCDs decreased from 4697.05 per 100000 to 3555.35 per 100000,with an average annual decline of 2.0%(95%CI:-2.7%--1.3%).The age-standardized mortality rates among different genders,urban and rural areas,and regions showed a downward trend.The age-standardized mortality rates of eastern region(AAPC=-2.1%,95%CI:-2.8%--1.3%)and central region(AAPC=-2.8%,95%CI:-3.4%--2.1%)fell faster than that of western region(AAPC=-0.8%,95%CI:-1.8%-0.2%).The proportion of deaths caused by NCDs increased from 89.82%to 91.41%,with an average annual increase of 0.1%(95%CI:0.1%-0.2%).Expected to 2023,the age-standardized mortality rates for male(3906.23 per 100000)will be significantly higher than female's(2708.43 per 100000);and that in rural areas(3283.20 per 100000)will be approximately equal to that in urban areas(3250.01 per 100000);the gap of age-standardized mortality rate between the western(3782.48 per 100000),eastern(3037.01 per 100000),and central region(3249.24 per 100000)will be further increased.Conclusion From 2004 to 2018,age-standardized mortality rates of NCDs of the elderly residents in China showed a downward trend,and the proportion of deaths of NCDs showed an upward trend.Male and the western region elderly residents should be the key population for prevention and control of chronic diseases in the future.