1990-2019年江苏省老年人群跌倒疾病负担分析

杜文聪; 俞浩; 罗鹏飞; 孟娜; 周金意

doi:10.16462/j.cnki.zhjbkz.2023.10.004

1990-2019年江苏省老年人群跌倒疾病负担分析

doi: 10.16462/j.cnki.zhjbkz.2023.10.004

1.
江苏省疾病预防控制中心慢性非传染病防制所，南京 210009
2.
东南大学公共卫生学院流行病与卫生统计学系，南京 210009

基金项目:

江苏省十四五流行病学重点学科 ZDXK202250

详细信息

通讯作者:
周金意，E-mail: zhoujinyi74@sina.com

中图分类号: R780.1;R543.4
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- 被引次数: 0
出版历程
- 收稿日期: 2021-09-08
- 修回日期: 2022-03-12
- 网络出版日期: 2023-10-23
- 刊出日期: 2023-10-10

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

1.
Department of Non-Communicable Chronic Disease Control, Jiangsu Province Center for Disease Control and Prevention, Nanjing 210009, China
2.
Department of Epidemiology and Health Statistics, Southeast University, Nanjing 210009, China

Funds:

Jiangsu Province 14th Five-Year Plan Epidemiology Key Disciplines ZDXK202250

More Information

Corresponding author: ZHOU Jinyi, E-mail: zhoujinyi74@sina.com

摘要

摘要: 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。
- 跌倒 /
- 疾病负担 /
- 老年人 /
- 江苏省
Abstract: 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.
- Falls /
- Disease burden /
- Older adults /
- Jiangsu Province

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图 1 1990-2019年江苏省老年人群跌倒DALY变化情况

DALY: 伤残调整寿命年。

Figure 1. Changes in DALY on falls among older adults in Jiangsu Province, 1990-2019

DALY: disability adjusted life year.

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图 2 1990-2019年江苏省老年人群跌倒YLL变化情况

YLL，早死损失寿命年。

Figure 2. Changes in YLL on falls among older adults in Jiangsu Province, 1990-2019

YLL, years of life lost.

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图 3 1990-2019年江苏省老年人群跌倒YLD变化情况

YLD，伤残损失寿命年。

Figure 3. Changes in YLD on falls among older adults in Jiangsu Province, 1990-2019

YLD, year lived with disability.

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表 1 1990年和2019年江苏省老年人群跌倒疾病负担情况

Table 1. Disease burden on falls among older adults in Jiangsu Province, 1990 and 2019

性别Sex	死亡Death		伤残调整寿命年 Disability adjusted life year		过早死亡损失寿命年 Years of life lost		伤残损失寿命年 Years lived with disability
性别Sex	死亡数/例 Deaths/case	死亡率/10万^-1 Death rate /100 000^-1	人年/万 Person-years /million	率/10万^-1 Rate /100 000^-1	人年/万 Person-years /million	率/10万^-1 Rate /100 000^-1	人年/万 Person-years /million	率/10万^-1 Rate /100 000^-1
男性Male
1990年Year	804.000	25.634	3.945	1 258.396	1.437	458.476	2.508	799.920
2019年Year	3 938.000	46.561	13.105	1 549.605	0.5559	657.394	7.546	892.210
变化率/% Rate change/%	390.020	81.638	232.210	23.141	-61.316	43.387	200.905	11.537
AAPC/%		2.059 (1.535~2.585)		0.723 (0.550~0.896)		1.475 (0.436~2.525)		0.418 (0.141~0.695)
t值value		7.766		8.205		2.915		2.959
P值value		＜0.001		＜0.001		0.007		0.003
女性Female
1990年Year	1 163.000	30.475	4.716	1 235.693	16 342.218	428.159	3.082	807.534
2019年Year	5 757.000	61.930	15.023	1 616.004	59 255.840	637.396	9.098	978.608
变化率/% Rate change/%	394.961	103.216	218.528	30.777	262.594	48.869	195.164	21.185
AAPC/%		2.414 (1.646~3.187)		0.978 (0.461~1.497)		1.305 (0.510~2.106)		0.681 (0.564~0.798)
t值value		6.212		3.716		3.227		11.468
P值value		＜0.001		＜0.001		0.001		＜0.001
合计Total
1990年Year	1 967.000	28.292	8.661	1 245.931	30 714.982	441.830	5.590	804.101
2019年Year	9 695.000	54.609	28.129	1 584.374	114 853.749	646.922	16.643	937.451
变化率/% Rate change/%	392.942	93.019	224.760	27.164	273.934	46.419	197.740	16.584
AAPC/%		2.235 (1.396~3.082)		0.837 (0.529~1.147)		1.647 (0.092~3.226)		0.545 (0.399~0.691)
t值value		5.255		5.337		2.170		7.329
P值value		＜0.001		＜0.001		0.039		＜0.001
注：AAPC, 平均年度变化百分比。 Note: AAPC, average annual percentage change.

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表 2 1990-2019年江苏省老年人群跌倒死亡率变化情况

Table 2. Changes in mortality on falls among older adults in Jiangsu Province, 1990-2019

年龄段/岁 Age group/years	1990年跌倒死亡率/10万^-1 Falls mortality rate, 1990/100 000^-1	2000年跌倒死亡率/10万^-1 Falls mortality rate, 2000/100 000^-1	2010年跌倒死亡率/10万^-1 Falls mortality rate, 2010/100 000^-1	2019年跌倒死亡率/10万^-1 Falls mortality rate, 2019/100 000^-1	AAPC	t值 value	P值 value
60~＜65	9.217	7.172	8.277	8.626	-0.2979(-0.763~0.171)	-1.243	0.214
65~＜70	12.424	9.771	9.613	11.812	-0.276(-0.829~0.280)	-0.975	0.329
70~＜75	20.574	16.640	15.472	20.988	0.017(-0.549~0.585)	0.058	0.954
75~＜80	43.798	37.393	37.3743	45.023	0.025(-0.531~0.584)	0.088	0.930
≥80	155.722	142.882	228.787	275.696	1.897(1.426~2.370)	7.945	＜0.001
合计Total	28.292	27.144	42.017	54.609	2.059(1.535~2.585)	7.766	＜0.001
注：AAPC, 平均年度变化百分比。 Note: AAPC, average annual percentage change.

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表 3 1990-2019年江苏省老年人群跌倒DALY率变化情况(/10万)

Table 3. Changes in DALY rate on falls among older adults in Jiangsu Province, 1990-2019 (/100 000)

年龄段/岁 Age group/years	1990年跌倒DALY率/10万^-1 Falls DALY rate, 1990/100 000^-1	2000年跌倒DALY率/10万^-1 Falls DALY rate, 2000/100 000^-1	2010年跌倒DALY率/10万^-1 Falls DALY rate, 2010/100 000^-1	2019年跌倒DALY率/10万^-1 Falls DALY rate, 2019/100 000^-1	AAPC	t值 value	P值 value
60~＜65	877.921	786.779	758.834	799.736	-0.319(-0.441~-0.196)	-5.101	＜0.001
65~＜70	1 006.139	905.674	859.360	966.959	-0.149(-0.334~0.037)	-1.566	0.117
70~＜75	1 235.401	1 116.528	1 050.693	1 261.750	0.077(-0.097~0.252)	0.867	0.386
75~＜80	1 695.593	1 562.290	1 495.725	1 806.937	0.223(-0.064~0.510)	1.524	0.128
≥80	2 965.457	2 888.543	3 544.005	4 460.716	1.392(1.141~1.644)	10.938	＜0.001
合计Total	1 245.931	1 195.485	1 292.413	1 584.374	0.837(0.529~1.147)	5.337	＜0.001
注：DALY，伤残调整寿命年；AAPC，平均年度变化百分比。 Notes: DALY，disability adjusted life year；AAPC, average annual percentage change.

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表 4 1990-2019年江苏省老年人群跌倒YLL率变化情况(/10万)

Table 4. Changes in YLL rate on falls among older adults in Jiangsu Province, 1990-2019 (/100 000)

年龄段/岁 Age group/years	1990年跌倒YLL率/10万^-1 Falls YLL rate, 1990/100 000^-1	2000年跌倒YLL率/10万^-1 Falls YLL rate, 2000/100 000^-1	2010年跌倒YLL率/10万^-1 Falls YLL rate, 2010/100 000^-1	2019年跌倒YLL率/10万^-1 Falls YLL rate, 2019/100 000^-1	AAPC	t值 value	P值 value
60~＜65	256.589	199.514	230.267	240.026	-0.298(-0.765~0.171)	-1.246	0.213
65~＜70	289.791	227.639	224.292	275.224	-0.280(-0.834~0.277)	-0.988	0.323
70~＜75	392.598	317.569	294.648	399.826	0.011(-0.555~0.580)	0.039	0.969
75~＜80	661.956	564.952	562.408	676.855	0.006(-0.548~0.564)	0.023	0.982
≥80	1 520.634	1 379.554	2 094.165	2 420.625	1.515(1.067~1.964)	6.668	＜0.001
合计Total	441.830	395.811	524.082	646.922	1.647(0.092~3.226)	2.170	0.039
注：YLL，早死损失寿命年; AAPC, 平均年度变化百分比。 Notes: YLL，years of life lost; AAPC, average annual percentage change.

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表 5 1990-2019年江苏省老年人群跌倒YLD率变化情况(/10万)

Table 5. Changes in YLD rate on falls among older adults in Jiangsu Province, 1990-2019 (/100 000)

年龄段/岁 Age group/years	1990年跌倒YLD率/10万^-1 Falls YLD rate, 1990/100 000^-1	2000年跌倒YLD率/10万^-1 Falls YLD rate, 2000/100 000^-1	2010年跌倒YLD率/10万^-1 Falls YLD rate, 2010/100 000^-1	2019年跌倒YLD率/10万^-1 Falls YLD rate, 2019/100 000^-1	AAPC	t值 value	P值 value
60~＜65	621.332	587.265	528.567	559.7097	-0.346(-0.404~-0.287)	-11.612	＜0.001
65~＜70	716.348	678.035	635.068	691.7349	-0.096(-0.186~-0.007)	-2.110	0.035
70~＜75	842.803	798.959	756.046	861.9247	0.105(-0.027~0.238)	1.557	0.120
75~＜80	1 033.637	997.338	933.317	1 130.082	0.322(0.231~0.412)	6.974	＜0.001
≥80	1 444.823	1 508.989	1 449.840	2 040.091	1.222(1.054~1.390)	14.328	＜0.001
合计Total	804.101	799.674	768.331	937.451	0.545(0.399~0.691)	7.329	＜0.001
注：YLD，伤残损失寿命年; AAPC, 平均年度变化百分比。 Notes: YLD, year lived with disability; AAPC, average annual percentage change.

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