全球、地区和国家70岁及以上成年人的疾病和伤害负担：2019年全球疾病负担研究的系统分析

SCI

8 April 2022

Global, regional, and national burden of diseases and injuries for adults 70 years and older: systematic analysis for the Global Burden of Disease 2019 Study

(British Medical Journal, IF: 39.890)

• on behalf of GBD 2019 Ageing Collaborators

• CORRESPONDENCE TO: nickjk@uw.edu

Objectives 目标

To use data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) to estimate mortality and disability trends for the population aged ≥70 and evaluate patterns in causes of death, disability, and risk factors.

使用《2019年全球疾病、伤害和风险因素负担研究》（GBD 2019）的数据，估计≥70岁的老年人口的死亡率和残疾趋势并评估死亡、残疾和风险因素的模式。

Design 设计

Systematic analysis.

系统分析。

Setting 背景

Participants were aged ≥70 from 204 countries and territories, 1990-2019.

参与者年龄≥70岁，1990年至2019年，来自204个国家和地区。

Main Outcomes Measures 主要观察指标

Years of life lost, years lived with disability, disability adjusted life years, life expectancy at age 70 (LE-70), healthy life expectancy at age 70 (HALE-70), proportion of years in ill health at age 70 (PYIH-70), risk factors, and data coverage index were estimated based on standardised GBD methods.

根据标准化GBD方法，估计了寿命损失年数、残疾年数、残疾调整后的寿命年数、70岁时的预期寿命（LE-70）、70岁时的健康预期寿命（HALE-70）、70岁时的健康不良年数比例（PYIH-70）、风险因素和数据覆盖指数。

Results 后果

Globally the population of older adults has increased since 1990 and all cause death rates have decreased for men and women. However, mortality rates due to falls increased between 1990 and 2019. The probability of death among people aged 70-90 decreased, mainly because of reductions in non-communicable diseases. Globally disability burden was largely driven by functional decline, vision and hearing loss, and symptoms of pain. LE-70 and HALE-70 showed continuous increases since 1990 globally, with certain regional disparities. Globally higher LE-70 resulted in higher HALE-70 and slightly increased PYIH-70. Sociodemographic and healthcare access and quality indices were positively correlated with HALE-70 and LE-70. For high exposure risk factors, data coverage was moderate, while limited data were available for various dietary, environmental or occupational, and metabolic risks.

自1990年以来，全球老年人人口有所增加，男性和女性的全因死亡率有所下降。然而，1990年至2019年间，因跌倒而导致的死亡率有所上升。70-90岁人群的死亡概率下降，主要是因为非传染性疾病的减少。在全球范围内，残疾负担主要由功能衰退、视力和听力丧失以及疼痛症状所驱动。自1990年以来，LE-70和HALE-70在全球范围内持续增长，但存在一定的地区差异。全球范围内，LE-70的升高导致HALE-70的升高，而PYIH-70则略有增加。社会人口统计学、医疗保健和质量指数与HALE-70和LE-70呈正相关。对于高暴露风险因素，数据覆盖率适中，而对于各种饮食、环境或职业以及代谢风险的可用数据有限。

Conclusions 结论

Life expectancy at age 70 has continued to rise globally, mostly because of decreases in chronic diseases. Adults aged ≥70 living in high income countries and regions with better healthcare access and quality were found to experience the highest life expectancy and healthy life expectancy. Disability burden, however, remained constant, suggesting the need to enhance public health and intervention programmes to improve wellbeing among older adults.

全球70岁的预期寿命持续增长，主要是因为慢性病的减少。生活在高收入国家和地区的≥70岁的老年人的医疗服务和质量更好，也拥有更高的预期寿命和健康预期寿命。然而，残疾负担保持不变，这表明需要加强公共卫生和干预方案，以改善老年人的福祉。