Vercelli Marina, Lillini Roberto, Quaglia Alberto, Micale Rosanna T, La Maestra Sebastiano, De Flora Silvio
Department of Health Sciences, University of Genoa, Genoa, Italy.
Descriptive Epidemiology Unit, IRCCS Azienda Ospedaliera Universitaria San Martino - Istituto Nazionale per la Ricerca sul Cancro (IST), Genoa, Italy; Vita-Salute San Raffaele University, Milan, Italy.
PLoS One. 2014 Dec 8;9(12):e114027. doi: 10.1371/journal.pone.0114027. eCollection 2014.
We stratified the Italian population according to age and gender in order to evaluate mortality trends over more than one century. Data covering the 1901-2008 period were used to study the yearly variations in mortality. Fluctuations in age-adjusted mortality curves were analyzed by Join Point Regression Models, identifying Join Points and Annual Percent Changes. A consistent decline in all-cause mortality occurred across the whole period, the most striking variations being observed in the 0-49 years population. In 1901, other and undefined diseases were the main causes of death, followed by infectious, digestive, and respiratory diseases in the 0-49 years population and by respiratory, cardiovascular, and cerebrovascular diseases in the ≥ 50 years population groups. In 2008 the main causes of death were accidents (males) and tumors (females) in the 0-49 age class, tumors in the 50-69 age class (both genders), and tumors (males) and cardiovascular diseases (females) in the elderly. The results highlight the interplay between age and gender in affecting mortality trends and reflect the dramatic progress in nutritional, lifestyle, socioeconomic, medical, and hygienic conditions.
我们根据年龄和性别对意大利人口进行分层,以评估一个多世纪以来的死亡率趋势。利用涵盖1901年至2008年期间的数据来研究死亡率的年度变化。通过连接点回归模型分析年龄调整死亡率曲线的波动,确定连接点和年度百分比变化。在整个时期内,全因死亡率持续下降,最显著的变化出现在0至49岁人群中。1901年,其他和不明疾病是主要死因,在0至49岁人群中其次是传染病、消化系统疾病和呼吸系统疾病,在≥50岁人群组中是呼吸系统疾病、心血管疾病和脑血管疾病。2008年,0至49岁年龄组的主要死因是事故(男性)和肿瘤(女性),50至69岁年龄组(男女皆是)是肿瘤,老年人中是肿瘤(男性)和心血管疾病(女性)。结果突出了年龄和性别在影响死亡率趋势方面的相互作用,并反映了营养、生活方式、社会经济、医疗和卫生条件方面的巨大进步。