Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil.
, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Popul Health Metr. 2020 Sep 30;18(Suppl 1):14. doi: 10.1186/s12963-020-00206-3.
Brazil is the world's fifth most populous nation, and is currently experimenting a fast demographic aging process in a context of scarce resources and social inequalities. To understand the health profile of older adults in Brazil is fundamental for planning public policies.
The estimates were derived from data obtained through the collaboration between the Brazilian Ministry of Health and the Institute of Health Metrics and Evaluation of the University of Washington. The Brazilian Institute of Geography and Statistics provided the population estimates. Data on causes of death came from the Mortality Information System. To calculate morbidity, population-based studies on the prevalence of diseases in Brazil were comprehensively searched, in addition to information obtained from national databases such as the Hospital Information System, the Outpatient Information System, and the Injury Information System. We presented the Global Burden of Disease (GBD) 2017 estimates among Brazilian older adults (60+ years old) for life expectancy at birth (LE), healthy life expectancy (HALE), cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs), from 2000 to 2017.
LE at birth significantly increased from 71.3 years (95% UI to 70.9-71.8) to 75.2 years (95% UI 74.7-75.7). There was a trend of increasing HALE, from 62.2 years (95% UI 59.54-64.5) to 65.5 years (95% UI 62.6-68.0). The proportion of DALYs among older adults increased from 7.3 to 10.3%. Chronic noncommunicable diseases are the leading cause of death among middle aged and older adults, while Alzheimer's disease is a leading cause only among older adults. Mood disorders, musculoskeletal pain, and hearing or vision losses are among the leading causes of disability.
The increase in LE and the decrease of the DALYs rates are probably results of the improvement of social conditions and health policies. However, the smaller increase of HALE than LE means that despite living more, people spend a substantial time of their old age with disability and illness. Preventable or potentially controllable diseases are responsible for most of the burden of disease among Brazilian older adults. Health investments are necessary to obtain longevity with quality of life in Brazil.
巴西是世界上人口第五多的国家，目前正在经历人口快速老龄化的过程，资源匮乏且社会不平等。了解巴西老年人的健康状况对于制定公共政策至关重要。
这些估计数源自巴西卫生部与华盛顿大学健康指标与评估研究所合作获得的数据。巴西地理统计局提供了人口估计数。死因数据来自死亡率信息系统。为了计算发病率，我们全面搜索了巴西基于人群的疾病流行情况研究，此外还利用了国家数据库（如医院信息系统、门诊信息系统和伤害信息系统）中的信息。我们呈现了 2000 年至 2017 年全球疾病负担（GBD）2017 年巴西老年人（60 岁及以上）的出生时预期寿命（LE）、健康预期寿命（HALE）、特定死因死亡率、生命损失年数（YLLs）、失能生存年数（YLDs）和残疾调整生命年（DALYs）的估计数。
出生时预期寿命显著增加，从 71.3 岁（95%置信区间为 70.9-71.8）增加到 75.2 岁（95%置信区间为 74.7-75.7）。健康预期寿命呈上升趋势，从 62.2 岁（95%置信区间为 59.54-64.5）增加到 65.5 岁（95%置信区间为 62.6-68.0）。老年人的 DALYs 比例从 7.3%增加到 10.3%。慢性非传染性疾病是中老年人死亡的主要原因，而阿尔茨海默病仅是老年人死亡的主要原因。心境障碍、肌肉骨骼疼痛以及听力或视力丧失是导致残疾的主要原因。
LE 的增加和 DALYs 率的下降可能是社会条件和卫生政策改善的结果。然而，HALE 的增长低于 LE，这意味着尽管寿命延长，但人们在老年时仍有相当长的时间处于残疾和患病状态。可预防或潜在可控制的疾病是巴西老年人疾病负担的主要原因。在巴西，需要健康投资以获得长寿和高质量的生活。
