School of Health Policy & Management, Nanjing Medical University, Nanjing, China.
Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China.
Front Public Health. 2021 Feb 25;9:638704. doi: 10.3389/fpubh.2021.638704. eCollection 2021.
The population is aging much faster in China than other low- and middle-income countries. With the accelerated aging of the population, incidence and disease burden of age-related diseases have also continued to increase. Exploring the burden of age-related diseases is crucial for early disease prevention, assessing the extent of population aging, and achieving the goal of healthy aging. We used the dataset from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), and selected data on incidence, prevalence, and disease burden in China, in 1997, 2007, and 2017. We classified age-related diseases, which were defined as diseases in which the incidence rate increased quadratically with age in the adult population. Additionally, we described the changes in age-related diseases during the study period by different GBD categories. It also measured changes in the age-related disease burden in our study period, including disability-adjusted life years (DALY), years of life lost (YLL), and years lived with disability (YLD). Finally, we compared the differences in the age-related disease burdens for men and women. Among the 293 diseases listed in the GBD study, 69 in 2017, 78 in 1997 and 72 in 2007 were identified as age-related diseases. More than half of the age-related diseases belonged to non-communicable diseases (NCDs) in our study period. The rate of age-standardized age-related disease burden decreased between 1997 and 2017. DALYs decreased by 24.89% for non-age-related diseases and by 50.15% in age-related diseases from 1997 to 2017. The age-related disease burden of men was higher than that of women; we found a decreasing trend, with -46.23% in men and -54.90% in women. Comparing characteristics of the aging population in China and the world, we found that China does not have the typical disease characteristics of aging society. Currently, China faces the dual threat of NCDs and communicable diseases, and NCDs account for the vast majority of the age-related disease burden. Our health systems should focus on disease prevention and early detection among the entire population, instead of treatment. Further studies should focus on reducing the duration and severity of morbidity in later life.
中国人口老龄化速度比其他中低收入国家快得多。随着人口老龄化的加速，与年龄相关的疾病的发病率和疾病负担也在持续增加。探索与年龄相关的疾病负担对于早期疾病预防、评估人口老龄化程度以及实现健康老龄化目标至关重要。我们使用了全球疾病、伤害和危险因素研究（GBD）的数据，并选择了 1997 年、2007 年和 2017 年中国的发病率、患病率和疾病负担数据。我们将与年龄相关的疾病定义为成年人中发病率随年龄呈二次增长的疾病。此外，我们还按不同的 GBD 类别描述了研究期间与年龄相关的疾病变化。它还衡量了我们研究期间与年龄相关的疾病负担的变化，包括残疾调整生命年（DALY）、寿命损失年（YLL）和残疾生存年（YLD）。最后，我们比较了男性和女性与年龄相关的疾病负担的差异。在 GBD 研究中列出的 293 种疾病中，2017 年有 69 种、1997 年有 78 种和 2007 年有 72 种被确定为与年龄相关的疾病。在我们的研究期间，超过一半的与年龄相关的疾病属于非传染性疾病（NCDs）。1997 年至 2017 年，年龄标准化与年龄相关的疾病负担率下降。非年龄相关疾病的 DALY 下降了 24.89%，年龄相关疾病的 DALY 下降了 50.15%。男性与年龄相关的疾病负担高于女性；我们发现男性呈下降趋势，下降了-46.23%，女性下降了-54.90%。将中国和世界人口老龄化特征进行比较后发现，中国没有典型的老龄化社会疾病特征。目前，中国面临着非传染性疾病和传染病的双重威胁，非传染性疾病占与年龄相关的疾病负担的绝大部分。我们的卫生系统应将重点放在全民疾病预防和早期检测上，而不是治疗上。进一步的研究应侧重于减少生命后期发病率的持续时间和严重程度。
