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基于《2017年全球疾病负担研究》的1990年至2030年70岁及以上人群自杀死亡率的时间趋势及预测

Time Trends and Predictions of Suicide Mortality for People Aged 70 Years and Over From 1990 to 2030 Based on the Global Burden of Disease Study 2017.

作者信息

He Jun, Ouyang Feiyun, Qiu Dan, Li Ling, Li Yilu, Xiao Shuiyuan

机构信息

Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.

Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China.

出版信息

Front Psychiatry. 2021 Sep 27;12:721343. doi: 10.3389/fpsyt.2021.721343. eCollection 2021.

Abstract

High suicide rate in the elderly is an important global public health problem but has not received the attention it deserves. This study aimed to examine time trends of suicide mortality for people aged 70 years and over by sex, age, and location from 1990 to 2017, and to provide predictions up to 2030. Using data from the Global Burden of Disease study 2017, we presented elderly suicide mortality changes and compared the patterns for the elderly with that for all ages. We estimated associations between socio-demographic index (SDI) and suicide mortality rates using a restricted cubic spline smoother, and predicted suicide mortality rates up to 2030. In 2017, 118,813 people aged 70 years and over died from suicide, indicating a mortality rate of 27.5 per 100,000, with the highest rates in Eastern Sub-Saharan Africa, Western Sub-Saharan Africa, and Central Sub-Saharan Africa, and for countries and territories, the highest were in South Korea, Zimbabwe, Lesotho, Mozambique, and Senegal. Between 1990 and 2017, suicide mortality rate for the elderly aged 70 years and over decreased globally (percentage change -29.1%), and the largest decreases occurred in East Asia, Southern Latin America, and Western Europe. Nationally, the largest decrease was found in Chile, followed by Czech Republic, Hungary, Turkey, and Philippines. For most countries, the elderly mortality rate was higher than the age-standardized rate, with the largest percentage differences in China and countries in Sub-Saharan Africa. The elderly suicide mortality rate decreased as SDI increased, except for a slight rebound at mid to high SDI. According to projections, 10 out of 195 countries were expected to meet the SDGs indicator of a third reduction by 2030. Variability in suicide mortality rates for the elderly aged 70 years and over by sex, age, region, country, and SDI can guide preventive policies, but causes of the variability need further study. Comprehensive strategies should be adopted to reduce suicide rates and close the gap to the 2030 SDGs.

摘要

老年人的高自杀率是一个重要的全球公共卫生问题,但尚未得到应有的关注。本研究旨在考察1990年至2017年70岁及以上人群按性别、年龄和地点划分的自杀死亡率的时间趋势,并提供截至2030年的预测。利用2017年全球疾病负担研究的数据,我们展示了老年人自杀死亡率的变化,并将老年人的模式与所有年龄段的模式进行了比较。我们使用受限立方样条平滑器估计社会人口指数(SDI)与自杀死亡率之间的关联,并预测了截至2030年的自杀死亡率。2017年,118813名70岁及以上的人死于自杀,死亡率为每10万人27.5人,在东撒哈拉以南非洲、西撒哈拉以南非洲和中撒哈拉以南非洲最高,在国家和地区方面,最高的是韩国、津巴布韦、莱索托、莫桑比克和塞内加尔。1990年至2017年期间,全球70岁及以上老年人的自杀死亡率下降(百分比变化-29.1%),最大降幅出现在东亚、拉丁美洲南部和西欧。在国家层面,最大降幅出现在智利,其次是捷克共和国、匈牙利、土耳其和菲律宾。对于大多数国家来说,老年人死亡率高于年龄标准化率,在中国和撒哈拉以南非洲国家差异百分比最大。老年人自杀死亡率随SDI的增加而下降,但在中高SDI时略有反弹。根据预测,195个国家中有10个预计到2030年将实现将自杀率降低三分之一的可持续发展目标指标。70岁及以上老年人自杀死亡率按性别、年龄、地区、国家和SDI的差异可指导预防政策,但差异的原因需要进一步研究。应采取综合战略降低自杀率,并缩小与2030年可持续发展目标的差距。

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