National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Division of General Internal Medicine and Geriatrics, Department of Medicine, Oregon Health & Science University, Portland, OR, USA.
Public Health Rep. 2024 Jan-Feb;139(1):54-58. doi: 10.1177/00333549231155869. Epub 2023 Mar 11.
Reports on recent mortality trends among adults aged ≥65 years are lacking. We examined trends in the leading causes of death from 1999 through 2020 among US adults aged ≥65 years.
We used data from the National Vital Statistics System mortality files to identify the 10 leading causes of death among adults aged ≥65 years. We calculated overall and cause-specific age-adjusted death rates and then calculated the average annual percentage change (AAPC) in death rates from 1999 through 2020.
The overall age-adjusted death rate decreased on average by 0.5% (95% CI, -1.0% to -0.1%) per year from 1999 through 2020. Although rates for 7 of the top 10 causes of death decreased significantly, the rates of death from Alzheimer disease (AAPC = 3.0%; 95% CI, 1.5% to 4.5%) and from unintentional injuries (AAPC = 1.2%; 95% CI, 1.0% to 1.4%), notably falls (AAPC = 4.1%; 95% CI, 3.9% to 4.3%) and poisoning (AAPC = 6.6%; 95% CI, 6.0% to 7.2%), increased significantly.
Public health prevention strategies and improved chronic disease management may have contributed to decreased rates in the leading causes of death. However, longer survival with comorbidities may have contributed to increased rates of death from Alzheimer disease and unintentional falls.
缺乏关于≥65 岁成年人近期死亡率趋势的报告。我们研究了 1999 年至 2020 年期间美国≥65 岁成年人主要死亡原因的趋势。
我们使用国家生命统计系统死亡率文件中的数据,确定了≥65 岁成年人的 10 大主要死因。我们计算了总体和特定死因的年龄调整死亡率,然后计算了 1999 年至 2020 年死亡率的平均年百分比变化(AAPC)。
1999 年至 2020 年期间,总体年龄调整死亡率平均每年下降 0.5%(95%CI,-1.0%至-0.1%)。尽管前 10 大死因中的 7 种死因的死亡率显著下降,但阿尔茨海默病(AAPC=3.0%;95%CI,1.5%至 4.5%)和意外伤害(AAPC=1.2%;95%CI,1.0%至 1.4%)的死亡率显著上升,尤其是跌倒(AAPC=4.1%;95%CI,3.9%至 4.3%)和中毒(AAPC=6.6%;95%CI,6.0%至 7.2%)。
公共卫生预防策略和慢性疾病管理的改善可能导致主要死因的死亡率下降。然而,随着合并症的生存时间延长,可能导致阿尔茨海默病和意外伤害导致的死亡率上升。