Department of Epidemiology and Biostatistics, The Chair of Social and Preventive Medicine of the Medical University of Lodz, Lodz, Poland.
Front Public Health. 2023 Mar 6;11:1060028. doi: 10.3389/fpubh.2023.1060028. eCollection 2023.
The aim of the study was to assess mortality trends in Poland between 2000 and 2019 in the early and late old age population (65-74 years and over 75 years).
The work used data on all deaths of Polish residents aged over 65 years ( = 5,496,970). The analysis included the five most common major groups of causes of death: diseases of the circulatory system, malignant neoplasms, diseases of the respiratory system, diseases of the digestive system and external causes of mortality. The analysis of time trends has been carried out with the use of joinpoint models. The Annual Percentage Change (APC) for each segments of broken lines, the Average Annual Percentage Change (AAPC) for the whole study period (95% CI), and standardized death rates (SDRs) were calculated.
The percentage of deaths due to diseases of the circulatory system decreased in all the studied subgroups. Among malignant neoplasms, lung and bronchus cancers accounted for the largest percentage of deaths, for which the SDRs among men decreased, while those among women increased. In the early old age, the SDR value increased from 67.8 to 76.3 (AAPC = 0.6%, > 0.05), while in the late old age group it increased from 112.1 to 155.2 (AAPC = 1.8%, < 0.05). Among men, there was an upward trend for prostate cancer (AAPC = 0.4% in the early old age group and AAPC = 0.6% in the late old age group, > 0.05) and a downward trend for stomach cancer (AAPC -3.2 and -2.7%, respectively, < 0.05). Stomach cancer also showed a decreasing trend among women (AAPC -3.2 and -3.6%, < 0.05). SDRs due to influenza and pneumonia were increasing. Increasing trends in mortality due to diseases of the digestive system in women and men in the early old age group have been observed in recent years, due to alcoholic liver disease. Among the external causes of mortality in the late old age group, the most common ones were falls.
It is necessary to conduct further research that will allow to diagnose risk and health problems of the elderly subpopulation in order to meet the health burden of the aging society.
本研究旨在评估 2000 年至 2019 年期间波兰老年早期（65-74 岁）和老年晚期（75 岁以上）人群的死亡率趋势。
本研究使用了所有波兰 65 岁以上居民死亡数据（n=5496970）。分析包括五个最常见的主要死因：循环系统疾病、恶性肿瘤、呼吸系统疾病、消化系统疾病和外部死因。采用 joinpoint 模型对时间趋势进行分析。计算各分段折线的年变化百分比（APC）、整个研究期间的平均年变化百分比（AAPC）和标准化死亡率（SDR）。
在所有研究亚组中，循环系统疾病导致的死亡率百分比均有所下降。在恶性肿瘤中，肺癌和支气管癌导致的死亡率最高，其中男性的 SDR 下降，而女性的 SDR 上升。在老年早期，SDR 值从 67.8 增加到 76.3（AAPC=0.6%，>0.05），而在老年晚期，SDR 值从 112.1 增加到 155.2（AAPC=1.8%，<0.05）。在男性中，前列腺癌呈上升趋势（老年早期组 AAPC=0.4%，老年晚期组 AAPC=0.6%，>0.05），胃癌呈下降趋势（AAPC 分别为-3.2%和-2.7%，<0.05）。女性胃癌也呈下降趋势（AAPC 分别为-3.2%和-3.6%，<0.05）。流感和肺炎导致的死亡率呈上升趋势。近年来，老年早期女性和男性消化系统疾病的死亡率呈上升趋势，原因是酒精性肝病。在老年晚期人群的外部死因中，最常见的是跌倒。
有必要开展进一步的研究，以便诊断老年亚人群的健康风险和问题，以应对老龄化社会的健康负担。
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