Wu Haotian, Wang Yaqiang, Zhang Han, Yin Xiangjun, Wang Lijun, Wang Limin, Wu Jing
School of Public Health, Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Sci Rep. 2024 Dec 28;14(1):31123. doi: 10.1038/s41598-024-82443-2.
The phenomenon of population aging in China has evolved into an irreversible trend. The state places significant emphasis on the health-related initiatives for the elderly and has implemented pertinent policies. This study aims to identify the primary health issues affecting the elderly population in China, ascertain the key risk factors influencing their health, and offer a scientific foundation for the government to develop ongoing policies and strategies, as well as to allocate health resources efficiently. This study was conducted utilizing the nationwide surveillance and survey data collected by the National Center for Chronic and Noncommunicable Disease Control and Prevention, China. Descriptive statistics were employed to delineate the mortality rates, disease burden, prevalence of significant risk factors for chronic illnesses, as well as the incidence of disabilities and impairments among the elderly population in China. In 2019, the mortality rate of chronic non-communicable diseases among the elderly population in China aged 60 years and above was 31,238 per 100,000 individuals, representing 93.9% of all deaths. The disability-adjusted life years for males in the elderly population aged 60 years and above in 2019 totaled 103,850,000 person-years, while females accounted for 86,404,000 person-years. Among the elderly population in China, the top three diseases contributing to the highest Disability-Adjusted Life Years (DALYs) were stroke (19.202 million DALYs, representing 18.5% of the total DALYs), ischemic heart disease (13.895 million DALYs, 13.4%), and chronic obstructive pulmonary disease (COPD; 9.453 million DALYs, 9.1%). The primary risk factors associated with chronic diseases among the elderly population in China include inadequate consumption of fruits and vegetables, excessive intake of red meat, lack of physical activity, smoking, alcohol consumption, and being overweight or obese. There exist variations among genders, urban and rural areas, and regions. In 2015, the disability rate for activities of daily living (ADL) was notably high among the elderly population in China, reaching 19.4%. The prevalence of dysfunctions such as depressive symptoms, sleep disorders, and hearing loss is substantial. The prevalence of osteoporosis among the elderly in China is concerning. While China has achieved some progress in enhancing the health of the elderly, the current scenario of population aging in China is grave, and the health of the elderly continues to encounter numerous challenges. The prevalence of chronic diseases continues to be significant, with chronic conditions being the primary cause of mortality in the elderly population. Secondly, risk factors for chronic diseases persist among the elderly population, with a significant prevalence of smoking, alcohol consumption, and obesity. This issue is particularly serious in rural areas, showing an escalating trend that demands heightened attention. The prevalence of functional disorders among the elderly is notably high, and the issue of disability in this population segment is of significant concern. This study suggests five recommendations aimed at enhancing health-related policies and the health service system for the elderly, in response to the existing health challenges and demographic trends. The recommendations include creating an elderly-friendly environment, increasing government investment in elderly health, and addressing the aging population in China and so on to enhance the health outcomes of the elderly population in the country.
中国人口老龄化现象已演变成一种不可逆转的趋势。国家高度重视老年人的健康相关举措，并已实施相关政策。本研究旨在确定影响中国老年人口的主要健康问题，查明影响其健康的关键风险因素，为政府制定持续的政策和战略以及有效分配卫生资源提供科学依据。本研究利用中国国家慢性病预防控制中心收集的全国监测和调查数据进行。采用描述性统计来描述中国老年人口的死亡率、疾病负担、慢性病主要风险因素的患病率以及残疾和损伤发生率。2019年，中国60岁及以上老年人口中慢性非传染性疾病的死亡率为每10万人31238例，占总死亡人数的93.9%。2019年，60岁及以上老年男性的伤残调整生命年总计10385万人年，女性为8640.4万人年。在中国老年人口中，导致伤残调整生命年最高的三大疾病是中风（1920.2万伤残调整生命年，占总伤残调整生命年的18.5%）、缺血性心脏病（1389.5万伤残调整生命年，13.4%）和慢性阻塞性肺疾病（COPD；945.3万伤残调整生命年，9.1%）。中国老年人口中与慢性病相关的主要风险因素包括水果和蔬菜摄入不足、红肉摄入过多、缺乏体育活动、吸烟、饮酒以及超重或肥胖。在性别、城乡和地区之间存在差异。2015年，中国老年人口的日常生活活动（ADL）残疾率显著较高，达到19.4%。抑郁症状、睡眠障碍和听力损失等功能障碍的患病率很高。中国老年人骨质疏松症的患病率令人担忧。虽然中国在改善老年人健康方面取得了一些进展，但中国目前的人口老龄化形势严峻，老年人的健康仍然面临众多挑战。慢性病的患病率仍然很高，慢性病是老年人口死亡的主要原因。其次，老年人口中慢性病的风险因素仍然存在，吸烟、饮酒和肥胖的患病率很高。这个问题在农村地区尤为严重，呈上升趋势，需要高度关注。老年人群中功能障碍的患病率显著较高，这一人群的残疾问题备受关注。本研究针对现有的健康挑战和人口趋势，提出了五项旨在加强老年人健康相关政策和卫生服务体系的建议。这些建议包括营造老年人友好型环境、增加政府对老年人健康的投入以及应对中国的老龄化人口等，以提高该国老年人口的健康水平。
