Wang Ping, Liu Qingping, Wang Jing, Du Jing, Tong Chao, Wei Zaihua, Su Jianting
Department of Statistics and Information Beijing Center for Disease Prevention and Control Beijing China.
Aging Med (Milton). 2025 Apr 24;8(2):91-98. doi: 10.1002/agm2.70019. eCollection 2025 Apr.
This study aims to comprehensively describe and analyze the disease burden of falls attributed to low bone mineral density (BMD) in China from 1990 to 2019. Furthermore, we seek to predict the future trends of this burden from 2020 to 2030 to inform evidence-based prevention and control strategies.
Using data from the 2019 Global Burden of Disease (GBD) study, we conducted an in-depth analysis of mortality and disability-adjusted life year (DALY) trends related to falls attributed to low BMD in China from 1990 to 2019. An age-period-cohort (APC) model was employed to estimate mortality risk, accounting for age, period, and cohort effects. A Bayesian framework was utilized to project mortality and DALY rates for the period 2020-2030.
From 1990 to 2019, there was a significant increase in both crude death rate (224.79%) and DALY rate (196.27%) among the Chinese population affected by falls due to low bone mineral density. The standardized death rate was higher among males compared to females; however, the standardized DALY rate remained lower than that observed among females throughout this period. Importantly, China witnessed a greater surge in deaths and DALYs compared with global figures as well as other socio-demographic index regions during this time frame. The APC model demonstrated a global change of 1.06% (95% confidence interval [CI]: 0.910-1.210) for men and 0.29% (95% CI: 0.147-0.426) for women over time. The death rate increased across all age groups for men, while it specifically increased for women aged 62.5 years and older. The risk of mortality dramatically escalates for individuals over 80 years old. Projections indicate a decline in the standardized mortality rate from falls due to low bone mineral density in both men and women in China during the period of 2020-2030; however, an increase is anticipated in the standardized DALY rate.
The mortality risk associated with falls due to low BMD in China is influenced by age, period, and cohort effects. Strengthening fall prevention and treatment strategies for older adults and younger birth cohorts, as well as addressing fall-related disabilities, is crucial to reducing the substantial burden posed by non-fatal falls. Targeted interventions are needed to mitigate the growing health and economic impacts of this public health issue.
本研究旨在全面描述和分析1990年至2019年中国低骨密度（BMD）所致跌倒的疾病负担。此外，我们试图预测2020年至2030年这一负担的未来趋势，为基于证据的预防和控制策略提供依据。
利用2019年全球疾病负担（GBD）研究的数据，我们对1990年至2019年中国低BMD所致跌倒相关的死亡率和伤残调整生命年（DALY）趋势进行了深入分析。采用年龄-时期-队列（APC）模型估计死亡风险，同时考虑年龄、时期和队列效应。利用贝叶斯框架预测2020 - 2030年的死亡率和DALY率。
1990年至2019年，中国受低骨密度所致跌倒影响人群的粗死亡率（224.79%）和DALY率（196.27%）均显著上升。男性的标准化死亡率高于女性；然而，在此期间，男性的标准化DALY率仍低于女性。重要的是，在此时间框架内，与全球数据以及其他社会人口指数地区相比，中国的死亡人数和DALYs增长更为显著。APC模型显示，随着时间推移，男性的全球变化为1.06%（95%置信区间[CI]：0.910 - 1.210），女性为0.29%（95%CI：0.147 - 0.426）。男性所有年龄组的死亡率均有所上升，而女性在62.5岁及以上年龄组死亡率尤其上升。80岁以上人群的死亡风险急剧上升。预测表明，2020 - 2030年期间中国男性和女性因低骨密度所致跌倒的标准化死亡率将下降；然而，标准化DALY率预计将上升。
中国低BMD所致跌倒的死亡风险受年龄、时期和队列效应影响。加强针对老年人和年轻出生队列的跌倒预防和治疗策略，以及解决与跌倒相关的残疾问题，对于减轻非致命跌倒造成的巨大负担至关重要。需要有针对性的干预措施来减轻这一公共卫生问题日益增长的健康和经济影响。
