Yang Li, Xing Yuhan, Gao Xinjing, Guo Cui, Wu Dongze
Department of Dermatology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.
Front Public Health. 2025 Jul 29;13:1611901. doi: 10.3389/fpubh.2025.1611901. eCollection 2025.
Population aging represents a pressing challenge for China, given its vast population and the growing proportion of adults aged 65 years and older. The study aimed to assess burden of ageing spectrum of diseases in China from 1990 to 2021.
The main outcome measures were disability-adjusted life years (DALYs), summary exposure values (SEVs), and attributable risk. The average annual percent change (AAPC) in number and age specific rate (ASR) were calculated to quantify the temporal trends. The decomposition analysis was utilized to assess the impact of population aging on the burden of disease.
From 1990 to 2021, The ASR of all-cause DALYs in China decreased by 35.94% overall and by 33.99% among individuals ≥65 years. However, the number of DALYs attributed to population ageing among people aged 65 and older has been increasing by 10.45 million. Chronic obstructive pulmonary disease, stroke, and ischemic heart disease are most significantly affected by the aging trend. Notably, the older adults population exhibited the most pronounced increase in HIV/AIDS-related DALYs, especially in the 70-74 years group (AAPC: 7.96, 95% CI 6.69, 9.24). Additionally, notable changes in COVID-19-related DALYs became evident beginning in 2019. Regarding risk factors, particulate matter pollution, smoking, and high sodium diets emerged as the top three contributors to health risks among the older adults.
To address burden of ageing spectrum of diseases, China should leverage complementary roles of public and private insurance to manage cardiovascular and pulmonary disease, promote healthy environments and diets and prioritize prevention of HIV/AIDS.
鉴于中国人口众多且65岁及以上成年人比例不断增加，人口老龄化对中国构成了紧迫挑战。本研究旨在评估1990年至2021年中国老龄化疾病谱的负担。
主要结局指标为伤残调整生命年（DALYs）、汇总暴露值（SEVs）和归因风险。计算数量和年龄别率（ASR）的年均变化百分比（AAPC）以量化时间趋势。采用分解分析评估人口老龄化对疾病负担的影响。
1990年至2021年，中国全因DALYs的ASR总体下降了35.94%，65岁及以上人群下降了33.99%。然而，65岁及以上人群中归因于人口老龄化的DALYs数量一直在增加，增加了1045万。慢性阻塞性肺疾病、中风和缺血性心脏病受老龄化趋势影响最为显著。值得注意的是，老年人中与艾滋病毒/艾滋病相关的DALYs增幅最为明显，尤其是在70-74岁年龄组（AAPC：7.96，95%CI 6.69，9.24）。此外，2019年开始，与新冠病毒相关的DALYs出现了显著变化。在风险因素方面，颗粒物污染、吸烟和高钠饮食成为老年人健康风险的三大主要因素。
为应对老龄化疾病谱负担，中国应利用公共和私人保险的互补作用来管理心血管和肺部疾病，促进健康环境和饮食，并优先预防艾滋病毒/艾滋病。
