Wang Cao, Zhou Ben-Jun, Gao Wei, Li Yi-Min
Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.
Department of Cardiology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.
J Geriatr Cardiol. 2025 Aug 28;22(8):709-724. doi: 10.26599/1671-5411.2025.08.004.
Physical inactivity is a significant yet underappreciated risk factor for cardiovascular disease (CVD), particularly among older adults. The aim of this study was to analyze the global burden of CVD attributable to physical inactivity in individuals aged 70 years and older from 1990 to 2021 using the Global Burden of Disease data.
We assessed trends in disability-adjusted life years (DALYs) and deaths, decomposed changes into population growth, aging, and epidemiological factors, and examined health inequalities across sociodemographic index (SDI) regions.
From 1990 to 2021, a substantial rise in DALYs was observed, especially in low and middle SDI regions, with a 120.06% increase in the low SDI region, but a 23.10% decline in the high SDI region. Decomposition analysis identified population aging and growth as primary drivers for the burden, contributing 66.39% and 83.56% to the increase in middle and low SDI regions, respectively. By contrast, epidemiological improvements alleviated burden in the high SDI region (54.91%). Gender disparities persisted, with women experiencing a higher burden. Inequality analysis indicated a shift in CVD burden towards the low SDI region, with declining concentration indices for DALYs (-0.03 to -0.13) and deaths (-0.07 to -0.15). The Bayesian age-period-cohort projections suggest continued increases in DALYs and deaths through 2050, with women disproportionately affected.
These findings highlight the urgent need for targeted interventions promoting physical activity, improving healthcare access, and implementing region-specific prevention strategies.
身体活动不足是心血管疾病（CVD）的一个重要但未得到充分重视的风险因素，在老年人中尤为如此。本研究的目的是利用全球疾病负担数据，分析1990年至2021年70岁及以上人群中因身体活动不足导致的心血管疾病全球负担。
我们评估了伤残调整生命年（DALYs）和死亡的趋势，将变化分解为人口增长、老龄化和流行病学因素，并研究了社会人口指数（SDI）区域间的健康不平等情况。
1990年至2021年期间，观察到DALYs大幅上升，尤其是在中低SDI区域，低SDI区域增加了120.06%，而高SDI区域下降了23.10%。分解分析确定人口老龄化和增长是负担的主要驱动因素，分别导致中低SDI区域负担增加的66.39%和83.56%。相比之下，流行病学的改善减轻了高SDI区域的负担（54.91%）。性别差异依然存在，女性负担更重。不平等分析表明，心血管疾病负担向低SDI区域转移，DALYs（从-0.03降至-0.13）和死亡（从-0.07降至-0.15）的集中指数下降。贝叶斯年龄-时期-队列预测表明，到2050年DALYs和死亡人数将持续增加，女性受到的影响尤为严重。
这些发现凸显了针对性干预措施的迫切需求，这些措施包括促进身体活动、改善医疗服务可及性以及实施针对特定区域预防策略。
