Population ageing and mortality during 1990–2017: A global decomposition analysis
Autoři:
Xunjie Cheng aff001; Yang Yang aff002; David C. Schwebel aff004; Zuyun Liu aff005; Li Li aff006; Peixia Cheng aff001; Peishan Ning aff001; Guoqing Hu aff001
Působiště autorů:
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
aff001; Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
aff002; Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
aff003; Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
aff004; Department of Pathology, Yale School of Medicine, New Haven, Connecticut, United States of America
aff005; Division of Epidemiology, College of Public Health, Ohio State University, Columbus, Ohio, United States of America
aff006; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
aff007
Vyšlo v časopise:
Population ageing and mortality during 1990–2017: A global decomposition analysis. PLoS Med 17(6): e32767. doi:10.1371/journal.pmed.1003138
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pmed.1003138
Souhrn
Background
As the number of older people globally increases, health systems need to be reformed to meet the growing need for medical resources. A few previous studies reported varying health impacts of population ageing, but they focused only on limited countries and diseases. We comprehensively quantify the impact of population ageing on mortality for 195 countries/territories and 169 causes of death.
Methods and findings
Using data from the Global Burden of Disease Study 2017 (GBD 2017), this study derived the total number of deaths and population size for each year from 1990 to 2017. A decomposition method was used to attribute changes in total deaths to population growth, population ageing, and mortality change between 1990 and each subsequent year from 1991 through 2017, for 195 countries/territories and for countries grouped by World Bank economic development level. For countries with increases in deaths related to population ageing, we calculated the ratio of deaths attributed to mortality change to those attributed to population ageing. The proportion of people aged 65 years and older increased globally from 6.1% to 8.8%, and the number of global deaths increased by 9 million, between 1990 and 2017. Compared to 1990, 12 million additional global deaths in 2017 were associated with population ageing, corresponding to 27.9% of total global deaths. Population ageing was associated with increases in deaths in high-, upper-middle-, and lower-middle-income countries but not in low-income countries. The proportions of deaths attributed to population ageing in 195 countries/territories ranged from −43.9% to 117.4% for males and −30.1% to 153.5% for females. The 2 largest contributions of population ageing to disease-specific deaths globally between 1990 and 2017 were for ischemic heart disease (3.2 million) and stroke (2.2 million). Population ageing was related to increases in deaths in 152 countries for males and 159 countries for females, and decreases in deaths in 43 countries for males and 36 countries for females, between 1990 and 2017. The decreases in deaths attributed to mortality change from 1990 to 2017 were more than the increases in deaths related to population ageing for the whole world, as well as in 55.3% (84/152) of countries for males and 47.8% (76/159) of countries for females where population ageing was associated with increased death burden. As the GBD 2017 does not provide variances in the estimated death numbers, we were not able to quantify uncertainty in our attribution estimates.
Conclusions
In this study, we found that population ageing was associated with substantial changes in numbers of deaths between 1990 and 2017, but the attributed proportion of deaths varied widely across country income levels, countries, and causes of death. Specific preventive and therapeutic techniques should be implemented in different countries and territories to address the growing health needs related to population ageing, especially targeting the diseases associated with the largest increase in number of deaths in the elderly.
Klíčová slova:
Age groups – Aging – Aging and cancer – Alzheimer's disease – Coronary heart disease – Death rates – Global health – Population growth
Zdroje
1. United Nations Population Division. World population prospects 2019. New York: United Nations Population Division; 2019 [cited 2019 Aug 16]. Available from: https://population.un.org/wpp/Download/Standard/Population/.
2. Prince MJ, Wu F, Guo YF, Gutierrez Robledo LM, O’Donnell M, Sullivan R, et al. The burden of disease in older people and implications for health policy and practice. Lancet. 2015;385(9967):549–62.
3. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2197–223.
4. Pou SA, Tumas N, Coquet JB, Niclis C, Román MD, Díaz MD. Burden of cancer mortality and differences attributable to demographic aging and risk factors in Argentina, 1986–2011. Cad Saude Publica. 2017;33(2):e00016616.
5. GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1345–422.
6. Modig K, Drefahl S, Andersson T, Ahlbom A. The aging population in Sweden: can declining incidence rates in MI, stroke and cancer counterbalance the future demographic challenges? Eur J Epidemiol. 2012;27(2):139–45.
7. Xu JF, Wang J, Wimo A, Fratiglioni L, Qiu CX. The economic burden of dementia in China, 1990–2030: implications for health policy. Bull World Health Organ. 2017;95(1):18–26.
8. Moran A, Gu DF, Zhao D, Coxson P, Wang YC, Chen CS, et al. Future cardiovascular disease in China: Markov model and risk factor scenario projections from the coronary heart disease policy model-china. Circ Cardiovasc Qual Outcomes. 2010;3(3):243–52.
9. Martini EM, Garrett N, Lindquist T, Isham GJ. The boomers are coming: a total cost of care model of the impact of population aging on health care costs in the United States by Major Practice Category. Health Serv Res. 2007;42(1 Pt 1):201–18.
10. Boyle JP, Honeycutt AA, Narayan KM, Hoerger TJ, Geiss LS, Chen H, et al. Projection of diabetes burden through 2050: impact of changing demography and disease prevalence in the U.S. Diabetes Care. 2001;24(11):1936–40.
11. Guzman Castillo M, Gillespie DO, Allen K, Bandosz P, Schmid V, Capewell S, et al. Future declines of coronary heart disease mortality in England and Wales could counter the burden of population ageing. PLoS ONE. 2014;9(6):e99482.
12. Guzman Castillo M, Ahmadi Abhari S, Bandosz P, Capewell S, Steptoe A, Singh Manoux A, et al. Forecasted trends in disability and life expectancy in England and Wales up to 2025: a modelling study. Lancet Public Health. 2017;2(7):e307–13.
13. Cheng J, Zhao D, Zeng ZC, Critchley JA, Liu J, Wang W, et al. The impact of demographic and risk factor changes on coronary heart disease deaths in Beijing, 1999–2010. BMC Public Health. 2009;9:30.
14. Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Akinyemiju TF, Al Lami FH, Alam T, Alizadeh-Navaei R, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2016: a systematic analysis for the Global Burden of Disease Study. JAMA Oncol. 2018;4(11):1553–68.
15. GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1736–88.
16. Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Allen C, Barber RM, Barregard L, Bhutta ZA, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the Global Burden of Disease Study. JAMA Oncol. 2017;3(4):524–48.
17. GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1459–544.
18. Cheng XJ, Tan LH, Gao YY, Yang Y, Schwebel DC, Hu GQ. A new method to attribute differences in total deaths between groups to population size, age structure and age-specific mortality rate. PLoS ONE. 2019;14(5):e0216613.
19. Global Health Data Exchange. GBD results tool. Seattle: Institute for Health Metrics and Evaluation; 2019 [cited 2019 Jun 3]. Available from: http://ghdx.healthdata.org/gbd-results-tool.
20. Global Health Data Exchange. Global Burden of Disease Study 2017 (GBD 2017) population estimates 1950–2017. Seattle: Institute for Health Metrics and Evaluation; 2019 [cited 2019 Jun 24]. Available from: http://ghdx.healthdata.org/record/ihme-data/gbd-2017-population-estimates-1950-2017.
21. Ahern RM, Lozano R, Naghavi M, Foreman K, Gakidou E, Murray CJ. Improving the public health utility of global cardiovascular mortality data: the rise of ischemic heart disease. Popul Health Metr. 2011;9:8.
22. GBD 2017 Population and Fertility Collaborators. Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1995–2051.
23. World Bank Group. World development indicators. Washington (DC): World Bank Group; 2019 [cited 2019 Jun 28]. Available from: http://wdi.worldbank.org/tables.
24. Stevens GA, Alkema L, Black RE, Boerma JT, Collins GS, Ezzati M, et al. Guidelines for Accurate and Transparent Health Estimates Reporting: the GATHER statement. PLoS Med. 2016;13(6):e1002056.
25. Roth GA, Forouzanfar MH, Moran AE, Barber R, Nguyen G, Feigin VL, et al. Demographic and epidemiologic drivers of global cardiovascular mortality. N Engl J Med. 2015;372(14):1333–41.
26. Kiadaliri AA, Woolf AD, Englund M. Musculoskeletal disorders as underlying cause of death in 58 countries, 1986–2011: trend analysis of WHO mortality database. BMC Musculoskelet Disord. 2017;18(1):62.
27. Lutz W, Sanderson W, Scherbov S. The coming acceleration of global population ageing. Nature. 2008;451(7179):716–9.
28. Amosun SL, Doyle-Baker PK. What can Sub-Saharan Africa learn from Canada’s investment in active healthy ageing? A narrative view. Malawi Med J. 2019;31(1):95–8.
29. Assmann KE, Adjibade M, Adriouch S, Andreeva VA, Julia C, Hercberg S, et al. Association of diet quality and physical activity with healthy ageing in the French NutriNet-Santé cohort. Br J Nutr. 2019;122(1):93–102.
30. Saito J, Haseda M, Amemiya A, Takagi D, Kondo K, Kondo N. Community-based care for healthy ageing: lessons from Japan. Bull World Health Organ. 2019;97(8):570–4.
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