Chronic and non-communicable disease mortality and trends in Chinese elderly, 2004-2018

Abstract

Objective: To analyze the mortality level and trend of chronic and non-communicable diseases (NCDs) among elderly residents aged 65 and over in China from 2004 to 2018, and predict the age-standardized mortality rate of NCDs from 2019 to 2023. Methods: Data on resident death was collected from the National Mortality Surveillance data set and used to analyze the unstandardized mortality rates, age-standardized mortality rates, composition ratios and changing trends of NCDs among different genders, urban and rural areas, and geographical regions in China during 2004 to 2018. The age-standardized mortality rates were calculated based on the Year 2010 Population Census of China. The Joinpoint Regression Models were fitted by the weighted least squares method. The average annual percent change (AAPC) and its 95% confidence interval for the entire time period were calculated. Log-linear models were used to predict age-standardized mortality rates. Results: From 2004 to 2018, the age-standardized mortality rates of NCDs decreased from 4 697.05 per 100 000 to 3 555.35 per 100 000, with an average annual decline of 2.0% (95%CI: -2.7%- -1.3%). The age-standardized mortality rates among different genders, urban and rural areas, and regions showed a downward trend. The age-standardized mortality rates of eastern region (AAPC = -2.1%, 95%CI: -2.8%- -1.3%) and central region (AAPC = -2.8%, 95%CI: -3.4%- -2.1%) fell faster than that of western region (AAPC = -0.8%, 95%CI: -1.8%-0.2%). The proportion of deaths caused by NCDs increased from 89.82% to 91.41%, with an average annual increase of 0.1% (95%CI: 0.1%-0.2%). Expected to 2023, the age-standardized mortality rates for male (3 906.23 per 100 000) will be significantly higher than female's (2 708.43 per 100 000); and that in rural areas (3 283.20 per 100 000) will be approximately equal to that in urban areas (3 250.01 per 100 000); the gap of age-standardized mortality rate between the western (3 782.48 per 100 000), eastern (3 037.01 per 100 000), and central region (3 249.24 per 100 000) will be further increased. Conclusion: From 2004 to 2018, age-standardized mortality rates of NCDs of the elderly residents in China showed a downward trend, and the proportion of deaths of NCDs showed an upward trend. Male and the western region elderly residents should be the key population for prevention and control of chronic diseases in the future.