Trends in all-cause mortality and leading causes of death from 2009 to 2019 among older adults in China

Jian Wu; Zihan Mu; Shuai Jiang; Yudong Miao; Yanyu Tang; Jing Wang; Suxian Wang; Yaojun Zhao

doi:10.1186/s12877-023-04346-7

Trends in all-cause mortality and leading causes of death from 2009 to 2019 among older adults in China

BMC Geriatr. 2023 Oct 11;23(1):645. doi: 10.1186/s12877-023-04346-7.

Authors

Jian Wu¹, Zihan Mu², Shuai Jiang³, Yudong Miao¹, Yanyu Tang¹, Jing Wang¹, Suxian Wang¹, Yaojun Zhao⁴

Affiliations

¹ Department of Health Management, College of Public Health, Zhengzhou University, Henan, People's Republic of China.
² Operation Management Department, Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China.
³ The First Affiliated Hospital of Zhengzhou University, Henan, People's Republic of China.
⁴ Operation Management Department, Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China. zhaoyaojun@zzu.edu.cn.

Abstract

Background: This study aimed to determine long-term variations in mortality trends and identify the leading causes of death among older adults in China from 2009 to 2019 so as to propose interventions to further stabilise the mortality rate among older adults and facilitate healthy ageing.

Methods: We extracted data from the China Death Surveillance database from 2009 to 2019 for all-cause mortality and cause-specific death among individuals aged ≥ 65 years. A joinpoint regression model was used to estimate mortality trends by calculating the annual percentage change (APC). A trend chi-square test was used to estimate sex differences in mortality, and descriptive analysis was used to estimate the leading causes of death. Semi-structured expert interviews were conducted to examine health interventions for older adults.

Results: We observed an overall declining trend in age-adjusted mortality rates among older adults aged ≥ 65 years in China from 2009 to 2019 (APC, -2.44; P < 0.05). In this population, the male mortality rate was higher than the female mortality rate during this period (P < 0.05). However, the mortality rate among older adults aged ≥ 85 years increased since 2014, particularly among females. Cardiovascular disease (CVD) was the leading cause of death among older adults aged 65-84 years, whereas ischaemic heart disease was the leading cause of death among individuals aged ≥ 85 years, especially among females. The majority of injuries resulting in death were caused by falls, showing an increasing trend.

Conclusions: CVD is a major cause of death among older adults aged ≥ 65 years in China, and relevant health intervention strategies should be implemented from the perspectives of physiology, psychology, and living environment. The change in the mortality trend and the distribution of cause of death among older adults aged ≥ 85 years is noteworthy; a diagnostic and management model centred around females aged ≥ 85 years should be implemented. Additionally, a multidimensional fall prevention strategy involving primary medical institutions and care services needs to be implemented to reduce the risk of falls among older adults.

Keywords: China; Leading causes of death; Mortality trends; Older adults.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cardiovascular Diseases*
Causality
Cause of Death
China / epidemiology
Female
Humans
Male
Mortality