Article(id=1324077461671125987, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077443828560770, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202510109, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1760025600000, receivedDateStr=2025-10-10, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614267032, onlineDateStr=2026-11-02, pubDate=1775750400000, pubDateStr=2026-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614267032, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614267032, creator=13701087609, updateTime=1793614267032, updator=13701087609, issue=Issue{id=1324077443828560770, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='7', pageStart='1153', pageEnd='1344', issueExtLink='null', onlineDate='null', pubDate='1775750400000', pubDateStr='2026-04-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614262778, creator='13701087609', updateTime=1793614352085, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324077818509918661, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077443828560770, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324077818509918662, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077443828560770, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1180, endPage=1185, ext={EN=ArticleExt(id=1324077462023447524, articleId=1324077461671125987, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Comparative analysis and forecasting of mortality and life expectancy among the aged in China and globally, 1990—2021, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the trend of mortality and life expectancy (LE) among people aged 60 years and above in China and globally from 1990 to 2021, to provide scientific evidence for improving the health of the aged.

Methods

Based on the GBD 2021 data, mortality rate, rank of causes of death, LE of the aged 60 years and above in China and globally were selected to compare the changes of each index from 1990 to 2019 and 2019 to 2021. The Joinpoint model was used to calculate the average annual percentage change (AAPC), and the ARIMA model was used to predict the mortality and LE of the aged.

Results

Compared with 1990, the mortality rate of the aged in China and globally decreased significantly in 2019 (P<0.001), and the decline was greater in China. Compared with 2019, the mortality rate of the aged in the world increased in 2021, while it decreased slightly in China. The mortality rate of the older adults in the oldest age group in China was higher than that in the world. In terms of the ranking of causes of death, cardiovascular disease was always the first cause of death both in China and globally. Compared with 1990, the LE and health-adjusted life expectancy (HALE) of the aged in China and the world increased significantly in 2019(P<0.001). Compared with 2019, the LE and HALE of the aged in China increased in 2021, while the global values decreased. The LE of the older adults in the oldest age group in China was lower than that in the world. LE was higher in women than in men. The prediction showed that the LE of the aged in China would increase in the next 15 years, while the LE of the aged in the world would decline slightly.

Conclusion

The LE and HALE of the aged in China increased from 1990 to 2021, but decreased from 2019 to 2021 in the world. The health deficiencies, “unhealthy longevity”, and gender differences among the older adults in the oldest age group in China are prominent, and targeted, strengthened care and intervention are needed.

, authors=Jin-feng WANG1, Yuan-ze DU1, Bing-yi WU2, Juan-juan LIANG3, Xiao-fang ZHANG1, Xin-yu ZHANG1, Jia-qi ZHANG1, Yue-yuan LI1, Fang-yu CHENG1, Chun-ping WANG1, authorsList=Jin-feng WANG, Yuan-ze DU, Bing-yi WU, Juan-juan LIANG, Xiao-fang ZHANG, Xin-yu ZHANG, Jia-qi ZHANG, Yue-yuan LI, Fang-yu CHENG, Chun-ping WANG, authorCompany=null, correspAuthors=Chun-ping WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324077464510669801, articleId=1324077461671125987, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=1990—2021年中国与全球老年人死亡率与期望寿命的比较及预测研究, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

分析1990—2021年中国与全球60岁及以上老年人死亡率及期望寿命的变化趋势,为提升老年人健康水平提供科学依据。

方法

基于2021年全球疾病负担数据,选取中国与全球60岁及以上老年人的死亡率、死因顺位、期望寿命等指标,比较1990—2019年和2019—2021年各指标变化情况,采用joinpoint模型计算平均年度变化百分比,并利用差分自回归移动平均模型预测老年人死亡率及期望寿命。

结果

与1990年相比,2019年中国与全球老年人死亡率显著下降(P<0.001),且中国降幅更大;与2019年相比,2021年全球老年人死亡率有所上升,中国则小幅下降,其中中国高龄组老年人死亡率高于全球。死因顺位方面,无论是中国还是全球,心血管疾病始终为首位死因。与1990年相比,2019年中国与全球老年人期望寿命和健康预期寿命(health-adjusted life expectancy,HALE)呈显著上升趋势(P<0.001);与2019年相比,2021年中国老年人期望寿命和HALE有所上升,而全球有所下降;中国高龄组老年人期望寿命低于全球;女性期望寿命普遍高于男性。预测显示,未来15年中国老年人期望寿命呈上升趋势,全球老年人期望寿命呈小幅下降趋势。

结论

1990—2021年中国老年人期望寿命和HALE呈上升趋势,但在2019—2021年,全球老年人期望寿命和HALE有所下降。中国高龄老人健康短板、“长寿不健康”及性别差异问题突出,需针对性强化照护与干预。

, authors=王金凤1, 杜媛泽1, 吴炳义2, 梁娟娟3, 张小芳1, 张信宇1, 张佳琪1, 李月圆1, 成方宇1, 王春平1, authorsList=王金凤, 杜媛泽, 吴炳义, 梁娟娟, 张小芳, 张信宇, 张佳琪, 李月圆, 成方宇, 王春平, authorCompany=null, correspAuthors=王春平, authorNote=

王金凤(1999—),女,硕士在读,研究方向:公共卫生

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王春平,E-mail:
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Changes in mortality, life expectancy and healthy life expectancy of the aged in China and globally from 1990 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄(岁)年份(年)全球中国
合计死亡率(1/10万)男性期望寿命女性期望寿命合计期望寿命合计HALE合计死亡率(1/10万)男性期望寿命女性期望寿命合计期望寿命合计HALE
60~6419901 969.5216.5619.7118.1913.801 953.3315.7418.0716.8913.19
20191 327.9219.5422.7821.1815.901 021.7419.1823.1021.0216.10
20211 610.7718.0321.6719.8314.90987.4619.3223.2321.1516.15
变化率(%)或可变数量*-32.582.983.072.992.10-47.693.445.034.122.91
变化率(%)或可变数量#21.30-1.51-1.11-1.35-1.01-3.360.140.130.140.05
AAPC(%)*-1.400.580.500.540.49-2.260.670.910.770.71
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
65~6919902 919.3713.4016.0614.8110.973 096.5512.3414.3613.3710.17
20191 994.3416.0118.8317.4612.791 618.4715.3018.8416.9712.66
20212 394.3614.7017.8516.2811.931 602.5015.4218.9617.0912.71
变化率(%)或可变数量*-31.692.612.772.651.82-47.732.954.483.602.49
变化率(%)或可变数量#20.06-1.31-0.98-1.17-0.86-0.990.120.120.120.05
AAPC(%)*-1.290.630.550.580.54-2.150.731.000.840.78
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
70~7419904 552.5110.5712.7111.758.465 408.369.3010.9810.187.52
20193 054.4112.7815.1514.039.992 971.9611.6914.8513.199.55
20213 649.2611.6814.3213.049.282 926.9611.7914.9513.309.59
变化率(%)或可变数量*-32.912.212.442.281.53-45.052.393.863.012.03
变化率(%)或可变数量#19.47-1.10-0.84-0.99-0.71-1.510.100.110.110.04
AAPC(%)*-1.370.680.600.620.58-2.150.801.120.930.86
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
75~7919906 892.978.189.839.136.368 572.556.868.187.585.42
20194 831.559.9011.8310.957.555 078.028.5911.329.926.93
20215 560.399.0211.1610.157.004 955.958.6611.4210.006.96
变化率(%)或可变数量*-29.911.722.001.821.19-40.761.733.142.341.51
变化率(%)或可变数量#15.09-0.88-0.67-0.80-0.55-2.400.080.090.080.03
AAPC(%)*-1.290.660.640.620.59-1.800.761.200.950.88
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
80~84199010 595.586.187.356.894.6214 188.304.745.835.373.69
20197 859.457.388.948.265.499 324.445.868.247.064.73
20219 007.776.698.377.625.069 174.205.918.327.124.74
变化率(%)或可变数量*-25.821.201.581.370.87-34.281.112.411.701.03
变化率(%)或可变数量#14.61-0.69-0.57-0.64-0.43-1.610.050.080.060.01
AAPC(%)*-1.000.630.660.600.58-1.500.721.280.970.89
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
85~89199016 497.424.575.375.093.2725 214.512.904.013.572.35
201912 877.275.346.606.093.8817 446.423.565.924.833.08
202114 406.774.796.195.613.5717 306.833.595.984.873.08
变化率(%)或可变数量*-21.940.771.221.000.62-30.810.661.911.260.72
变化率(%)或可变数量#11.88-0.55-0.41-0.48-0.31-0.800.030.060.040.00
AAPC(%)*-0.830.490.670.620.59-1.320.691.481.090.98
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
90~94199024 296.443.463.973.812.3440 363.621.782.822.451.54
201919 620.224.074.794.542.7627 162.572.374.173.492.10
202122 132.443.574.484.152.5226 906.912.394.213.522.10
变化率(%)或可变数量*-19.250.610.810.720.43-32.710.581.351.040.56
变化率(%)或可变数量#12.80-0.50-0.30-0.38-0.24-0.940.020.040.030.00
AAPC(%)*-0.740.570.600.580.60-1.370.991.541.271.13
P值<0.0010.002<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
≥95199032 362.482.943.093.051.7848 477.192.421.962.041.21
201927 365.943.503.593.562.0834 572.042.253.062.841.61
202129 936.793.103.453.351.9534 164.152.273.102.871.61
变化率(%)或可变数量*-15.440.550.500.520.30-28.68-0.171.100.800.39
变化率(%)或可变数量#9.39-0.40-0.14-0.22-0.13-1.180.020.040.040.00
AAPC(%)*-0.590.480.510.490.50-1.16-0.311.541.150.98
P值<0.0010.003<0.001<0.001<0.001<0.0010.293<0.001<0.0010.002
), ArticleFig(id=1324077470680490033, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077461671125987, language=CN, label=表1, caption=

1990—2021年全球与中国老年人死亡率、期望寿命及HALE的变化

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄(岁)年份(年)全球中国
合计死亡率(1/10万)男性期望寿命女性期望寿命合计期望寿命合计HALE合计死亡率(1/10万)男性期望寿命女性期望寿命合计期望寿命合计HALE
60~6419901 969.5216.5619.7118.1913.801 953.3315.7418.0716.8913.19
20191 327.9219.5422.7821.1815.901 021.7419.1823.1021.0216.10
20211 610.7718.0321.6719.8314.90987.4619.3223.2321.1516.15
变化率(%)或可变数量*-32.582.983.072.992.10-47.693.445.034.122.91
变化率(%)或可变数量#21.30-1.51-1.11-1.35-1.01-3.360.140.130.140.05
AAPC(%)*-1.400.580.500.540.49-2.260.670.910.770.71
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
65~6919902 919.3713.4016.0614.8110.973 096.5512.3414.3613.3710.17
20191 994.3416.0118.8317.4612.791 618.4715.3018.8416.9712.66
20212 394.3614.7017.8516.2811.931 602.5015.4218.9617.0912.71
变化率(%)或可变数量*-31.692.612.772.651.82-47.732.954.483.602.49
变化率(%)或可变数量#20.06-1.31-0.98-1.17-0.86-0.990.120.120.120.05
AAPC(%)*-1.290.630.550.580.54-2.150.731.000.840.78
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
70~7419904 552.5110.5712.7111.758.465 408.369.3010.9810.187.52
20193 054.4112.7815.1514.039.992 971.9611.6914.8513.199.55
20213 649.2611.6814.3213.049.282 926.9611.7914.9513.309.59
变化率(%)或可变数量*-32.912.212.442.281.53-45.052.393.863.012.03
变化率(%)或可变数量#19.47-1.10-0.84-0.99-0.71-1.510.100.110.110.04
AAPC(%)*-1.370.680.600.620.58-2.150.801.120.930.86
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
75~7919906 892.978.189.839.136.368 572.556.868.187.585.42
20194 831.559.9011.8310.957.555 078.028.5911.329.926.93
20215 560.399.0211.1610.157.004 955.958.6611.4210.006.96
变化率(%)或可变数量*-29.911.722.001.821.19-40.761.733.142.341.51
变化率(%)或可变数量#15.09-0.88-0.67-0.80-0.55-2.400.080.090.080.03
AAPC(%)*-1.290.660.640.620.59-1.800.761.200.950.88
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
80~84199010 595.586.187.356.894.6214 188.304.745.835.373.69
20197 859.457.388.948.265.499 324.445.868.247.064.73
20219 007.776.698.377.625.069 174.205.918.327.124.74
变化率(%)或可变数量*-25.821.201.581.370.87-34.281.112.411.701.03
变化率(%)或可变数量#14.61-0.69-0.57-0.64-0.43-1.610.050.080.060.01
AAPC(%)*-1.000.630.660.600.58-1.500.721.280.970.89
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
85~89199016 497.424.575.375.093.2725 214.512.904.013.572.35
201912 877.275.346.606.093.8817 446.423.565.924.833.08
202114 406.774.796.195.613.5717 306.833.595.984.873.08
变化率(%)或可变数量*-21.940.771.221.000.62-30.810.661.911.260.72
变化率(%)或可变数量#11.88-0.55-0.41-0.48-0.31-0.800.030.060.040.00
AAPC(%)*-0.830.490.670.620.59-1.320.691.481.090.98
P值<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
90~94199024 296.443.463.973.812.3440 363.621.782.822.451.54
201919 620.224.074.794.542.7627 162.572.374.173.492.10
202122 132.443.574.484.152.5226 906.912.394.213.522.10
变化率(%)或可变数量*-19.250.610.810.720.43-32.710.581.351.040.56
变化率(%)或可变数量#12.80-0.50-0.30-0.38-0.24-0.940.020.040.030.00
AAPC(%)*-0.740.570.600.580.60-1.370.991.541.271.13
P值<0.0010.002<0.001<0.001<0.001<0.001<0.001<0.001<0.001<0.001
≥95199032 362.482.943.093.051.7848 477.192.421.962.041.21
201927 365.943.503.593.562.0834 572.042.253.062.841.61
202129 936.793.103.453.351.9534 164.152.273.102.871.61
变化率(%)或可变数量*-15.440.550.500.520.30-28.68-0.171.100.800.39
变化率(%)或可变数量#9.39-0.40-0.14-0.22-0.13-1.180.020.040.040.00
AAPC(%)*-0.590.480.510.490.50-1.16-0.311.541.150.98
P值<0.0010.003<0.001<0.001<0.001<0.0010.293<0.001<0.0010.002
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1990—2021年中国与全球老年人死亡率与期望寿命的比较及预测研究
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王金凤 1 , 杜媛泽 1 , 吴炳义 2 , 梁娟娟 3 , 张小芳 1 , 张信宇 1 , 张佳琪 1 , 李月圆 1 , 成方宇 1 , 王春平 1
现代预防医学 | 流行病与统计方法 2026,53(7): 1180-1185
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现代预防医学 |流行病与统计方法 2026 , 53 (7) : 1180 -1185
1990—2021年中国与全球老年人死亡率与期望寿命的比较及预测研究
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王金凤1, 杜媛泽1, 吴炳义2, 梁娟娟3, 张小芳1, 张信宇1, 张佳琪1, 李月圆1, 成方宇1, 王春平1
作者信息
  • 1.山东第二医科大学公共卫生学院,山东 潍坊 261053
  • 2.山东第二医科大学管理学院
  • 3.河南省第三人民医院
通讯作者:
王春平,E-mail:
作者简介:

王金凤(1999—),女,硕士在读,研究方向:公共卫生

Comparative analysis and forecasting of mortality and life expectancy among the aged in China and globally, 1990—2021
Jin-feng WANG1, Yuan-ze DU1, Bing-yi WU2, Juan-juan LIANG3, Xiao-fang ZHANG1, Xin-yu ZHANG1, Jia-qi ZHANG1, Yue-yuan LI1, Fang-yu CHENG1, Chun-ping WANG1
Affiliations
  • School of Public Health, Shandong Second Medical University, Weifang, Shandong 261053, China
出版时间: 2026-04-10 doi: 10.20043/j.cnki.MPM.202510109
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目的

分析1990—2021年中国与全球60岁及以上老年人死亡率及期望寿命的变化趋势,为提升老年人健康水平提供科学依据。

方法

基于2021年全球疾病负担数据,选取中国与全球60岁及以上老年人的死亡率、死因顺位、期望寿命等指标,比较1990—2019年和2019—2021年各指标变化情况,采用joinpoint模型计算平均年度变化百分比,并利用差分自回归移动平均模型预测老年人死亡率及期望寿命。

结果

与1990年相比,2019年中国与全球老年人死亡率显著下降(P<0.001),且中国降幅更大;与2019年相比,2021年全球老年人死亡率有所上升,中国则小幅下降,其中中国高龄组老年人死亡率高于全球。死因顺位方面,无论是中国还是全球,心血管疾病始终为首位死因。与1990年相比,2019年中国与全球老年人期望寿命和健康预期寿命(health-adjusted life expectancy,HALE)呈显著上升趋势(P<0.001);与2019年相比,2021年中国老年人期望寿命和HALE有所上升,而全球有所下降;中国高龄组老年人期望寿命低于全球;女性期望寿命普遍高于男性。预测显示,未来15年中国老年人期望寿命呈上升趋势,全球老年人期望寿命呈小幅下降趋势。

结论

1990—2021年中国老年人期望寿命和HALE呈上升趋势,但在2019—2021年,全球老年人期望寿命和HALE有所下降。中国高龄老人健康短板、“长寿不健康”及性别差异问题突出,需针对性强化照护与干预。

老年人  /  死亡率  /  期望寿命  /  健康预期寿命  /  新冠感染疫情
Objective

To analyze the trend of mortality and life expectancy (LE) among people aged 60 years and above in China and globally from 1990 to 2021, to provide scientific evidence for improving the health of the aged.

Methods

Based on the GBD 2021 data, mortality rate, rank of causes of death, LE of the aged 60 years and above in China and globally were selected to compare the changes of each index from 1990 to 2019 and 2019 to 2021. The Joinpoint model was used to calculate the average annual percentage change (AAPC), and the ARIMA model was used to predict the mortality and LE of the aged.

Results

Compared with 1990, the mortality rate of the aged in China and globally decreased significantly in 2019 (P<0.001), and the decline was greater in China. Compared with 2019, the mortality rate of the aged in the world increased in 2021, while it decreased slightly in China. The mortality rate of the older adults in the oldest age group in China was higher than that in the world. In terms of the ranking of causes of death, cardiovascular disease was always the first cause of death both in China and globally. Compared with 1990, the LE and health-adjusted life expectancy (HALE) of the aged in China and the world increased significantly in 2019(P<0.001). Compared with 2019, the LE and HALE of the aged in China increased in 2021, while the global values decreased. The LE of the older adults in the oldest age group in China was lower than that in the world. LE was higher in women than in men. The prediction showed that the LE of the aged in China would increase in the next 15 years, while the LE of the aged in the world would decline slightly.

Conclusion

The LE and HALE of the aged in China increased from 1990 to 2021, but decreased from 2019 to 2021 in the world. The health deficiencies, “unhealthy longevity”, and gender differences among the older adults in the oldest age group in China are prominent, and targeted, strengthened care and intervention are needed.

The aged  /  Mortality  /  Life expectancy  /  Healthy life expectancy  /  COVID-19 pandemic
王金凤, 杜媛泽, 吴炳义, 梁娟娟, 张小芳, 张信宇, 张佳琪, 李月圆, 成方宇, 王春平. 1990—2021年中国与全球老年人死亡率与期望寿命的比较及预测研究. 现代预防医学, 2026 , 53 (7) : 1180 -1185 . DOI: 10.20043/j.cnki.MPM.202510109
Jin-feng WANG, Yuan-ze DU, Bing-yi WU, Juan-juan LIANG, Xiao-fang ZHANG, Xin-yu ZHANG, Jia-qi ZHANG, Yue-yuan LI, Fang-yu CHENG, Chun-ping WANG. Comparative analysis and forecasting of mortality and life expectancy among the aged in China and globally, 1990—2021[J]. Modern Preventive Medicine, 2026 , 53 (7) : 1180 -1185 . DOI: 10.20043/j.cnki.MPM.202510109
近年来,随着人民生活质量的提高与医疗科技的进步,人口老龄化问题已成为全球社会发展的重大议题之一。根据联合国数据显示,全球约8亿人处于老年阶段,在未来老年人口数量将增长到10亿。第七次全国人口普查数据显示,60岁及以上人口已超过2.6亿,预计2035年将达3.8亿[1]。由此可见,中国将持续处于老龄化阶段,且这一阶段的老龄人口规模大、增长速度快。在这一背景下,老年人的期望寿命(life expectancy)与生存质量也愈来愈受到社会关注,将生命长度和生存质量结合起来,已成为衡量老年人健康水平的尺度[2]。近十年来,国内外学者更侧重于研究老年人慢性病[3]、心理健康[4]、认知功能[5]等,而对老年人期望寿命的相关研究较少,也缺乏对中国与全球60岁及以上老年人期望寿命的比较及预测。因此,本研究基于2021年全球疾病负担(Global Burden of Disease,GBD)数据,对1990—2021年中国与全球老年人死亡率与期望寿命比较及预测,为老年人生命长度以及质量提供科学依据。
本研究数据来源于GBD 2021,该数据库估计了全球204个国家和地区以及811个次国家级地点的全球年龄性别死亡率、预期寿命和人口估计数[6,7]。纳入本研究的资料包括1990—2021年中国与全球60岁及以上老年人死亡率、期望寿命相关指标数据。具体数据均可通过GBD查询工具下载(https://vizhub.healthdata.org/gbd-results/)。
本研究用1990—2021年中国与全球老年人的死亡率、死因顺位、期望寿命、健康预期寿命(health-adjusted life expectancy,HALE)来综合评价老年人的状况。期望寿命是指某年龄的群体今后尚能生存的平均寿命,反映生命长度[8];HALE是指某年龄人群在保持完全健康状态下尚能存活的期望年数,体现生命长度跟质量[9-10]。
考虑到新冠感染疫情影响,因此将死亡率的变化率、期望寿命及HALE的可变数量分为2019年前后两个时间段进行分析,并用EXCEL软件计算。变化率=[(m年死亡率-n年死亡率)/n年死亡率]×100%,期望寿命的可变数量=m年的期望寿命-n年的期望寿命[11],HALE可变数量的算法同期望寿命。
运用Joinpoint 5.3.0软件计算1990—2019年中国与全球老年人死亡率、期望寿命以及HALE的平均年度变化百分比(average annual percentage change,AAPC)及检验趋势,检验水准α=0.05[12];2019—2021年因观测年限不足五年,未对该阶段相关指标进行AAPC及趋势分析。
使用R软件,采用ARIMA模型[13]对中国与全球老年人死亡率及期望寿命预测。
2021年中国60~64岁、65~69岁、70~74岁、75~79岁、80~84岁、85~89岁、90~94岁、95岁及以上年龄组老年人死亡率分别为987.46/10万、1 602.50/10万、2 926.96/10万、4 955.95/10万、9 174.20/10万、17 306.83/10万、26 906.91/10万、34 164.15/10万,其中80~84岁、85~89岁、90~94岁、95岁以上年龄组老年人死亡率高于全球。与1990年相比,2019年中国及全球各年龄组老年人死亡率均呈显著下降趋势(P<0.001),且中国下降幅度更大。与2019年相比,2021年中国各年龄组老年人死亡率均有所下降,全球各年龄组老年人死亡率均有所上升。见表1。
1990年以来,中国老年人前三位死因始终为心血管疾病、肿瘤、慢性呼吸系统疾病,且心血管疾病始终居于首位。相较于1990年,2019年呼吸道感染及结核病顺位下降,由第四位下降到第六位。相较于2019年,2021年中国老年人死因顺位一致。在过去32年,2019年全球呼吸道感染及结核病顺位下降,由第四位下降至第六位。与2019年相比,2021年全球呼吸道感染及结核病由第六位上升至第二位。见图1。
1990年中国60~64岁、65~69岁、70~74岁、75~79岁、80~84岁、85~89岁、90~94岁、95岁及以上年龄组老年人期望寿命分别为16.89、13.37、10.18、7.58、5.37、3.57、2.45和2.04岁,全球各年龄组老年人期望寿命分别为18.19、14.81、11.75、9.13、6.89、5.09、3.81和3.05岁,由此可见1990年中国各年龄组老年人期望寿命均低于全球;2019年中国各年龄组老年人期望寿命也均低于全球;2021年中国80岁及以上高龄组老年人期望寿命始终低于全球。与1990年相比,2019年中国及全球各年龄组老年人期望寿命呈显著上升趋势(P<0.001);与2019年相比,2021年中国各年龄组老年人期望寿命均有所上升,全球各年龄组老年人期望寿命均有所下降;HALE呈现的变化趋势与期望寿命一致。1990、2019以及2021年,中国及全球老年人男性期望寿命低于女性。见表1。
未来15年中国高龄组(80岁及以上)老年人死亡率呈持续下降趋势,预计2036年高龄组老年人死亡率分别为4 439.678/10万、14 024.84/10万、15 590.09/10万、23 423.25/10万,低龄组(60~79岁)老年人死亡率变化趋势较小;全球老年人死亡率呈小幅上升趋势。中国老年人期望寿命呈上升趋势,预计2036年中国60~64岁、65~69岁、70~74岁、75~79岁、80~84岁、85~89岁、90~94岁、95岁及以上年龄组老年人期望寿命分别为24.26、19.83、15.68、11.90、8.54、6.04、4.54和3.65岁;全球各年龄组老年人期望寿命分别为18.99、15.62、12.57、9.85、7.66、5.64、4.18和3.34岁。见图2。
死因顺位结果显示,中国与全球老年人心血管疾病始终居于首位。众所周知,缺血性心脏病、脑出血和脑梗死是中国心血管疾病死亡的三大主要原因[14]。由此可见,加强老年人心血管疾病的管理和防治尤为重要。一方面可通过社区门诊及医护人员加大心血管疾病健康知识的宣传力度,积极倡导健康生活方式,以提升老年人对心血管疾病的认知;另一方面,鼓励老年人调整膳食结构,如减少钠盐及腌制食品摄入,增加膳食纤维的摄入等,从而降低老年人心血管疾病死亡风险,减少其带来的寿命损失,进而提高老年人期望寿命。
本研究发现,与1990年相比,2021年中国老年人期望寿命及HALE呈上升趋势,这一结果与我国医疗技术进步、居民生活质量改善及“健康中国”战略推进、老龄化应对政策落地密切相关[15-16]。在新冠感染疫情期间,中国通过严格的防控措施有效降低了感染率和重症率[17],为老年人死亡率的持续下降提供了保障。与1990年相比,2021年全球各年龄组老年人期望寿命及HALE有所下降,这一差异可能与新冠感染疫情带来的的全球影响相关。
中国80岁及以上高龄组期望寿命始终低于全球,此现象进一步凸显我国高龄老人的健康短板,提示高龄老人的健康脆弱性更高,其医疗需求与长期照护服务亟待强化。因此,建议国家相关行政部门进一步优化重大公共卫生事件下老年人保护机制,如优先疫苗接种、绿色通道就医等服务[18],从而降低突发公共卫生事件对其健康的影响;建议完善高龄老人专项医疗与长期照护体系,探索建立家庭医生签约、社区医养结合以及远程健康监测的整合式照护模式[19],为高龄老人提供更加完善的健康管理服务,缓解其健康脆弱性,从而提升老年人生命质量。
中国及全球各年龄组男性期望寿命低于女性,这与既往研究结果一致[14,20]。这可能与以下几个方面有关:第一,男性更容易暴露于饮酒、吸烟等不良行为习惯;第二,男性更易从事劳动强度大和危险系数高的工作;第三,女性的X染色体可提供更强的抗衰老能力,且雌激素对心血管和免疫系统的保护作用更强;第四,女性更善于情感表达和倾诉,能够更好地释放压力[21]。因此,建议将男性作为重点健康教育对象,鼓励其定期体检、积极参与疾病筛查,进一步提升男性对自身健康的重视程度和管理能力,重点推广戒烟限酒、规律运动等健康生活方式[22];此外,后续研究应更为深入地探讨男性群体的心理健康状况及其情感表达特征,鼓励男性积极参与社交活动,引导男性主动倾诉压力,从而提升其整体健康水平与生活质量。
本研究首次基于GBD 2021数据,对1990—2021年中国与全球老年人死亡率及期望寿命比较并预测,但仍存在一定局限性:一是,GBD 2021数据通过模型估算得出,可能导致结果存在偏差;二是,2019—2021年的数据年份跨度小于5年,未能利用Joinpoint软件对2019—2021年中国与全球老年人死亡率及期望寿命的AAPC及趋势进行分析。建议未来研究可延长观测周期,进一步对2019年后中国与全球老年人的期望寿命变化趋势进行分析;此外,后续研究建议聚焦中国各省份老年人期望寿命变化趋势的精细化对比,这对理解健康老龄化的区域格局至关重要。
综上所述,1990—2021年中国老年人期望寿命和HALE呈上升趋势,但2019—2021年全球各年龄组老年人期望寿命和HALE有所下降,体现出中国在疫情期间防控及时,但高龄老人健康短板、“长寿不健康”及性别差异问题突出,需针对性强化照护与干预。
  • 山东省自然科学基金面上项目(ZR2022MG032)
  • 全生命周期下老年人口健康预期寿命关键因素及政策因应研究(23ARK001)
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doi: 10.20043/j.cnki.MPM.202510109
  • 接收时间:2025-10-10
  • 首发时间:2026-11-02
  • 出版时间:2026-04-10
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  • 收稿日期:2025-10-10
基金
山东省自然科学基金面上项目(ZR2022MG032)
全生命周期下老年人口健康预期寿命关键因素及政策因应研究(23ARK001)
作者信息
    1.山东第二医科大学公共卫生学院,山东 潍坊 261053
    2.山东第二医科大学管理学院
    3.河南省第三人民医院

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王春平,E-mail:
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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