摘要
目的分析2012—2023年重庆市老年人自杀死亡率与死亡疾病负担变化趋势,为开展有针对性的干预提供建议。方法利用重庆市2012—2023年死因监测数据中根本死因为自杀(《国际疾病与相关健康问题统计分类第10版》编码:X60~X84、Y87)的60岁及以上老年人死亡个案,分析死亡率、标化死亡率、早死寿命损失年(years of life lost,YLL)率、平均寿命损失年(average years of life lost,AYLL)及不同死因构成比,比较不同性别和地区死亡率,率的趋势变化采用年度变化百分比(annual percent of change,APC)和平均年度变化百分比(average annual percent of change,AAPC)进行分析。结果2012—2023年60岁及以上老年人自杀死亡率与标化死亡率总体呈下降的趋势,分别以年均3.54%与4.02%下降,变化趋势均有统计学意义(P<0.05)。2012—2016年自杀死亡率以年均4.53%上升,2016—2021年以年均8.91%下降,变化趋势均有统计学意义(P<0.05)。仅2020年与2022年男性自杀死亡率高于女性(P<0.05)。2012—2023年男性自杀死亡率与标化死亡率分别以年均2.86%和3.44%下降,女性分别以年均4.21%和4.69%下降,变化趋势均有统计学意义(P<0.05)。农村地区老年人历年自杀死亡率均高于城市地区,差异均有统计学意义(P<0.05)。2012—2023年城市地区老年人自杀死亡率与标化死亡率均保持相对平稳的水平(P>0.05),而农村地区老年人自杀死亡率与标化死亡率分别以年均3.44%与4.02%下降(P<0.05)。60岁及以上老年人自杀导致的YLL率与AYLL分别由2012年的3.03‰与18.54年下降至2023年的2.26‰与17.50年,AAPC分别为-4.02%与-0.60%,变化趋势均有统计学意义(P<0.05)。比较历年不同自杀方式构成发现,杀虫剂中毒死亡占比呈下降的趋势,而悬吊死亡、从高处跳下、淹溺占比均呈上升的趋势(P<0.05)。结论重庆市60岁及以上老年人自杀死亡率较高,疾病负担较重,总体呈下降的趋势,应重视老年人自杀的早期识别与干预。
Objective To analyze the trends of suicide mortality and disease burden among the elderly aged 60 and above in Chongqing from 2012 to 2023,providing evidence for targeted interventions.Methods Death cases of elderly aged 60 and above were extracted from death registration between 2012 and 2023 according to death records(International Statistical Classification of Diseases and Related Health Problems,10th version:X60-X84,Y87).The data were analyzed to calculate indicators such as the mortality rate,standardized mortality rate,years of life lost(YLL)rate,and average years of life lost(AYLL),and the composition ratio of different causes of death with using Excel 2010 and SPSS 26.0.The comparison of mortality rates between male and female,urban and rural area was conducted using theχ2 test.The trend changes of the rates were expressed by the annual percentage change(APC)and the average annual percentage change(AAPC).Results From 2012 to 2023,the suicide mortality rate and standardized mortality rate of the elderly aged 60 and above generally showed a downward trend,decreasing by 3.54%and 4.02%,respectively(P<0.05).From 2012 to 2016,the suicide mortality rate increased by an average of 4.53%per year,and from 2016 to 2021,it decreased by an average of 8.91%per year,and both trends were significant(P<0.05).Only in 2020 and 2022,the male suicide mortality rate was significantly higher than that of females(P<0.05).From 2012 to 2023,the suicide mortality rate and standardized mortality rate of males and females decreased by an average of 2.86%,3.44%,4.21%,and 4.69%per year respectively,and the trends were significant(P<0.05).The suicide mortality rate of the elderly aged 60 and above in rural areas was significantly higher than that in urban areas over the years(P<0.05).From 2012 to 2023,the suicide mortality rate and standardized mortality rate in urban areas remained relatively stable(P>0.05),while the suicide mortality rate and standardized mortality rate of the elderly aged 60 and above in rural areas decreased by an average of 3.44%and 4.02%per year respectively,and the trends were significant(P<0.05).The YLL rate and AYLL caused by suicide among the elderly aged 60 and above decreased from 3.03‰and 18.54 years in 2012 to 2.26‰and 17.50 years in 2023 respectively,and the AAPC were-4.02%and-0.60%respectively,and the trends were significant(P<0.05).By comparing the composition of deaths by different suicide methods over the years,it was found that the proportion of deaths due to pesticide poisoning showed a downward trend,while the proportions of deaths by hanging,jumping from a height,and drowning showed an upward trend.Conclusion The suicide mortality rate of the elderly aged 60 and above in Chongqing is relatively high.Although demonstrating an overall downward trend,enhanced efforts toward early identification and intervention for elderly suicide should be enhanced.
作者
丁贤彬
杨弦弦
焦艳
丁睿
陈婷
吕晓燕
唐佳诗
DING Xianbin;YANG Xianxian;JIAO Yan;DING Rui;CHEN Ting;LV Xiaoyan;TANG Jiashi(The Depart-ment of Non-communicable Disease Prevention and Control,Chongqing Center for Disease Control and Prevention,Chongq-ing 400707,China)
出处
《中国神经精神疾病杂志》
北大核心
2025年第6期327-334,共8页
Chinese Journal of Nervous and Mental Diseases
基金
重庆市科卫联合项目(编号:2024ZDXM017)。
