Abstract：Objective To investigate the trend in burden of mental disorders among the elderly in China from 1990 to 2021, so as to provide the basis for formulating prevention, control and intervention measures for mental disorders in this population. Methods Based on the data of the Global Burden of Disease 2021 (GBD 2021), the number of cases, prevalence, disability-adjusted life years (DALY) and DALY rate of mental disorders among the elderly in China were collected, and standardized prevalence and DALY rate were calculated using the world standard population. The burden of mental disorders was analyzed, and the trend in burden was analyzed using average annual percent change (AAPC). Results The standardized prevalence and standardized DALY rate of mental disorders among the elderly in China showed upward trends from 1990 to 2021 (AAPC=0.160% and 0.286%, both P<0.05). In 2021, there were 38.944 9 million cases of mental disorders among the elderly in China, the DALY was 5.389 8 million person-years, the standardized prevalence was 14 462.91/105, and the standardized DALY rate was 1 993.69/105, with the increases of 184.12%, 192.90%, 5.71% and 9.60% compared to 1990, respectively. The burden of mental disorders increased significantly among the elderly aged 60 to <65, 65 to <70, 70 to <75, and 75 to <80 years, with the increases of 5.81%, 5.92%, 6.08% and 6.03% in prevalence, and the increases of 10.16%, 10.12%, 10.31% and 9.88% in DALY rates, respectively. Depression and anxiety ranked the top two in standardized prevalence and standardized DALY rates. The standardized prevalence and standardized DALY rate of autism showed the largest increases, at 18.82% and 18.10%, respectively, while congenital intellectual disabilities exhibited the largest decreases, at 36.15% and 29.71%, respectively. The standardized prevalence and standardized DALY rate of mental disorders were higher in women than in men (both P<0.05). Compared to men, women had higher standardized prevalence and standardized DALY rates of depression, anxiety and congenital intellectual disabilities, but lower standardized prevalence and standardized DALY rates of schizophrenia, autism, attention deficit hyperactivity disorder, and other mental disorders (all P<0.05). Conclusion The burden of mental disorders among the elderly population in China showed an upward trend from 1990 to 2021, with heavier burdens observed among women, individuals aged 60 to <80 years, and those with depression and anxiety.
汪洋帆, 胡银环, 路少玉, 刘莎, 冯显东, 王慧. 1990—2021年中国老年人群精神障碍疾病负担趋势分析[J]. 预防医学, 2025, 37(2): 109-112,117.
WANG Yangfan, HU Yinhuan, LU Shaoyu, LIU Sha, FENG Xiandong, WANG Hui. Trend in burden of mental disorders among the elderly in China from 1990 to 2021. Preventive Medicine, 2025, 37(2): 109-112,117.
[1] 段芮,王红.2011—2018年我国中老年人抑郁症状流行趋势分析[J].预防医学,2023,35(8):649-654. DUAN R,WANG H.Trends in prevalence of depression symptoms among middle-aged and elderly residents in China from 2011 to 2018[J].China Prev Med J,2023,35(8):649-654.(in Chinese) [2] FIRTH J,SIDDIQI N,KOYANAGI A,et al.The Lancet Psychiatry Commission:a blueprint for protecting physical health in people with mental illness[J].Lancet Psychiatry,2019,6(8):675-712. [3] 中华人民共和国国家卫生健康委员会老龄健康司.2021年度国家老龄事业发展公报[EB/OL].[2024-12-06].http://www.nhc.gov.cn/lljks/pqt/202210/e09f046ab8f14967b19c3cb5c1d934b5.shtml. [4] GBD 2021 Diseases and Injuries Collaborators.Global incidence,prevalence,years lived with disability(YLDs),disability-adjusted life-years(DALYs),and healthy life expectancy(HALE)for 371 diseases and injuries in 204 countries and territories and 811 subnational locations,1990-2021:a systematic analysis for the Global Burden of Disease Study 2021BD 2021 Diseases and Injuries Collaborators.Global incidence,prevalence,years lived with disability(YLDs),disability-adjusted life-years(DALYs),and healthy life expectancy(HALE)for 371 diseases and injuries in 204 countries and territories and 811 subnational locations,1990-2021:a systematic analysis for the Global Burden of Disease Study 2021[J].Lancet,2024,403(10440):2133-2161. [5] Institute for Health Metrics and Evaluation.Global Burden of Disease Study 2021(GBD 2021)Demographics 1950-2021[EB/OL].[2024-12-06].https://ghdx.healthdata.org/record/ihme-data/global-burden-disease-study-2021-gbd-2021-demographics-1950-2021. [6] 李辉章,杜灵彬.Joinpoint回归模型在肿瘤流行病学时间趋势分析中的应用[J].中华预防医学杂志,2020,54(8):908-912. LI H Z,DU L B.Application of Joinpoint regression model in cancer epidemiological time trend analysis[J].Chin J Prev Med,2020,54(8):908-912.(in Chinese) [7] 高鑫磊,贾艾楠,刘敏,等.1990年和2019年中国分省精神障碍伤残负担分析[J].中华精神科杂志,2023,56(1):40-46. GAO X L,JIA A N,LIU M,et al.The burden of disability associated with mental disorders in China by province between 1990 and 2019[J].Chin J Psychiatry,2023,56(1):40-46.(in Chinese) [8] DENG Y,SUN S W,WU S X,et al.Burden and trends of mental disorders in China from 1990 to 2019:findings from the Global Burden of Disease Study 2019[J].Soc Psychiatry Psychiatr Epidemiol,2024,59(9):1563-1567. [9] VOLLSET S E,ABABNEH H S,ABATE Y H,et al.Burden of disease scenarios for 204 countries and territories,2022-2050:a forecasting analysis for the Global Burden of Disease Study 2021[J].Lancet,2024,403(10440):2204-2256. [10] 李娟娟,赵树勇,杜媛泽,等.中国居民1990—2019年心理性疾病负担及其危险因素变化趋势[J].中国公共卫生,2022,38(5):518-522. LI J J,ZHAO S Y,DU Y Z,et al.Changing trend in disease burden of mental illness and its risk factors in China,1990–2019[J].Chin J Public Health,2022,38(5):518-522.(in Chinese) [11] 杨红英,李链,潘凯杰,等.老年人抑郁焦虑症状的影响因素研究[J].预防医学,2024,36(11):926-930. YANG H Y,LI L,PAN K J,et al.Influencing factors for depression and anxiety symptoms among the elderly[J].China Prev Med J,2024,36(11):926-930.(in Chinese) [12] LI Z,YANG L J,CHEN H,et al.Global,regional and national burden of autism spectrum disorder from1990 to 2019:results from the Global Burden of Disease Study 2019[J/OL].Epidemiol Psychiatr Sci,2022,31[2024-12-06].https://doi.org/10.1017/S2045796022000178. [13] 邢玉萍,邢辉,李淼,等.中老年人群抑郁症状与衰弱的关系研究[J].预防医学,2024,36(8):649-653. XING Y P,XING H,LI M,et al.Relationship between depressive symptoms and frailty among middle-aged and elderly populations[J].China Prev Med J,2024,36(8):649-653.(in Chinese) [14] BRAND B A,DE BOER J N,SOMMER I E C.Estrogens in schizophrenia:progress,current challenges and opportunities[J].Curr Opin Psychiatry,2021,34(3):228-237. [15] SANDIN S,YIP B H K,YIN W Y,et al.Examining sex differences in autism heritability[J].JAMA Psychiatry,2024,81(7):673-680. [16] FAHEEM M,AKRAM W,AKRAM H,et al.Gender-based differences in prevalence and effects of ADHD in adults:a systematic review[J/OL].Asian J Psychiatr,2022,75[2024-12-06].https://doi.org/10.1016/j.ajp.2022.103205.
