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. 2021 Jun 16;21(1):369.
doi: 10.1186/s12877-021-02322-7.

Disability-adjusted life years associated with population ageing in China, 1990-2017

Ruotong Li #  1 , Xunjie Cheng #  2 , David C Schwebel  3 , Yang Yang  4   5 , Peishan Ning  1 , Peixia Cheng  1 , Guoqing Hu  6   7
Affiliations

Disability-adjusted life years associated with population ageing in China, 1990-2017

Ruotong Li et al. BMC Geriatr. .

Abstract

Background: The Chinese population has aged significantly in the last few decades. Comprehensive health losses including both fatal and non-fatal health outcomes associated with ageing in China have not been detailed.

Methods: Based on freely accessible disability adjusted life years (DALYs) estimated by the Global Burden of Diseases (GBD) 2017, we adopted a robust decomposition method that ascribes changes in DALYs in any given country across two time points to changes resulting from three sources: population size, age structure, and age-specific DALYs rate per 100,000 population. Using the method, we calculated DALYs associated with population ageing in China from 1990 to 2017 and examined the counteraction between the effects of DALYs rate change and population ageing. This method extends previous work through attributing the change in DALYs to the three sources.

Results: Population ageing was associated with 92.8 million DALYs between 1990 and 2017 in China, of which 65.8% (61.1 million) were years of life lost (YLLs). Males had comparatively more DALYs associated with population ageing than females in the study period. The five leading causes of DALYs associated with population ageing between 1990 and 2017 were stroke (23.6 million), chronic obstructive pulmonary disease (COPD) (18.3 million), ischemic heart disease (13.0 million), tracheal, bronchus, and lung cancer (6.1 million) and liver cancer (5.0 million). Between 1990 and 2017, changes in DALYs associated with age-specific DALY rate reductions far exceeded those related to population ageing (- 196.2 million versus 92.8 million); 57.5% (- 112.8 million) of DALYs were caused by decreases in rates attributed to 84 modifiable risk factors.

Conclusion: Population ageing was associated with growing health loss in China from 1990 to 2017. Despite the recent progress in alleviating health loss associated with population ageing, the government should encourage scientific research on effective and affordable prevention and control strategies and should consider investment in resources to implement strategies nationwide to address the future challenge of population ageing.

Keywords: China; Disability adjusted life years; Health burden; Population ageing.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Change in disability-adjusted life years (DALYs) associated with population ageing in China, 1990-2017. Notes: YLLs - years of life lost, YLDs - years lived with disability, DALYs equals to the sum of YLLs and YLDs
Fig. 2
Fig. 2
Top 10 diseases with the largest disability-adjusted life years (DALYs) change associated with population ageing between 1990 and 2017 in China. Notes: YLLs - years of life lost, YLDs - years lived with disability, DALYs equals to the sum of YLLs and YLDs
Fig. 3
Fig. 3
Change in disability-adjusted life years (DALYs) associated with rate changes versus population ageing in China, 1990-2017. Notes: DALYs - disability-adjusted life years
Fig. 4
Fig. 4
Disability-adjusted life years (DALYs) change associated with population ageing, change in risk-attributable DALY rates and change in non-risk-attributable DALY rates by sex among top 20 diseases most affected by population ageing in China, 1990–2017. Notes: 1. DALY change associated with change in risk-attributable DALY rates in this study refers to decrease of age-specific rate that can be explained by attributable GBD risk factors. 2. Diseases included in this part must be attributable and the number of DALY change associated with population ageing are greater than zero
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