2014—2019年武汉市老年人自杀死亡率与疾病负担分析

Analysis of suicide mortality and disease burden among elderly adults in Wuhan in 2014-2019

目的分析2014—2019年武汉市60岁及以上老年人自杀死亡率变化趋势,了解武汉市老年人群自杀死亡疾病负担,为开展老年人群自杀干预提供决策依据。方法利用武汉市死因监测信息系统收集的2014—2019年武汉市户籍居民死亡年龄≥60岁的老年人群自杀死亡个案资料。分别计算死亡率、标化死亡率、早死所致损失寿命年(YLL)和平均减寿年数(AYLL)。使用SPSS 26.0软件进行统计分析,采用χ^(2)检验对不同性别与地区间老年人群自杀死亡率进行比较,采用年度变化百分比(APC)进行趋势分析。结果2014—2019年武汉市60岁及以上老年人共报告自杀死亡1010例,自杀粗死亡率介于(7.60~10.77)/10万,老年男性自杀死亡率高于老年女性,农村老年人自杀死亡率高于城市老年人,农村老年人自杀死亡率呈下降趋势。武汉市老年人自杀死亡率整体上随年龄的升高而显著升高,2014—2019年老年男性和老年女性平均自杀死亡率各年龄组之间差异均具有统计学意义(P<0.01或P<0.05)。2014—2019年武汉市老年人自杀死亡YLL率呈先降低后升高的趋势,AYLL整体保持小幅波动,YLL率和AYLL变化趋势均无统计学意义。结论武汉市60岁及以上老年人自杀死亡率较高,尤其是农村老年男性,老年人自杀死亡导致的疾病负担较重,需采取多种针对性措施以预防和减少老年人自杀事件的发生。

Objective To analyze the trend of suicide mortality among the elderly aged 60 years and above in Wuhan from 2014 to 2019,to understand the disease burden of suicide deaths among the elderly adults in Wuhan,and to provide a basis for decision making to carry out suicide interventions in the elderly population.Methods The data on suicide deaths in the elderly adults of Wuhan residents whose death age was 60 years or older were collected from 2014 to 2019 using the Wuhan City’s Cause of Death Monitoring Information System.Mortality,standardized mortality,years of life lost(YLL)due to early death and average years of life lost(AYLL)were calculated separately.Statistical analysis was performed using SPSS 26.0.Theχ^(2) test was used to compare the suicide mortality rates among the elderly population by gender and region,and the annual percentage change(APC)was used for trend analysis.Results From 2014 to 2019,a total of 1010 suicide deaths were reported among elderly adults aged 60 years and older in Wuhan,with crude suicide mortality rates ranging from 7.60 to 10.77/100000.The suicide mortality rate of elderly men was higher than that of elderly women.The suicide mortality rate of rural elderly adults was higher than that of urban elderly adults,and the suicide mortality rate of the rural elderly was decreasing.The overall suicide mortality rate of elderly people in Wuhan increased significantly with age,and the differences between the average suicide mortality rates of elderly males and elderly females in 2014-2019 were statistically significant among all age groups(P<0.01 or P<0.05).From 2014 to 2019,the YLL rate of suicide death among the elderly in Wuhan showed a trend of decreasing first and then increasing,and AYLL kept a slight fluctuation as a whole.The trends of both YLL rate and AYLL changes were not statistically significant.Conclusion The suicide mortality rate of elderly adults aged 60 years and above in Wuhan is high,especially in rural elderly men.The burden of disease caused by suicide deaths in the elderly is high,so it is necessary to take a variety of targeted measures to prevent and reduce the incidence of suicide among the elderly.