Effect of Age and Sex on Stroke Mortality of Young and Middle-aged Adults in China,2002–2019,and Predictions to 2030

Objective This study aimed to examine the trends in stroke mortality among young and middle-aged adults in China.Methods Data were obtained from the China national vital registration system.Significant changes in mortality were assessed by Joinpoint regression.Age-period-cohort analysis was used to explain the reasons for the changes.Future mortality and counts were predicted by the Bayesian age-period-cohort model.Results Between 2002 and 2019,a total of 6,253,951 stroke mortality in young and middle-aged adults were recorded.The age-adjusted mortality rates(AAMRs)of women showed a downward trend.The annual percent changes(APC)were-3.5%(-5.2%,-1.7%)for urban women and-2.8%(-3.7%,-1.9%)for rural women.By contrast,the AAMRs per 100,000 for rural men aged 25–44 years continued to rise from 9.40 to 15.46.The AAMRS for urban men aged 25–44 years and urban and rural men aged 45–64years did not change significantly.Between 2020 and 2030,the projected stroke deaths are 1,423,584 in men and 401,712 in women.Conclusion Significant sex and age disparities in the trends of stroke mortality among young and middle-aged adults were identified in China.Targeted health policy measures are needed to address the burden of stroke in the young generation,especially for rural men,with a focus on the prevention and management of high risk factors.

Alcohol Cessation in Late Life is Associated with Lower Risk of Cognitive Impairment among the Older Adults in China

Objective Evidence regarding alcohol consumption and cognitive impairment is controversial.Whether cessation of drinking alcohol by non-dependent drinkers alters the risk of cognitive impairment remains unknown.This study prospectively evaluated the potential association between the history of lifetime alcohol cessation and risk of cognitive impairment.Methods This study included 15,758 participants age 65 years or older,selected from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)that covered 23 provinces in China.Current alcohol use status,duration of alcohol cessation,and alcohol consumption before abstinence were self-reported by participants;cognitive function was evaluated using Mini-mental State Examination(MMSE).Causespecific hazard models and restricted cubic splines were applied to estimate the effect of alcohol use on cognitive impairment.Results Among the 15,758 participants,mean(±SD)age was 82.8 years(±11.9 years),and 7,199(45.7%)were males.During a mean of 3.9 years of follow-up,3,404 cases were identified as cognitive impairment.Compared with current drinkers,alcohol cessation of five to nine years[adjusted HR,0.79(95%CI:0.66-0.96)]and more than nine years[adjusted HR,0.82(95%CI:0.69-0.98)]were associated with lower risk of cognitive impairment.Conclusion A longer duration of alcohol cessation was associated with a lower risk of cognitive impairment assessed by MMSE.Alcohol cessation is never late for older adults to prevent cognitive impairment.