Intracerebral hemorrhage death trend for elderly Chinese population from 1990 to 2021 and a trend prediction age-period-cohort model
LIU Xiyu
ZHANG Bingying
DONG Yushu
HAO Guangzhi
LIU Shuang
LIANG Yong
Abstract：Objective To analyze the mortality trend of intracerebral hemorrhage(ICH)in the elderly over 65 years old in China from 1990 to 2021,with an emphasis on the effects of age,period and birth cohort on mortality,and predict the mortality trend from 2022 to 2044,so as to provide a reference for the prevention and treatment of ICH in the elderly population.Methods The data of deaths,crude mortality and standardized mortality of ICH in the elderly population in China from 1990 to 2021 were extracted from the GBD 2021(Global Burden of Disease study,GBD 2021)database.The Joinpoint model was used to fit the mortality data,and determine the optimal number of inflection points by Monte Carlo permutation test,and divided the whole time period into multiple trend bands,and in each trend segment,the annual percentage change(APC)and the average annual percentage(AAPC)of mortality were estimated,and trends in mortality over different time periods were explained.At the same time,the data of 7 age groups and 6 period groups were extracted from the GBD 2021 database,and the age-period-cohort(APC)model was constructed using R language,and the parameter values of age effect,period effect and cohort effect were estimated through model fitting,and the effects of the three effects on ICH mortality in the elderly population in China were explained.Nordpred Packet in R was used to predict the trend of disease mortality risk from 2022 to 2044.Results From 1990 to 2021,the number of ICH deaths in the elderly population over 65 years old in China increased by 72.44%,while the crude mortality rate and standardized mortality rate decreased by 42.98%and 49.19%respectively.The results of Joinpoint analysis showed that the AAPC values of male and female patients were-1.75%and-2.57 respectively,indicating a slow downward trend,while the age-standardized mortality rate(ASMR)of males and females showed an upward trend from 1998 to 2004,with APC values of 2.63%and 1.36%respectively.From 1990 to 2021,the net ICH drift value(95%CI)of the elderly population in China was-2.41(-2.59,-2.23),and the local drift value increased with age.The prediction results show that the number of deaths from ICH disease in the elderly population in China will increase from 2022 to 2044,but the crude mortality rate and standardized mortality rate will decrease.Conclusions The mortality rate of ICH in the elderly population in China from 1990 to 2021 shows a general trend of fluctuation decline,but there are differences among different age groups,periods and birth cohorts.Continuous attention and strengthening of prevention and treatment are still needed to reduce the burden of ICH in the elderly population.
Keywords：intracerebral hemorrhagejoinpoint regression modelage-period-cohort modeltrend prediction model
Publication Date：2025-10-28
Online Publishing Date：2025-10-09(First online date of this platform, not the publication date of the document)
Pages：8( 44-51 )