Mortality trend of elderly population with ischemic stroke in China from 1990 to 2021 and its prediction

ZHANG Na; ZHANG Bingying; DONG Yushu; HAO Guangzhu; DAI Yunliang

doi:10.3969/j.issn.1671-2897.2025.06.013

Abstract：Objective To analyze mortality trend of elderly population(≥65 years)with ischemic stroke in China from 1990 to 2021,and predict its trends in the next 20 years.Methods Based on mortality data of elderly people with ischemic stroke in China from 1990 to 2021,this study used the Joinpoint regression model to identify significant change points and analyze the impact of different ages,periods,and birth cohorts on mortality through the age-period-cohort model.The Nordpred model was applied to predict mortality and death number of elderly population with ischemic stroke in the next 20 years.Results The death number of elderly people with ischemic stroke in China increased from 344 182 in 1990 to 1 061 572 in 2021,with the highest mortality in those aged 80 and above,and consistently higher rates in men than in women.Joinpoint analysis indicated that the annual percent change(APC)from 1998 to 2004 reached 3.17%,then gradually declined to-1.07%by 2021.Age-period-cohort model analysis showed that mortality among men with ischemic stroke who aged 90-94 exceeded 6 000 per 100 000,higher than that of women in the same age.Nordpred model predicted that by 2044,the estimated number of deaths of elderly people with ischemic stroke would increase to 2 366 561,and the estimated crude mortality would rise to 646.95 per 100 000.In the next 20 years,the mortality of male ischemic stroke population will continue to be higher than that of female,reaching 810.83 per 100 000 and 540.67 per 100 000 respectively.Conclusions This study reveals trends and gender differences of the estimated mortality of the elderly population with ischemic stroke in China,and emphasizes the importance of prevention and control of ischemic stroke in this group,especially among those aged 80 and older and the male population.