Objective To evaluate the impact of cerebrovascular disease mortality on life expectancy (LE) in China in 2010 compared with 2005, and to identify the high-risk population (age, sex, and region) where cerebrovascular disease mortality has had a major impact on LE.
Methods LE and cause-eliminated LE were calculated by using standard life tables which used adjusted mortality data from the Death Surveillance Data Sets in 2005 and 2010 from the National Disease Surveillance System. Decomposition was used to quantitate the impact of cerebrovascular disease in different age groups.
Results LE in China was 73.24 years in 2010, which was higher in women and urban residents compared with men and rural residents. The loss of LE caused by cerebrovascular disease mortality was 2.26 years, which was higher in men and rural residents compared with women and urban residents. More than 30%of the loss of LE were attributed to premature death from cerebrovascular disease in people aged <65 years. Compared with 2005, LE in 2010 increased by 0.92 years. The reduction of cerebrovascular disease mortality in urban residents contributed 0.45 years to the increase of LE, but the increase of cerebrovascular disease mortality caused a 0.12-year loss of LE in rural residents.
Conclusion Cerebrovascular disease mortality had a major impact on LE in China, with a significant difference between urban and rural residents. LE is likely to be further increased by reducing cerebrovascular disease mortality, and special attention should be paid to reducing premature deaths in people aged<65 years.

Objective We aimed to analyze the impact of cardiovascular disease (CVD) deaths on life expectancy (LE) in Chinese population and estimate the percentage reduction in CVD mortality needed to increase LE by 1 year from the current level, a national target of health improvement.
Methods We used life tables, cause-elimination life tables, and age decomposition of LE with corrected mortality data from the National Disease Surveillance System in 2010.
Results LE at birth of Chinese people was 73.24 years in 2010. Women had a longer LE than men, and urban population had a longer LE than rural population. CVD deaths resulted in a 4.79-year LE loss and premature deaths in people aged 25 to 64 years were responsible for a substantial part of LE loss from CVD. Death from ischemic heart disease and cerebrovascular diseases accounted for 69.2%of LE loss from CVD deaths and death from cerebrovascular diseases was the largest contributor. In rural men, 51.1% LE loss from CVD deaths was caused by cerebrovascular diseases. If there were no changes in mortality rates for all other diseases, a 27.4%reduction in CVD mortality would increase LE by 1 year in Chinese population.
Conclusion There is a considerable impact of CVD deaths on LE. A 1-year LE increase in the future requires at least a 27.4% reduction in CVD mortality from the current level. Targeting the rural population and tackling cerebrovascular diseases are important for reaching the national goal of health improvement.

伤害导致的潜在寿命损失评价指标--期望寿命损失年数

现较多学者在研究中普遍引用潜在寿命损失年数、平均潜在寿命损失年数等指标衡量伤害的危害性,但它无法衡量在各种死因中伤害所发挥的作用,即无法确定伤害作用的大小,为解决此问题,本研究提出一个新的指标期望寿命损失年数(Years of Life Expectancy Lost,YLEL).

我国老年平均预期寿命的多层次分析

在老年健康期望寿命(Active Life Expectancy,ALE)的计算中,Katz指出,老年人能维持良好的日常生活活动功能的年限称为ALE.ALE的终点是日常生活活动功能能力的丧失,Katz使用反映老年人躯体功能能力的四项指标(吃饭、穿衣、洗澡、上厕所),每项指标设有三项答案(1)能自理(2)部分自理(3)不能自理,并规定上述四项功能中至少有一项部分自理或不能自理者为生活自理能力的丧失.上述Katz方法中,对问题的回答虽然都设有3项,但在计算受损率时,把生活部分自理及完全需要帮助这两项实际有区别的回答合并为一项讨论.本文将老年人的健康状态根据功能受损的不同程度分层讨论,依旧引用上述指标,分无受损、中度受损、重度受损多层次计算其预期寿命.目的在于:计算需全部帮助和需部分帮助的预期寿命年限及该部分占老年平均预期寿命的比重,为老年政策的制定提供参考依据.

上海市居民健康期望寿命的分析

国家人口普查办公室第四次人口普查资料显示，上海市居民期望寿命男、女均居全国首位。1995年世界人口数据表明，发达国家预期寿命为77岁，上海已达欧美等发达国家水平。随着期望寿命的增长，寿命质量越来越受到重视。丧失日常生活活动能力和参与社会活动受限的残疾不仅给本人的生活质量带来影响，而且给社会和家庭造成一定的负担。期望寿命实际上是去除死亡后所能生存的年限，并不能反映生存者的健康、现状和功能状况〔1〕。 人在生命过程中，无时不受到疾病的威胁，在人的一生中有多少时间处于健康状态，有多少时间处于疾病状态。如何延长健康寿命，而缩短非健康寿命是一重大命题。 1983年Katz〔2〕首次提出健康寿命这一术语，并首次将日常生活活力指标用于健康期望寿命Active life expectancy(ALE)的计算，此方法目前已得到广泛的应用〔3，4〕。本文也尝试着用ALE这一既包括人群死亡因素，又包括发病因素的指标来衡量上海地区人群的寿命质量，为社会卫生保健工作提供更科学的依据。

人群健康总体衡量方法学概述

为了改善健康水平,减少健康不公平性,对全球卫生状况进行评估是全球公共卫生政策的一个关键组成部分.目前各国按年龄,性别及死因来估计死伤情况.这有效的解决了一些公共卫生问题,如新流行病的监测,促进某些国家已实施的、低效疾病控制项目的下马等.但通过这些方法所得结果的可比性都较差,除非所有研究都按同一模式来收集资料,但这一点在实际中又很难做到.2000年世界卫生报告提出了伤残调整期望寿命[1](Disability-adjusted Life Expectancy,DALE),作为衡量成员国健康状况的尺度,并提供了可比的健康水平尺度,同时也将DALE作为卫生系统综合绩效的衡量方法之一.

HEALTHY AGEING POLICY IN ASIA

Populations in Asia are experiencing significant gains in life expectancy,especially in North East Asia and amongst Orientals throughout the region,with Japan,HongKong,Singapore and Macau having amongst the world's best life expectancies.

Mild cognitive impairment: a concept useful for early detection and intervention of dementia

As life expectancy increases around the globe,dementia has become an increasingly important public health issue that has created new challenges for communities' social service networks[1].The early detection and prevention of dementia,particularlyAIzheimer's disease (AD),necessitate the development of effective public health education programs about the early symptoms and preclinical changes of dementia.To promote this effort the concept of mild cognitive impairment (MCI)-which some experts consider an early form of AD-has been created.

The number of patients who suffer from vertigo or dizziness becomes greater during the sixth and seventh decades of life and is now increasing to total, which could be related to recent longer life expectancy. Pertinent medical care should be given to those patients to better obtain so-called quality of life (QOL), and this could be attained with the help of accurate diagnosis. In general,accurate diagnosis is made by thorough neurotological examinations.

Chronic kidney disease and the aging population

The proportion of older people in the general population is steadily increasing worldwide,with the most rapid growth in low-and middle-income countries[1].This demographic change is to be celebrated,because it is the consequence of socioeconomic development and better life expectancy.However,population aging also has important implications for society,in diverse areas including health systems,labor markets,public policy,social programs,and family dynamics[2].A successful response to the aging population will require capitalizing on the opportunities that this transition offers,as well as effectively addressing its challenges.

Osteoporosis and consequent fracture are not limited to postmenopausal women. There is increasing attention being paid to osteoporosis in older men. Men suffer osteoporotic fractures about 10 years later in life than women, but life expectancy is increasing faster in men than women. Thus, men are living long enough to fracture, and when they do the consequences are greater than in women, with men having about twice the 1-year fatality rate after hip fracture, compared to women. Men at high risk for fracture include those men who have already had a fragility fracture, men on oral glucocorticoids or those men being treated for prostate cancer with androgen deprivation therapy. Beyond these high risk men, there are many other risk factors and secondary causes of osteoporosis in men. Evaluation includes careful history and physical examination to reveal potential secondary causes, including many medications, a short list of laboratory tests, and bone mineral density testing by dual energy X-ray absorptiometry (DXA) of spine and hip. Recently, international organizations have advocated a single normative database for interpreting DXA testing in men and women. The consequences of this change need to be determined. There are several choices of therapy for osteoporosis in men, with most fracture reduction estimation based on studies in women.