Risk factors associated with heatwave mortality in Chinese adults over 65 years.
Risk factors associated with heatwave mortality in Chinese adults over 65 years.
复制标题
DOI：
10.1038/s41591-024-02880-4
复制
发表时间：
2024-03
期刊：
影响因子：
82.9
通讯作者：
Di Xi;Linxin Liu;Min Zhang;Cunrui Huang;Katrin G Burkart;Krsitie L. Ebi;Yi Zeng;John S. Ji
中科院分区：
文献类型：
--
作者：
Di Xi;Linxin Liu;Min Zhang;Cunrui Huang;Katrin G Burkart;Krsitie L. Ebi;Yi Zeng;John S. Ji
由于生理因素和合并症，老龄人口易受热相关死亡的影响。然而，对老龄化人口中个体脆弱性的理解是不完整的。在中国纵向健康寿命调查中，我们分别评估了13,527名参与者（中位年龄= 89岁）的每日热浪暴露情况，并在2008年至2018年的随访期间评估了3,249名夏季死亡率。根据相对温度，热浪天的死亡风险大约增加了一倍（风险比（HR）范围= 1.78-1.98）。我们发现，在行动能力下降（HR范围= 2.32-3.20）、日常生活活动依赖（HR范围= 2.22 - 3.27）、认知障碍（HR = 2.22）和社会孤立（HR范围= 2.14-10.21）的个体中，热浪死亡风险增加。与目前的理解相反，在考虑到个人功能下降后，年龄并不能预测热浪死亡风险；性别差异无统计学意义。除了年龄是风险因素外，我们的研究结果强调，功能性衰老是增强热浪抵御能力的潜在因素。评估功能衰退和实施护理战略对于有针对性地预防热浪期间的死亡至关重要。
Aging populations are susceptible to heat-related mortality because of physiological factors and comorbidities. However, the understanding of individual vulnerabilities in the aging population is incomplete. In the Chinese Longitudinal Healthy Longevity Survey, we assessed daily heatwave exposure individually for 13,527 participants (median age = 89 years) and 3,249 summer mortalities during follow-up from 2008 to 2018. The mortality risk during heatwave days according to relative temperature is approximately doubled (hazard ratio (HR) range = 1.78–1.98). We found that heatwave mortality risks were increased for individuals with functional declines in mobility (HR range = 2.32–3.20), dependency in activities of daily living (HR range = 2.22–3.27), cognitive impairment (HR = 2.22) and social isolation reflected by having nobody to ask for help during difficulties (HR range = 2.14–10.21). Contrary to current understanding, older age was not predictive of heatwave mortality risk after accounting for individual functional declines; no statistical differences were detected according to sex. Beyond age as a risk factor, our findings emphasize that functional aging is an underlying factor in enhancing heatwave resilience. Assessment of functional decline and implementing care strategies are crucial for targeted prevention of mortality during heatwaves.