Time trends of incidence of age-associated diseases in the US elderly population: medicare-based analysis
Time trends of incidence of age-associated diseases in the US elderly population: medicare-based analysis
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DOI：
10.1093/ageing/aft032
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发表时间：
2013-07-01
期刊：
影响因子：
6.7
通讯作者：
Yashin, Anatoly I.
中科院分区：
文献类型：
--
作者：
Akushevich, Igor;Kravchenko, Julia;Yashin, Anatoly I.
目的：利用NLTCS-Medicare和SEER-Medicare数据(分别为NLTCS-Medicare和SEER-Medicare)，对1992-2005年间19种老年相关疾病的年龄调整发病率的时间趋势进行评估。结果：肾脏疾病的发病率显著增加[平均年百分比变化(APC)为8.56%，年平均百分比变化(APC)为8.56%，甲状腺肿(APC=6.67%，95%CI=5，90，7，44%)、黑色素瘤(APC=6.15%，95%CI=4.31，8.02%)和阿尔茨海默病(APC=3.96%，95%CI=2.67，5.26%)，糖尿病和肺癌的发病率较低。心绞痛(APC=-6.17%，95%CI=-6.96，-5.38%)；慢性阻塞性肺疾病(APC=-5.14%，95%CI=-6.78%，-3.47%)；溃疡(APC=-5.82%，95%CI=-6.77%，-4.86%)；结肠癌、前列腺癌、中风、髋部骨折、哮喘等发病率下降幅度较小。女性乳腺癌、心肌梗死、帕金森氏病和类风湿性关节炎的发病率几乎稳定。对于大多数疾病，NLTCS-Medicare和SEER-Medicare之间的发病率有很好的一致性。敏感性分析证明了评价时间趋势的稳定性。结论：评价了美国老年人群常见病发病率的时间趋势。结果显示，在1992-2005年间，黑色素瘤、甲状腺肿、慢性肾脏病和阿尔茨海默病的发病率急剧上升。除了指定与年龄相关疾病的广泛认可的时间趋势外，还获得了关于美国老年人哮喘、溃疡和甲状腺肿趋势的新信息。
Objectives: time trends of age-adjusted incidence rates of 19 ageing-related diseases were evaluated for 1992-2005 period with the National Long Term Care Survey and the Surveillance, Epidemiology and End Results Registry data both linked to Medicare data (NLTCS-Medicare and SEER-Medicare, respectively).Methods: the rates were calculated using individual medical histories (34,077 individuals from NLTCS-Medicare and 199,418 from SEER-Medicare) reconstructed using information on diagnoses coded in Medicare data, dates of medical services/procedures and Medicare enrolment/disenrolment.Results: increases of incidence rates were dramatic for renal disease [the average annual percent change (APC) is 8.56%, 95% CI = 7.62, 9.50%], goiter (APC = 6.67%, 95% CI = 5, 90, 7, 44%), melanoma (APC = 6.15%, 95% CI = 4.31, 8.02%) and Alzheimer's disease (APC = 3.96%, 95% CI = 2.67, 5.26%), and less prominent for diabetes and lung cancer. Decreases of incidence rates were remarkable for angina pectoris (APC = -6.17%, 95% CI = -6.96, -5.38%); chronic obstructive pulmonary disease (APC = -5.14%, 95% CI = -6.78,-3.47%), and ulcer (APC = -5.82%, 95% CI = -6.77,-4.86%) and less dramatic for carcinomas of colon and prostate, stroke, hip fracture and asthma. Incidence rates of female breast carcinoma, myocardial infarction, Parkinson's disease and rheumatoid arthritis were almost stable. For most diseases, an excellent agreement was observed for incidence rates between NLTCS-Medicare and SEER-Medicare. A sensitivity analysis proved the stability of the evaluated time trends.Conclusion: time trends of the incidence of diseases common in the US elderly population were evaluated. The results show dramatic increase in incidence rates of melanoma, goiter, chronic renal and Alzheimer's disease in 1992-2005. Besides specifying widely recognised time trends on age-associated diseases, new information was obtained for trends of asthma, ulcer and goiter among the older adults in the USA.