1990-2023年中国60岁以上老年人蛋白质能量营养不良疾病负担趋势和预测分析OA

[Objective]To analyze the epidemiological characteristics and trends in the disease burden of protein-energy malnutrition(PEM)among Chinese adults aged 60 years and older from 1990 to 2023,and to project its development trajectory for 2024-2032,thereby providing evidence for formulating differentiated nutritional intervention strategies for the elderly.[Method]Based on Global Burden of Disease(GBD)2023 data,we extracted indicators including prevalence,incidence,and disability-adjusted life years(DALYs)for PEM among Chinese adults aged 60 years and older.Joinpoint regression models were used to calculate estimated annual percentage change(EAPC)for trend analysis,while Bayesian age-period-cohort(BAPC)models were applied for disease burden projections.[Result]From 1990 to 2023,the age-standardized prevalence of PEM among Chinese adults aged 60 years and older increased from 1 360.99 per 100 000 to 2 435.18 per 100 000(EAPC=2.33％),while the age-standardized incidence rate increased from 1 347.15/100 000 to 2 326.54/100 000(EAPC=2.25％).Conversely,the age-standardized DALYs rate decreased by 28.72％(EAPC=-0.65％),revealing a trend of"separation of incidence and burden."Significant population disparities existed in disease burden:males bore a higher burden than females;The rate of decline in DALYs decreases with increasing age,and improvements in burden among the oldest-old aged 85 and above have stalled.During the COVID-19 pandemic period(2020-2023),the growth in prevalence and incidence slowed,and the downward trend in DALYs reversed.Projections indicate that by 2032,prevalence and incidence will plateau,while the DALYs rate will continue to decline gradually.[Conclusion]China's elderly population aged 60 and above exhibits a"decoupling of incidence and burden"trend in PEM,characterized by rising case numbers but declining health loss.This reflects both the widespread implementation of nutritional screening and enhanced diagnostic capabilities among China's elderly,as well as the significant effectiveness of medical advancements in reducing PEM-related mortality and disability rates.This study provides crucial scientific evidence for develop-ing differentiated nutritional intervention strategies for the elderly.Future efforts should prioritize vulnerable populations such as the very old and males,implementing tailored and precise nutritional improvement strategies.