Assessment of risk factors for cerebrovascular disease among the elderly in Beijing: A 23-year community-based prospective study in China

Trends in all-cause mortality and leading causes of death from 2009 to 2019 among older adults in China

BACKGROUND

This study aimed to determine long-term variations in mortality trends and identify the leading causes of death among older adults in China from 2009 to 2019 so as to propose interventions to further stabilise the mortality rate among older adults and facilitate healthy ageing.

METHODS

We extracted data from the China Death Surveillance database from 2009 to 2019 for all-cause mortality and cause-specific death among individuals aged ≥ 65 years. A joinpoint regression model was used to estimate mortality trends by calculating the annual percentage change (APC). A trend chi-square test was used to estimate sex differences in mortality, and descriptive analysis was used to estimate the leading causes of death. Semi-structured expert interviews were conducted to examine health interventions for older adults.

RESULTS

We observed an overall declining trend in age-adjusted mortality rates among older adults aged ≥ 65 years in China from 2009 to 2019 (APC, -2.44; P < 0.05). In this population, the male mortality rate was higher than the female mortality rate during this period (P < 0.05). However, the mortality rate among older adults aged ≥ 85 years increased since 2014, particularly among females. Cardiovascular disease (CVD) was the leading cause of death among older adults aged 65-84 years, whereas ischaemic heart disease was the leading cause of death among individuals aged ≥ 85 years, especially among females. The majority of injuries resulting in death were caused by falls, showing an increasing trend.

CONCLUSIONS

CVD is a major cause of death among older adults aged ≥ 65 years in China, and relevant health intervention strategies should be implemented from the perspectives of physiology, psychology, and living environment. The change in the mortality trend and the distribution of cause of death among older adults aged ≥ 85 years is noteworthy; a diagnostic and management model centred around females aged ≥ 85 years should be implemented. Additionally, a multidimensional fall prevention strategy involving primary medical institutions and care services needs to be implemented to reduce the risk of falls among older adults.

Pharmacokinetic Analysis of Huangqi Guizhi Wuwu Decoction on Blood and Brain Tissue in Rats with Normal and Cerebral Ischemia-Reperfusion Injury by Microdialysis with HPLC-MS/MS

Objective

The aim of our research was to analyze and compare the pharmacokinetics of paeoniflorin, calycosin, calycosin-7-o-β-d-6-glucoside, and 6-gingerol in the blood and brain tissue of normal and cerebral ischemia-reperfusion injury rats by HPLC-MS/MS method.

Methods

The blood and brain tissue samples of normal and middle cerebral artery occlusion (MCAO) rats were compared. The blood and brain tissue samples were collected by using microdialysis technique. The concentrations of paeoniflorin, calycosin, calycosin-7-o-β-d-6-glucoside, and 6-gingerol in blood and brain tissues were determined by the HPLC-MS/MS internal standard method.

Results

Compared with the normal group, the model group after the administration of the Huangqi Guizhi Wuwu Decoction showed that C_{max blood}, AUC_{0-t blood}, and AUC_{0-inf blood} of paeoniflorin were increased, CL_blood, t_{1/2 brain}, and V_brain of paeoniflorin were decreased; C_maxblood, AUC_0-tblood, AUC_0-infblood, and average residence time (MRT_brain) of calycosin-7-o-β-d-6-glucoside were decreased and the CL_blood and C_{max brain} of calycosin-7-o-β-d-6-glucoside were increased; C_{max blood} of calycosin was decreased, V_blood and V_brain of calycosin were increased; C_{max blood}, AUC_{0-t blood}, AUC_{0-inf blood}, and MRT_brain of 6-gingerol were decreased, CL_blood of 6-gingerol was increased.

Conclusion

This method is simple, rapid, and sensitive. It is suitable for the pharmacokinetic study of Huangqi Guizhi Wuwu Decoction in the blood and brain tissue of rats. Cerebral ischemia-reperfusion injury increased the content of paeoniflorin, calycosin, calycosin-7-o-β-d-6-glucoside, and 6-gingerol in the blood, affecting the clearance rate of paeoniflorin in the brain, the detention time of calycosin-7-o-β-d-6-glucoside and the 6-gingerol in the brain. In normal and cerebral ischemia-reperfusion rats, the content of paeoniflorin and 6-gingerol in the blood was higher than that in brain tissue, while the content of calycosin, calycosin-7-o-β-d-6-glucoside in the brain tissue was higher than that in blood, suggesting that calycosin and calycosin-7-o-β-d-6-glucoside have brain targeting properties.