更长的寿命伴随着老年人中更多的慢性疾病。由于美国老年人的比例越来越高,这使得与年龄相关的发病率问题成为医疗支出增加的主要原因。我们评估了美国65岁以上老年人48种急性和慢性非癌症疾病和癌症患病率的15年时间趋势(从1998年到2013年),并使用SEER-Medicare和HRS-Medicare数据估计了这些患病率趋势的年度变化百分比。我们发现年龄调整后的肾癌患病率,胰腺,和黑色素瘤,以及糖尿病,肾脏疾病,四肢骨折,抑郁症,贫血,体重不足,痴呆症/阿尔茨海默病,药物/药物滥用和其他几种疾病/状况随着时间的推移而增加。相反,心肌梗塞的患病率,心力衰竭,心肌病,肺炎/流感,消化性溃疡,胃肠道出血,其中,随着时间的推移而减少。还有一些疾病的患病率随着时间的推移没有实质性变化,例如,一组快速进展的癌症和类风湿性关节炎。在一项研究设计中同时对多种疾病的趋势进行分析,重点是所有疾病的相同时间间隔和相同人群,这使我们能够深入了解这些疾病的流行病学,并确定最令人震惊和/或意外的趋势和权衡。获得的结果可用于美国老年人不断增长的健康支出计划
Longer lifespan is accompanied by a larger number of chronic diseases among older adults. Because of a growing proportion of older adults in the U.S., this brings the problem of age-related morbidity to the forefront as a major contributor to rising medical expenditures. We evaluated 15-year time trends (from 1998 to 2013) in the prevalence of 48 acute and chronic non-cancer diseases and cancers in older U.S. adults aged 65+ and estimated the annual percentage changes of these prevalence trends using SEER-Medicare and HRS-Medicare data. We found that age-adjusted prevalence of cancers of kidney, pancreas, and melanoma, as well as diabetes, renal disease, limb fracture, depression, anemia, weight deficiency, dementia/Alzheimer\'s disease, drug/medications abuse and several other diseases/conditions increased over time. Conversely, prevalence of myocardial infarction, heart failure, cardiomyopathy, pneumonia/influenza, peptic ulcer, and gastrointestinal bleeding, among others, decreased over time. There are also diseases whose prevalence did not change substantially over time, e.g., a group of fast progressing cancers and rheumatoid arthritis. Analysis of trends of multiple diseases performed simultaneously within one study design with focus on the same time interval and the same population for all diseases allowed us to provide insight into the epidemiology of these conditions and identify the most alarming and/or unexpected trends and trade-offs. The obtained results can be used for health expenditures planning for growing sector of older adults in the U.S.