Trends of Mortality and Years of Life Lost Due to Stroke Among Older Adults in China and Its Provinces, 2005–2020

OBJECTIVES: To evaluate trends in stroke-related mortality and years of life lost (YLL) among older adults in China during 2005-2020. METHODS: Leveraging data from National Mortality Surveillance System, we quantified counts and age-standardized rates for mortality and YLL attributable to stroke and its subtypes among adults aged 65 years and older in China and its provinces from 2005 to 2020. RESULTS: During 2005-2020, age-standardized mortality rate (ASMR) of stroke among older adults in China decreased from 1,327.30 to 1,000.69 per 100,000, accompanied by a 26.58% reduction in YLL rate. Specifically, ASMRs decreased by 48.08% for intracerebral hemorrhage (ICH) and 7.57% for subarachnoid hemorrhage (SAH), whereas that for ischemic stroke (IS) increased by 1.24%. In 2020, ASMRs for IS, ICH, and SAH were 610.52, 357.86, and 32.32 per 100,000, respectively, with IS exhibiting the highest rate. Notably, IS mortality increased among men aged 75-79 years (1.95%), men aged 80+ years (17.79%), and women aged 80+ years (5.02%). In 2020, the highest ASMR of stroke was observed in Tibet, Anhui, and Shaanxi. DISCUSSION: The substantial burden of IS persists among older adults in China. Increased IS mortality among men aged 75+ years and women aged 80+ years warrants particular attention.