Self-Reported Prevalence and Potential Factors Influencing Cardio-Cerebral Vascular Disease Among the Chinese Elderly: A National Cross-Sectional Study

Abstract

Background: Aging is a basic national condition throughout China in the 21st century. The rapid development of this aging population will have a long-term and profound impact on China. It is a long-term strategic task for China to actively deal with this aging population. To do so requires a scientific strategy; the primary premise of a scientific strategy is to carry out comprehensive and in-depth investigations and research. Cardio-cerebral vascular disease (CCVD) is a common chronic vascular disease in the elderly. However, despite aging becoming an increasingly pressing issue, there has been no comprehensive national investigation into the risk factors, prevalence, and management of CCVD among the elderly population in China.

Methods: Through the 4^th Survey of the Aged Population in Urban and Rural China (SSAPUR), a nationally representative sample of 224,142 adults aged more than 60 years was surveyed using a multistage, stratified sampling method. The 4th SSAPUR was used to investigate CCVD in the elderly. Univariate and multivariate logistic proportional regression analyses were used to explore the risk factors. These risk factors were then entered into a multivariate linear regression model to identify independent predictive factors for CCVD. Disease management was assessed from the self-reported history of physician diagnosis, treatments, and hospital visits among individuals with CCVD.

Results: After excluding samples with missing information, 215,041 individuals were included in the analysis. The overall prevalence of CCVD was 26%. The main risk factors for CCVD among the elderly in China were living in a rural area, older age, being female, having low literacy, smoking, a lack of sleep, bereavement, non-marriage, living alone, lack of exercise, poor financial situation, and non-participation in public welfare activities (P<0.05). In the multivariate linear regression model, holding all other variables at any fixed value, CCVD remained associated with “urban and rural” (β=0.012, P<0.001), “age” (β=-0.003, P<0.001), “sex” (β=-0.022, P<0.001), “education level” (β=-0.017, P<0.001), “marriage” (β=0.004, P=0.047), “smoking” (β=0.012, P=0.003), “drinking” (β=-0.015, P=0.001), and “sleep” (β=0.008, P=0.005). There were no  collinearity problems among these factors.

Interpretation: CCVD is a major health problem among the elderly in China. Chinese national policies for the prevention, control, and management of risk factors for CCVD in the elderly must be urgently developed.

Funding: This work was supported by grants from the National Key R&D Program of China (Grant no. 2020YFC2003000, 2020YFC2003000), the Chinese Academy of Medical Sciences, CAMS Innovation Fund for Medical Sciences (Grant no. 2018-I2M-1-002.), and the National Natural Science Foundation of China (Grant no. 31271097, and 51672030).

Declaration of Interest: We declare no competing interests.

Ethical Approval: The research protocol was approved by the Ethical Review Committee of Beijing Hospital (2021BJYYEC-294-01) and the National Bureau of Statistics (No. [2014] 87). All participants provided written informed consent.

Keywords: potential factors influencing, cardio-cerebral vascular disease, Chinese elderly, national cross-sectional study