Age-Period-Cohort Analysis of Stroke Mortality in China: Data From the Global Burden of Disease Study 2013

Background and Purpose Stroke has been the leading cause of death in China. The aim of this study is to assess the long-term trends of stroke mortality in China between 1994 and 2013. Methods The mortality data were obtained from the GBD 2013 (Global Burden of Disease Study 2013) and were analyzed with the age-period-cohort framework. Results We found that the net drift was -2.665% (95% confidence interval, -2.854% to -2.474%) per year for men and -4.064% (95% confidence interval, -4.279% to -3.849%) per year for women, and the local drift values were below 0 in all age groups (P<0.05 for all) in both sexes during the period of 1994 to 2013. In the same birth cohort, the risk of death from stroke rose exponentially with age for both sexes after controlling for period deviations. The estimated period and cohort relative risks were found in similar monotonic downward patterns (significantly with P<0.05 for all) for both sexes, with more quickly decreasing for women than for men during the whole period (significantly with P<0.05 for both). Conclusions The decreased mortality rates of stroke in China are likely to be related to improvements in medical care and techniques, spectacular economic growth and fast urbanization, and better early life nutrition conditions of Chinese people. Besides, better education and better awareness of stroke-related knowledge in successive generations could also probably play a role.