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PubMedDate not supplied

[Decomposition of the differences in life expectancies].

"This study decomposes the differences between average life expectancies at age x by double standardization into effect of differences in the mortality structure by causes of death, and into effect of differences in the average life expectancies of those deceased due to certain causes of death, relying on abridged life tables by causes of death as for Belgium and Hungary in 1984.... The mortality structure by causes of death is more favourable in the case of females in both countries, but it contributes less to the rather significant differences in general mortality level. It is worth mentioning that the differences in the mortality level of males and females presents itself more definitely in Hungary than in Belgium." (SUMMARY IN ENG AND RUS)

Age Factors↗
PubMed1982

Correlates of life expectancy in less developed countries.

Analyses were performed to investigate several hypotheses concerning the multiple determinants of levels of life expectancy in developing countries in recent decades and some possible explanation for the observed variations in amount of gain in life expectancy from the 1950's to the 1970's. The findings were significant. For level of life expectancy the results of this present work conform by and large to results of other scholars in this area, although the present work is unique in that only developing countries were included. From the 1960's to the 1970's there has been a shift in the relative importance of economic indicators and general social indicators in favor of the social indicators. In the period 1960-65 some 70% of the variation in levels of life expectancy was associated with per capita income and literacy rates in a ratio of about three to two in favor of the economic variable. By 1970-75 the ratio has become six to one in favor of literacy. In addition, the multivariate model showed that the sanitation variables began to appear as significant correlates of levels of life expectancy in the more recent time period, playing a larger role than level of income per capita. Work pursued as part of a separate but concurrent project explored explicitly this three-way interaction between literacy, life expectancy and sanitation.

Developing Countries↗
PubMed1997

Socioeconomic status, race and life expectancy in Arkansas, 1970-1990.

Earlier research found that high socioeconomic populations in Arkansas experienced an increase in mean life expectancy over low socioeconomic populations between 1970 and 1990. The possibility that these findings are spurious because of race is tested in this paper. Using multivariate analysis in conjunction with estimates of life expectancy by race and socioeconomic status (SES) we find that between 1970 and 1990: (1) Black populations with high SES gained more than three additional years of life expectancy over Black populations with high SES; and (2) White populations with high SES gained more than .5 years of life expectancy over White populations with low SES. These findings support earlier findings that SES plays an instrumental role in differential life expectancy. They also suggest that the effects of SES on life expectancy are moderated differentially for Blacks and Whites.

Black or African American↗
PubMed2006

Life expectancy in patients with hereditary haemorrhagic telangiectasia.

BACKGROUND: There are few data on life expectancy in patients with hereditary haemorrhagic telangiectasia (HHT), a disorder with life-threatening complications. METHODS: Seventy HHT patients provided data on age and age at death of their HHT-affected parent, which was compared with that of the parent's non-affected partner. RESULTS: At the time of the study, 40 HHT parents (57.1%) vs. 36 (51.4%) non-HHT parents had died (p = 0.404). Median age at death was lower in HHT vs. non-HHT parents (63.2 vs. 70.0 years, respectively). The mortality of HHT parents showed an early peak in the under 50s and a late peak at 60-79 years. HHT was the main risk factor influencing life expectancy after 30 years (p < 0.05). No differences in survival probability were found in HHT patients with respect to sex (p = 0.37), or ENG vs. ALK-1 genotype (p < 0.9). DISCUSSION: Life expectancy appears to be significantly lower in HHT patients than in their partners. Prevention of HHT complications with screening programs could increase life expectancy.

Adult↗
PubMed1982

A convenient approximation of life expectancy (the "DEALE"). I. Validation of the method.

The physician developing a treatment plan for a particular patient often needs to know the life expectancy associated with the outcomes of therapeutic choices. Currently available methods for estimating life expectancy are cumbersome and of limited clinical use. We describe a simple approximation of life expectancy (the "DEALE") that is based on the assumption that survival follows a simple declining exponential function. In this approach, the reciprocal of the age-, sex-, and race-adjusted life expectancy is used to estimate the mortality rate of a healthy person. The life expectancy of a person who also has one or more diseases is obtained by adding disease-specific mortalities to the age-, sex-, and race-adjusted mortality rate and taking the reciprocal of that sum. In this paper we show that this approximation estimates life expectancy accurately for the great majority of clinical problems.

Adult↗
PubMed2003

Will human life expectancy quadruple in the next hundred years? Sixty gerontologists say public debate on life extension is necessary.

Sixty gerontologists were asked for estimates regarding the development of future life expectancy. For a person born in the year 2100, life expectancy estimates had a median of 100 years and a mean of 292 years. Changes in biogerontology suggest that the search for the "fountain of youth" is gaining respectability, becoming competitive with compression of morbidity as the predominant scientific goal. Appropriate debate should address questions raised by such a goal and prepare for sudden advances that may have a large impact on society.

Attitude of Health Personnel↗
PubMed2003

A further study of life expectancy by socioeconomic factors in the National Longitudinal Mortality Study.

OBJECTIVES: The objective of this article is to provide estimates of life expectancy for White, Black, and Hispanic populations by socioeconomic factors. Effects of educational, income, employment, and marital status on life expectancy are presented and interpreted. DESIGN: The National Longitudinal Mortality Study, consisting of a number of Current Population Surveys (CPS) linked to mortality information obtained from the National Death Index, provides data to construct life tables for various socioeconomic and demographic groups. Probabilities of death are estimated using a person-year approach to accommodate the aging of the population over 11 years of follow up. RESULTS: Across various ethnicity-race-sex groups, longer life expectancy was observed for individuals with higher levels of education and income, and for those who were married and employed. The differences in life expectancy between levels of the socioeconomic characteristics tended to be larger for men than for women. Also, differences were found to be larger for the non-Hispanic Black population compared to the non-Hispanic White population. Hispanic White men exhibited patterns similar to those of non-Hispanic White and Black men. CONCLUSIONS: For selected ethnicity-race-sex groups, the impact of socioeconomic variables on life expectancy is dramatic. The shorter life expectancy observed among the poor, the less educated, the unmarried, and those not in the labor force, highlights the impact of socioeconomic disadvantage on survival. Further, the substantial 14-year differential favoring the employed over those not in the labor force may be partially explained by unemployment due to poor health. Another reason may be that employed individuals have greater access to health care than do those not in the labor force.

Adult↗
PubMed1996

A method of estimating tooth life expectancy.

One of the most important outcome measures for dental services is the increase in tooth life expectancy which is brought about by the interventions provided. Thus, a convenient and accurate index of tooth survival is critical both to clinical decision making and to more general assessments of public dental health policies. This paper describes a simple method of approximating tooth life expectancy (TLE). The method is based on the assumption that tooth survival follows a simple declining exponential function. Assuming a constant mortality rate, TLE is the integral of the survival function, expressed as S(t) = e-mu t, where t is time and mu the constant mortality rate. Using 3-year tooth-specific mortality rates for 491 subjects aged 50 years or more, tooth-specific life expectancies for the population as a whole where found to range from 27 years for upper canines to 71 years for lower incisors. Individuals with a mean periodontal attachment loss greater than 4 mm and people on low incomes had significantly lower tooth life expectancies than their periodontally fit and more wealthy counterparts. This technique can be used to obtain disease-specific or intervention-specific tooth life expectancies. Thus, gains in TLE for individuals with different oral, social and behavioural characteristics can be calculated. The declining exponential approximation of tooth life expectancy has the potential to become a powerful tool in the evaluation of dental services and treatments.

Cuspid↗
PubMed2002

[Change in life expectancy in connection with three large groups of causes of death in Medellín, Colombia, between 1989-1991 and 1994-1996].

OBJECTIVES: To examine changes in life expectancy in Medellin, Colombia, between 1989-1991 y 1994-1996, in connection with four large groups of causes of death commonly employed in studies on the burden of disease: group 1, communicable diseases, perinatal and maternal health problems, and nutritional deficits; group 2, non-communicable diseases; group 3, wounds; group 4, ill-defined causes. The latter were excluded from the analysis because of their ambiguity. METHODS: The calculations were made according to the method described by J. H. Pollard in 1986, with the aid of Microsoft Excel, by using the recommended formulas. The computations were double checked with EPIDAT (version 3.0, unofficial). RESULTS: Between 1989-1991 y 1994-1996, a total gain of 1.93 years in life expectancy was seen in Medellin, with a rise from 62.13 to 64.06 years. The gain was greater in men than in women (2.42 vs. 1.09 years, respectively). The increase noted among females was greatest in the extreme age groups (girls 1 to 4 and women over 54 years of age); in men, it was highest in the middle years (between the ages of 25 and 44). In both sexes, the greatest percentage loss in life expectancy was seen in persons 15 to 19 years of age (23% in men and 4% in women, roughly). In the group comprising communicable diseases, perinatal and maternal health problems, and nutritional deficits, a loss in life expectancy was seen in men (0.04 years), whereas in the group of non-communicable diseases there was a gain in life expectancy in both sexes (0.60 years among men and 0.55 years among women). The greater gain in life expectancy among men was linked to a reduction in mortality from wounds (1.98 years). CONCLUSIONS: If one compares the results obtained in Medellin at the end of the study period with life expectancy at birth in Colombia in 1995, which was 70 years, it is obvious that life expectancy in Medellin is still lagging behind, even though it has risen progressively over the years. This is in keeping with the epidemiological transition the city has experienced, which has been linked with a rise in mortality from degenerative and cardiovascular diseases, chronic respiratory ailments, and diabetes, as well as from diseases resulting from human activity. Nevertheless, this epidemiological transition has been slow in Medellin when compared to Colombia as a whole due to high rates of death from infectious and parasitic diseases, which are more characteristic of the transition in its earlier stages. Despite the fact that mortality from wounds has decreased in Medellin, particularly among young males, it may be worthwhile to reassess the effectiveness of interventions undertaken in recent years to promote peaceful coexistence and tolerance in the community.

Adolescent↗
PubMed2005

Healthy life expectancy by area deprivation: magnitude and trends in England, 1994-1999.

This article examines the magnitude of inequalities in health by area deprivation using two composite indices of health expectancy, one based on a subjective assessment of general health status (healthy life expectancy) and the second on reported limiting longstanding illness (disability-free life expectancy). Trends in healthy life expectancy by deprivation for the period 1994-1999 were also examined. Results show that males and females living in the most deprived wards spend twice as many years in poor health, both in absolute (years of life) and relative (proportion of life) terms, than those living in the least deprived wards. There was no change in the healthy life expectancy gap between the most and least deprived areas over the study period.

Adolescent↗
PubMed2005

Life expectancy at the age of 65 years and environmental factors: an ecological study in Japan.

The purpose of this study was to examine the factors associated with life expectancy at the age of 65 years used as the index of longevity, using published data in Japan. Life expectancy at the age of 65 years was obtained from the 19th life table in 2000 published by the Ministry of Health, Labour and Welfare of Japan. The associations between life expectancy at the age of 65 years and environmental factors were assessed by Spearman correlation coefficients. Life expectancy at the age of 65 years was higher in females (22.54 years) than in males (17.42 years). In this study, the number of public health nurses and leisure time per day were found significantly associated with life expectancy at the age of 65 years in both men and women. For men, life expectancy at the age of 65 years was significantly associated with leisure time for sports and exercises and higher proportion of participation in volunteer activities in the community; for women, it was associated with a higher number of hospitals and proportion of participation in educational classes for the aged. Our ecological study might provide some clues to more practical planning for longevity in consideration of gender differences.

Age Factors↗
PubMed2003

Regional differences in trends in life expectancy and the influence of the political and socioeconomic contexts in Germany.

The aim of the study is to investigate to what extent trends in life expectancy are influenced by political variables and socioeconomic characteristics that play a role at the regional level of the federal states in Germany. Data on life expectancy in males and females at birth are analyzed from 1986 to 1998 for 12 federal states in Eastern and Western Germany. These states are classified into five types of political government since 1980: (1) long-term Christian democratic, (2) long-term social democratic, (3) change from Christian to social democratic, (4) change from communist to social democratic, and (5) change from communist to Christian democratic. The study showed three main results. First, life expectancy has been directly influenced by the major political forces that determined policies in East and West Germany. Second, life expectancy was higher in federal states with predominantly Christian democratic governments than in those with predominantly social democratic governments. Third, life expectancy was strongly related to the economic power of the federal states. Because federal states characterized by a more prosperous economic situation were those with a predominantly Christian democratic government, while federal states with a less prosperous situation were mostly governed by social democrats, it is difficult to disentangle the effects of economic and political factors on life expectancy. Nevertheless, this study underlines the importance of politics and policies on such robust and more general health indicators as mean life expectancy at birth.

Christianity↗
PubMed1998

Life expectancy as a measurement of the benefit shown by clinical trials of treatment for early breast cancer.

Improvements in life expectancy could be a more readily appreciated measure of benefit from a clinical trial than relative risks, odds ratios or increases in survival rate at some arbitrary point in time. Parametric models of survival experience can be used to determine differences in life expectancy. Using the log-normal model, it is shown that the increases in 10-year survival rate found by the overviews of adjuvant systemic therapy trials in early breast cancer are consistent with only small overall increases in life expectancy of about 1 year for Stage I and about 2 years for Stage II. However, if adjuvant therapy transfers a patient from being not cured to being cured, then her life expectancy will have been improved by 16 years for Stage I disease and by 21 years for Stage II. Model analyses on large data sets, such as are available in overviews, could possibly provide some evidence on whether the effect of adjuvant systemic therapy is to increase the cure rate, with the consequent considerable increase in life expectancy for some patients, or whether the effect is only a small increase in life expectancy for those who are not cured.

Breast Neoplasms↗
PubMed1997

Longevity and life expectancy.

"In this article the evolution of life expectancy is examined historically for various European nations at various ages, and according to sex. Appropriate logistic equations describe the facts and extrapolate into the future giving the doctor an indication of what is still to be accomplished and the demographer the tools with which to evaluate the aging of European population in the next 20 years....I posit that the increase in life expectancy is the product of a learning process to remove the accidents and obstacles on the way to the full life potential of an individual: longevity."

Age Factors↗
PubMed1988

Recent changes in mortality and labor force behavior among older Americans: consequences for nonworking life expectancy.

Increment-decrement working life tables for 1972 and 1980 are used to assess the relative impact of recent changes in mortality and labor force behavior on the number of years older men and women can expect to spend out of the labor force (nonworking life expectancy). The life tables are based on data from the Current Population Surveys and pertain to the population aged 55 and older for the two observation points. The results indicate that nonworking life expectancy increased dramatically between 1972 and 1980 for both men and women. Although labor force behavior changed markedly for both population groups during the observation period, the results clearly identify that changes in mortality were responsible for the increases in nonworking life expectancy. Implications of the findings for social policy are briefly discussed.

Actuarial Analysis↗
PubMedDate not supplied

Computing population-based estimates of health-adjusted life expectancy.

Observed health-adjusted life expectancy (HALE) is an indicator of population health. There are a number of ways to compute HALE for a community. The authors surveyed several methods and demonstrate resulting variation in the estimates of HALE. Quality of well-being (QWB) measures from 1,430 participants in the Beaver Dam Health Outcomes Study are taken as weights. Actuarial life-table methods using community mortality data, State of Wisconsin census data from two time frames, and U.S. census data are used with the QWB to estimate HALE. Measurement of community population health using HALE computations can be completed with national, regional, or local data. Community-level estimates may not be well approximated using large-scale mortality experience. A Bayesian method is developed combining the local data with regional data. The Bayesian method creates a smooth set of rates, retains the local flavor of the community, and gives a measure of variability of the estimated HALE.

Actuarial Analysis↗
PubMed2006

Determinants of life expectancy in medullary thyroid cancer: age does not matter.

OBJECTIVE: In medullary thyroid cancer (MTC) age is considered an important prognostic factor but survival has never been properly adjusted for baseline mortality in the general population. We aimed to identify prognostic factors by analysing patients with MTC regarding life expectancy. DESIGN: We described a retrospective cohort study with a median follow-up of 8 years (range 1-35 years). PATIENTS: We included 120 consecutive patients of whom 66 (55%) had sporadic MTC. Male/female ratio was 1 : 1; median age was 45 years (range 3-83 years). MEASUREMENTS: Measurements were overall and disease-specific survival and life expectancy expressed as survival adjusted for baseline mortality rate in the general population. RESULTS: Overall and disease-specific 10-year survival was 65% and 73%, respectively. After 10 years, 29% of patients were biochemically and 63% clinically cured. Median overall life expectancy was 0.58 (95%CI 0.37-0.80). Detectable recurrence occurred in 60 patients after a median of 36 months (range 5-518 months). On multivariate regression analysis only stage of disease and extrathyroidal extension predicted recurrence-free life expectancy. Extrathyroidal extension was the only independent predictor of overall life expectancy. Persistent biochemical MTC did not independently affect life expectancy but calcitonin doubling time of less than one year indicated worse prognosis. Patients without detectable recurrences after initial treatment had a life expectancy similar to the general population. CONCLUSIONS: In MTC patients, extrathyroidal extension and stage at diagnosis are the only independent predictors of (recurrence-free) life expectancy. Patients diagnosed in an early stage of disease and patients without detectable recurrence have favourable life expectancy independently of biochemical cure.

Adolescent↗
PubMedDate not supplied

[Life expectancy with functional disability in elderly persons in São Paulo, Brazil].

OBJECTIVE: For persons 60 years of age or older living in the city of São Paulo, Brazil, in the year 2000 to estimate four characteristics: (1) life expectancy free of functional disability, (2) life expectancy with functional disability, (3) life expectancy with functional disability but without dependence, and (4) life expectancy with functional disability and dependence. METHODS: The estimates of the four characteristics were calculated by means of a life table constructed based on the method proposed by Sullivan. The basic data used for the calculations were the elderly population estimated for the city of São Paulo as of mid-2000, obtained from the demographic censuses of 1991 and 2000, and deaths in the elderly population, obtained from the State Data Analysis System Foundation (Fundação Sistema Estadual de Análise de Dados, or SEADE) of the state of São Paulo. The prevalences of functional disability and of functional dependence were calculated based on data concerning activities of daily living collected in the city of São Paulo as part of a project called Health, Well-being, and Aging in Latin America and the Caribbean (the "SABE project"). The activities of daily living considered were: dressing, eating, bathing, using the bathroom, lying down on the bed and getting up from it, and walking across a room. Functional disability was defined as difficulty in performing one or more of the activities of daily living. Dependence was defined as the need for help in performing at least one of the activities of daily living. RESULTS: In 2000, 60-year-old men from the city of São Paulo could expect to live, on average, 17.6 years, of which 14.6 years (83%) would be free of functional disability. Women of the same age could expect to live 22.2 years, of which 16.4 years (74%) would be free of functional disability. Men would have a functional disability and be dependent on others for 1.6 years (9%), while the comparable period for women would be 2.5 years (11%). CONCLUSIONS: Despite their longer life expectancy, the women faced more years with functional disability. The number of years with functional disability and dependence was also higher for the women. Public policies should take into account the differing needs of elderly women and of elderly men as well as other specific characteristics of this older population.

Activities of Daily Living↗