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PubMed2004

[Cribra orbitalia, dentin hypoplasia and life expectancy of 20-year-old persons as social and sex specific stress indicators in correlation with the health status of an early medieval population].

The aim of this study is based on the analysis of diachronically social and sexual specific considerations on the life situation of the early medieval population of Schleitheim, Kanton Schaffhausen, Switzerland. Cribra orbitalia and the linear enamel hypoplasia of the teeth are considered as stressors. This study is based on the life expectancy of the 20 years old, as the life expectancy gives information on the health condition of a social group or an entire population. The considered indicators show the same tendencies in three of the four social groups (women social group A and group B/C, men of the social group A). The female and male population of the social group A show a steady decrease in the indicator from the 5th century to come to its lowest level in the 7th century. The same parameters indicate a continuous increase in stress for the female population of the group B/C. Only one of the three indicators, the Cribra orbitalia, shows a positive tendency in the male population of the social group B/C from the 6th century to the following period, while hypoplasia and the life expectancy on the other hand indicate a negative tendency. The results show equal tendencies in the three independent indicators concerning three of the four social groups. This proves the high reliability of the indicators. These results are astonishing in two ways. First of all, the tendencies show that the originally better life situation of women of the higher ranking social group decreases in the following periods, whereas the women of the lower social group show an inverse development. This female population of low life situation in the 5th century shows an increase in life qualities in the following periods. Remarkable, too, is the fact, that the female population of both social groups shows a lower level of stress than the corresponding male population. This fact is astonishing, as we would expect inverse results in a patriarchal society. This may point to a well known fact: Women show a higher vitality than the male population.

Adult↗

PubMed2006

Mortality and life expectancy of professional fire fighters in Hamburg, Germany: a cohort study 1950-2000.

BACKGROUND: The healthy worker effect may hide adverse health effects in hazardous jobs, especially those where physical fitness is required. Fire fighters may serve as a good example because they sometimes are severely exposed to hazardous substances while on the other hand their physical fitness and their strong health surveillance by far exceeds that of comparable persons from the general population. METHODS: To study this effect a historic cohort study was conducted to assess mortality and life expectancy of professional fire fighters of the City of Hamburg, Germany. Fire departments and trade unions questioned the validity of existing studies from outside Germany because of specific differences in the professional career. No mortality study had been conducted so far in Germany and only few in Europe. Information on all active and retired fire fighters was extracted from personnel records. To assure completeness of data the cohort was restricted to all fire fighters being active on January 1, 1950 or later. Follow up of the cohort ended on June 30th 2000. Vital status was assessed by personnel records, pension fund records and the German residence registries. Mortality of fire fighters was compared to mortality of the Hamburg and German male population by means of standardized mortality ratios. Life expectancy was calculated using life table analysis. Multivariate proportional hazard models were used to assess the effect of seniority, time from first employment, and other occupational characteristics on mortality. RESULTS: The cohort consists of 4640 fire fighters accumulating 111,796 person years. Vital status could be determined for 98.2% of the cohort. By the end of follow up 1052 person were deceased. Standardized Mortality Ratio (SMR) for the total cohort was 0.79 (95% CI, 0.74-0.84) compared to Hamburg reference data and 0.78 (95% CI, 0.74-0.83) compared to National German reference data. Conditional life expectancy of a 30 year old fire fighter was 45.3 years as compared to 42.9 year of a German male in normal population. Job tasks, rank status and early retirement negatively influenced mortality. For fire fighters with comparably short duration of employment the mortality advantage diminished with longer time since first employment. SMR of persons who retired early was 1.25 (95% CI, 1.13-1.60) in reference to the general German population and the SMR of 1.71 (1.18-2.50) in the multivariate regression model. CONCLUSION: A strong healthy worker effect was observed for the cohort, which diminished with longer time since first employment for fire fighters with shorter duration of employment, as expected. The negative effects on mortality of job tasks, rank status and in particular early retirement indicate the presence of undetermined and specific risks related to occupational hazards of fire fighters.

Adolescent↗

PubMed1998

Long-term cost and life-expectancy consequences of hypertension.

OBJECTIVE: To estimate hypertension's long-term cost and impact on life expectancy. DESIGN: A 19-year individual follow-up study. Subjects were categorized according to their baseline (1972) diastolic blood pressure (DBP) level into three groups: normotensive (DBP < 95 mmHg), mildly hypertensive (DBP 95-104 mmHg), and severely hypertensive (DBP > 104 mmHg). By using their social security identification numbers, we linked the subjects to a set of national registers covering hospital admissions, use of major drugs, absence due to sickness, disability pensions, and deaths. SUBJECTS: A random population sample of 10 284 men and women aged 25-59 years from the provinces of Kuopio and North Karelia in eastern Finland. MAIN OUTCOME MEASURES: The numbers of years of life and years of work lost, the cost of drugs and hospitalization, and the value of productivity lost due to disability and premature mortality. RESULTS: The difference in life expectancy between normotensive and severely hypertensive men was 2.7 years, of which 2.0 years was due to cardiovascular disease (CVD). Among women the corresponding differences were 2.0 and 1.5 years. Severely hypertensive men lost 2.6 years of work more than did normotensive men, of which 1.7 years was due to CVD. Among women the differences were 2.2 and 1.3 years. The mean undiscounted total costs (USA dollars at 1992 prices) were $132 500 among normotensive, $146 500 among mildly hypertensive, and $219 300 among severely hypertensive men, of which CVD accounted for 28, 39, and 43%, respectively. More than 90% of the total costs were indirect productivity losses. Among women the total costs were lower for all DBP categories, as were the shares of CVD-related costs. The proportional increase in costs on going from the lowest to the highest DBP category was, however, somewhat larger among women. CONCLUSIONS: On the population level, severe hypertension leads to considerable losses in terms of years of life lost, years of work lost, and costs. However, the overall impact of mild hypertension is much more limited.

Adult↗

PubMed1992

Adding years to life: effect of avoidable mortality on life expectancy at birth.

STUDY OBJECTIVE: The aim was to determine the number of years that could be gained by preventing avoidable deaths. DESIGN: The study arose from the concept of avoidable causes of death and life expectancy at birth. Four abbreviated life tables were computed. The first included all causes of death; the second excluded all avoidable causes of death; the third and fourth excluded respectively primary and secondary avoidable causes of death. SETTING: Mortality and population data were taken from Mortality Statistics Offices in Valencia Region, Spain. MAIN RESULTS: Life expectancy at birth (LEB) was 75.7 years. After removing all avoidable deaths, LEB increased by 1.74 years. This improvement is attributed to avoidable deaths by primary prevention (1.09 years) and avoidable death by secondary prevention (0.37 year). CONCLUSIONS: According to these results the greatest improvement in LEB would be gained by primary prevention.

Cause of Death↗

PubMed1992

The benefits of treating hyperlipidemia to prevent coronary heart disease. Estimating changes in life expectancy and morbidity.

OBJECTIVE: To evaluate the lifetime benefits of reducing total serum cholesterol levels to prevent coronary heart disease (CHD). DESIGN: We developed a CHD primary prevention computer model to estimate the benefits associated with lifelong risk factor modification. We validated the model by comparing the computer estimates with the observed results of three primary CHD prevention trials. PATIENTS: Men and women age 35 to 65 years who are free of CHD, with total serum cholesterol levels ranging from 5.2 to 7.8 mmol/L (200 to 300 mg/dL), with or without additional CHD risk factors. INTERVENTIONS: Serum cholesterol reduction through dietary modification or diet and medications. MAIN OUTCOME MEASURES: Changes in life expectancy and the delay of symptomatic CHD. RESULTS: The computer forecasts for CHD end points closely matched the observed results of the Lipid Research Clinics Trial, the Helsinki Heart Study, and MRFIT. We then applied the computer model to low-risk and high-risk men and women with total serum cholesterol levels between 5.2 and 7.8 mmol/L (200 and 300 mg/dL) and estimated that, after reducing serum cholesterol levels 5% to 33%, the average life expectancy would increase by 0.03 to 3.16 years. We also forecast that the average onset of symptomatic CHD would be delayed among these patient groups by 0.06 to 4.98 years. CONCLUSION: We conclude that this computer model accurately estimates the results of clinical trials and can be used to forecast the changes in life expectancy and morbidity (the development of CHD) associated with specific CHD risk reduction interventions. The wide variation surrounding these estimates underscores the need to better define which groups of individuals will gain the most from cholesterol reduction.

Adult↗

PubMed1994

Life expectancy and egg load affect oviposition decisions of a solitary parasitoid.

Life-history theory predicts that animals should be sensitive to both the amount of resources available and life expectancy in making reproductive decisions. Because it is easier to control the mortality of insect parasitoids (insects whose larva develop in or on another insect) than many other groups of animals, the best tests of these predictions have used them. However, because of the inter-correlation of several of the variables of interest, much of this evidence is equivocal, and experimental manipulations have failed to isolate the most important factors. Here we report an experiment which circumvents such problems by comparing the superparasitism rates of fed and starved parasitoids. By using the asexual solitary hymenopteran parasitoid Venturia canescens, we demonstrate that starved wasps with a reduced life expectancy lay eggs in low-quality hosts more frequently than those with a greater expected lifespan, as do parasitoids with higher egg loads and hence more resources available for reproduction.

Animals↗

PubMed1985

Gender differences in life expectancy among kibbutz members.

A literature review of findings reveals that the life expectancy (LE) of females is longer than that of males and that a strong relationship exists between LE and gender differences in LE. The arguments of biological vs societal reasons for such gender differences are presented and the kibbutz society is offered as a setting to test the rivaling hypotheses. It is argued that the kibbutz society offers more similar roles for both genders than outside the kibbutz and therefore the gender differences in LE should be reduced in comparison to what is expected, given the very high LE of kibbutz members. Statistical data of the kibbutz population between the years 1975-1980 are analyzed and the results support the following conclusions: female members have higher LE but the difference is much less than expected on the basis of a regression analysis of data from 73 societies; the difference is smaller due to the relatively higher gain in LE by males; the gender differences are even smaller at age 50 compared to LE differences at birth. The Discussion section dwells upon interpretations of the findings and argues against alternative interpretations that assume selection processes for the kibbutz population. Suggestions for further studies are also made.

Adolescent↗

PubMed2000

Life-expectancy projection by modelling and computer simulation (UKPDS 46).

A method is described for estimating the life-expectancy of cohorts of type 2 diabetic patients, based on computer simulation from a parametric model. The method can be used where non-parametric methods, such as the Kaplan-Meier estimate, fail due to lack of the data. The simulation algorithm combines observed and modelled information to estimate the life-expectancy implications of event rates observed within a study. The use of bootstrap methods to estimate confidence intervals is discussed. The methods are illustrated with results that have been previously published, without derivation, in a health economic analysis of tight blood pressure (BP) control in the UK Prospective Diabetes Study (UKPDS), and the application to other health economic analyses of UKPDS data is discussed.

Algorithms↗

PubMed1996

Changing life expectancy in central Europe: is there a single reason?

BACKGROUND: During the 1980s, at a time that life expectancy at birth in western Europe has increased by 2.5 years, it has stagnated or, for some groups, declined in the former socialist countries of central and eastern Europe. METHODS: A study was carried out to ascertain the contribution of deaths at different age groups and from different causes to changes in life expectancy at birth in Czechoslovakia, Hungary and Poland between 1979 and 1990. RESULTS: Improvements in infant mortality have been counteracted by deteriorating death rates among young and middle-aged people, with the deterioration commencing as young as late childhood in Hungary but in the thirties or forties in Czechoslovakia and Poland. The leading contributors to this deterioration are cancer and circulatory disease but, in Hungary, cirrhosis and accidents have also been of great importance. CONCLUSIONS: The patterns observed in each country differ in the age groups affected and the causes of death. Further work is required to explain these differences.

Adolescent↗

PubMed1983

[Trends of phase-specific life expectancy in postwar Taiwan].

The decline in mortality in Taiwan since World War II is analyzed using life tables. "Special features of the research include (1) a phase-of-life-specific, rather than an age-specific, analysis of mortality, and (2) the use of measures based upon person-years of life in phase intervals, rather than survival rates or expectation of life at given ages. The empirical results suggest that the mortality decline can be described as a two-stage process: an initial stage of substantial improvement in life expectancy between 1950 and 1965, and a final stage of slow gain in life expectancy since 1965." Age and sex variations in mortality and differing rates of mortality decline are noted. Implications of increased longevity for economic and social programs are also considered. (summary in ENG)

Age Factors↗

PubMed2002

Gender differences in disability-free life expectancy for selected risk factors and chronic conditions in Canada.

This article shows how mortality and morbidity patterns differ for women and men 45 years of age and older. The impact on disability-free life expectancy was calculated for selected risk factors and chronic conditions: low income, low education, abnormal body mass index, lack of physical activity, smoking, cancer, diabetes, and arthritis. For each factor, the expected number of years free of disability was calculated for men and women using multi-state life tables. In terms of disability-free life expectancy, the greatest impacts on affected women were for diabetes (14.1 years), arthritis (8.8 years), and physical inactivity (6.0 years), while for affected men, the greatest impacts were for diabetes (10.5 years), smoking (6.9 years), arthritis (6.5 years), and cancer (6.4 years). The implications of these results are discussed from the perspective of developing programs designed to improve population health status.

Activities of Daily Living↗

PubMed2006

General anesthesia does not reduce life expectancy in aged rats.

A recent clinical study demonstrated that deep anesthesia, as measured by Bispectral index monitoring, was associated with increased 1-yr mortality among middle-aged and elderly surgical patients. We have previously demonstrated impaired cognitive performance in aged rats for weeks after general anesthesia with 1.2% isoflurane-70% nitrous oxide-30% oxygen. However, the effects of 2 h of anesthesia with 1.2% isoflurane-70% nitrous oxide-30% oxygen on rodent life expectancy are unknown and may have confounded our results. Accordingly, we designed this study to determine if general anesthesia alters life expectancy in aged rats. Sixteen 22-mo-old Fischer 344 rats were randomized to anesthesia for 2 h with 1.2% isoflurane-70% nitrous oxide-30% oxygen or a control group that received 30% oxygen (n = 8 per group). Rats recovered in an enriched oxygen environment and then were placed in their home cage under routine conditions. The number of days between anesthesia administration and death were recorded and Kaplan-Meier survival curves generated and compared statistically using the log-rank test and bootstrap method. There was no difference in long-term survival between the control and anesthesia groups. Hence, general anesthesia with 1.2% isoflurane-70% nitrous oxide-30% oxygen does not reduce life expectancy in aged Fischer 344 rats.

Aging↗

PubMed1988

Active-life expectancy and terminal dependency: trends in long-term geriatric care over 33 years.

To determine whether medical advances will result in an increasing number of dependent elderly people, or whether postponement of disability in a finite lifespan will lead to a decrease in terminal dependency, an analysis was made of 24,117 admissions to a geriatric unit from 1954 to 1986. During this period, the average age on admission for long-term care rose by 0.24 years per year for women and by 0.09 years per year for men. The median length of stay also increased, more for women than for men, as did the proportion of the total lifespan spent in long-term care. Active-life expectancy became longer and terminal dependency was postponed, but the duration of terminal dependency increased. Active-life expectancy increased more rapidly in women than in men, as did the length of terminal dependency. As life expectancy continues to increase, high priority will have to be given to reduction of disability and dependency in advanced old age.

Aged↗

PubMedDate not supplied

Impact of particulate air pollution on quality-adjusted life expectancy in Canada.

Air pollution and premature death are important public health concerns. Analyses have repeatedly demonstrated that airborne particles are associated with increased mortality and estimates have been used to forecast the impact on life expectancy. In this analysis, we draw upon data from the American Cancer Society (ACS) cohort and literature on utility-based measures of quality of life in relation to health status to more fully quantify the effects of air pollution on mortality in terms of quality-adjusted life expectancy. The analysis was conducted within a decision analytic model using Monte Carlo simulation techniques. Outcomes were estimated based on projections of the Canadian population. A one-unit reduction in sulfate air pollution would yield a mean annual increase in Quality-Adjusted Life Years (QALYs) of 20,960, with gains being greater for individuals with lower educational status and for males compared to females. This suggests that the impact of reductions in sulfate air pollution on quality-adjusted life expectancy is substantial. Interpretation of the results is unclear. However, the potential gains in QALYs from reduced air pollutants can be contrasted to the costs of policies to bring about such reductions. Based on a tentative threshold for the value of health benefits, analysis suggests that an investment in Canada of over 1 billion dollars per annum would be an efficient use of resources if it could be demonstrated that this would reduce sulfate concentrations in ambient air by 1 microg/m(3). Further analysis can assess the efficiency of targeting such initiatives to communities that are most likely to benefit.

Adolescent↗

PubMed1994

Changes in active life expectancy in Taiwan: compression or expansion?

The 1986-1989 supplements on Elderly Living Conditions to the Monthly Surveys of Human Resources in the Taiwan area are used to estimate active life expectancy and to examine evidence for a compression of disability. Unlike recent results generated in Western countries in favour of the expansion of morbidity hypothesis, our findings tend to support the hypothesis that declining mortality leads to a compression of disability. In Taiwan fatal diseases (e.g. heart disease, stroke, and cancer) play a more important role in disability than to nonfatal diseases (e.g. arthritis, dementia, sensory impairments, and osteoporosis, etc.). Fatal diseases are still the leading causes of disability; modern technology has not prolonged life significantly to Taiwanese who contract such diseases. Hence the improvement in recent life expectancy is very slow and the duration between age at onset of fatal diseases and death tends to be short. As a result of such short duration, the area between the disability and the mortality curve in the life table narrows.

Adolescent↗

PubMed1993

A simplified method for determining the average life expectancy in the Republic of Bulgaria.

A simplified method was used in the present study to calculate the average life expectancy of newborn children in Bulgaria. In contrast to the classical methods for constructing mortality tables, this method is not time consuming and does not require complex mathematical calculations and therefore easily accessible for public health bodies and institutions. The average life expectancy of newborn children, by sex and place of residence, was calculated for the following periods: 1994- 1946, 1954-1956, 1963-1965, 1973-1975, 1983-1985. Relevant conclusions and recommendations were made.

Adolescent↗

PubMed2004

Using linked data to calculate summary measures of population health: Health-adjusted life expectancy of people with Diabetes Mellitus.

OBJECTIVES: To estimate the health-adjusted life expectancy (HALE) from diabetes mellitus (DM) using a population health survey linked to a population-based DM registry. METHODS: The 1996/97 Ontario Health Survey (N = 35,517) was linked to the Ontario Diabetes Database (N = 487,576). The Health Utilities Index (HUI3) was used to estimate health-related quality of life. HALE was estimated using an adapted Sullivan method. RESULTS: Life expectancy at birth of people with DM was 64.7 and 70.7 years for men and women - 12.8 and 12.2 years less than for men and women without DM. The HUI3 was lower for physician-diagnosed DM compared to self-reported DM (0.799 versus 0.872). HALE at birth was 58.3 and 62.8 years for men and women - 11.9 and 10.7 years less than that of men and women without DM. CONCLUSIONS: The linked data approach demonstrates that DM is an important cause of disease burden. This approach reduces assumptions when estimating the prevalence and severity of disability from DM compared to methods that rely on self-reported disease status or indirect assessment of disability severity.

Journal Article↗

PubMed1999

Possibilities of See5 software in forecasting of life expectancy not achieving.

Results of application of See5 to epidemiological domain were presented. The aim of this paper is to find out if See5 can be used for forecasting whether life expectancy will be achieved or not. The basis for forecasting are data-attributes, predictors (anthropological data, living habits, laboratory data, blood pressure measured in years 1970/71, and the status of examinee--class (alive or dead) in 1990. Data were split at random into 10 blocks with approximately the same number of cases and the same distribution of classes. Results were given in the form of decision trees and rulesets, and tested through crossvalidation. The most interesting question--what are prediction-candidates for not achieving life expectancy estimated in the year of examination--did not give a satisfactory result: the accuracy of classification was about 70%. However, a very interesting fact is that each rule consists of at least one candidate predictor, usually considered as risk factor (e.g. high diastolic blood pressure and animal fat consumption).

Adult↗