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PubMed2005

Delayed motherhood decreases life expectancy of mouse offspring.

This study analyzes the long-term effects of delayed motherhood on reproductive fitness and life expectancy of offspring in the mouse. Hybrid (C57BL/6JIco x CBA/JIco) first-generation (F1) females, either at the age of 10 or 51 wk, were individually housed with a randomly selected 12- to 14-wk-old hybrid male following a breeding pen system until females reached the end of their reproductive life. Reproductive fitness of second-generation (F2) females was tested from the age of 25 wk until the end of their reproductive life. In F2 males, the testing period ranged from the age of 52 wk until their natural death. Delayed motherhood of hybrid F1 female mice was associated with a decreased percentage of male F3 offspring at birth and lower life expectancy and body weight during adulthood of F2 offspring. There was, however, no evident negative effect of delayed motherhood on several reproductive fitness variables in either male or female F2 offspring. This included between-parturition interval, litter size at birth and at weaning, body weight at weaning and preweaning mortality of F3 pups, percentage of F3 litters with at least one pup cannibalized, and time at which female and male F2 offspring ceased their reproductive life. These data clearly show that delayed motherhood in the mouse is associated with negative long-term effects on offspring survival.

Animals↗
PubMed1998

[Demographic study of ages and causes of death which contribute to gender disparities in life expectancy--case of Switzerland (1969-1993)].

BACKGROUND: In Switzerland, women live about six years more than men. The purpose of our study was to measure and describe the respective contributions of the various age groups and causes of death to the difference in life expectancy at birth between men and women. METHODS: With an analytical demographic method, this difference in life expectancy can be distributed according to age and cause of death. The contribution of each age and cause can be discussed. RESULTS: All ages and quite all causes of death contribute to overmortality in men. Age groups over 50, as well as circulatory diseases and malignant neoplasms, contribute most to gender disparities in longevity while violent deaths play a less important role. CONCLUSIONS: Any attempt to reduce gender mortality disparities would involve the modification of a number of etiological factors, including biological factors or those linked to lifestyle.

Adolescent↗
PubMed2001

Living donor liver transplantation for early hepatocellular carcinoma: A life-expectancy and cost-effectiveness perspective.

Cadaveric liver transplantation (CLT) is an excellent treatment for early hepatocellular carcinoma (HCC). Its use, however, is limited by the shortage of grafts, with up to 30% of patients developing contraindications to the procedure while waiting for a donor. Living donor liver transplantation (LDLT) has emerged as an alternative to overcome this limitation. We compared the consequences of LDLT versus CLT using a Markov model balancing the gains and losses in life expectancy among donors and recipients. For a 60-year-old recipient with a 70% 5-year survival after transplantation, a 4% monthly drop-out rate, and a donor with 1% mortality, LDLT became more effective than CLT after 3.5 months on the waiting list. These results varied with the probability of developing contraindications to transplantation, the survival after transplantation, and the donor's mortality. For a 12-month delay saved on the waiting list, the gain in survival provided by LDLT compared with CLT ranged between 0 and 2.8 life years depending on survival after transplantation, time spent on the waiting list, and drop-out rate. LDLT was cost-effective (less than $50,000 per quality-adjusted life year saved) in all scenarios of waiting lists exceeding 7 months, and this figure ranged from 2 to 16 months when varying the drop-out rate. LDLT for early HCC offered substantial gains in life expectancy with acceptable cost-effectiveness ratios when the waiting list exceeds 7 months. The gain in life expectancy and the cost-effectiveness of LDLT were more dependent on the drop-out rate and the outcome after transplantation than on donor's mortality.

Carcinoma, Hepatocellular↗
PubMed2002

Measuring the health burden of chronic disease and injury using health adjusted life expectancy and the Health Utilities Index.

OBJECTIVES: To estimate the burden of illness from chronic disease and injury using a population based health survey, which contains both measures of chronic disease and a utility based health related quality of life (HRQOL) measure. DESIGN: An adapted Sullivan method was used to calculate cause deleted health adjusted life expectancies for chronic conditions. SETTING: Ontario, Canada, 1996/97. SUBJECTS: The 1996/97 Ontario Health Survey (n=35 527) was used to estimate the prevalence of chronic conditions. A cause deleted approach was used to estimate the impact of these conditions on the Health Utilities Index (HUI). Cause deleted probabilities of dying were derived with the cause eliminated life table technique and death data from vital statistics for Ontario 1996/97 (n=156 610). RESULTS: Eliminating cardiovascular disease and cancer will cause an "expansion of morbidity", while eliminating mental conditions and musculosketal disorders will result in a "contraction of morbidity". The HUI score varies depending on chronic condition, age, and sex-most of which were assumed not to vary in previous summary measures of population health. CONCLUSIONS: Health adjusted life expectancy estimated for chronic conditions using a utility based measure of health related quality of life from population health surveys addresses several limitations of previous studies that estimate the burden of disease using either a categorical measure of disability or expert opinion and related epidemiological evidence.

Adolescent↗
PubMed2000

A model for predicting life expectancy of children with cystic fibrosis.

In this study the authors aimed to produce a model for predicting the life expectancy of children with severe cystic fibrosis (CF) lung disease. The survival of 181 children with severe CF lung disease referred for transplantation assessment 1988-1998 (mean age 11.5 yrs, median survival without transplant 1.9 yrs from date of assessment) were studied. Proportional hazards modelling was used to identify assessment measurements that are of value in predicting longevity. The resultant model included low height predicted forced expiratory volume in one second (FEV1), low minimum oxygen saturation (Sa,O2min) during a 12-min walk, high age adjusted resting heart rate, young age, female sex, low plasma albumin, and low blood haemoglobin as predictors for poor prognosis. Extrapolation from the model suggests that a 12-yr old male child with an FEV1 of 30% pred and a Sa,O2min of 85% has a 44% risk of death within 2 yrs (95% confidence interval (CI) 35-54%), whilst a female child with the same measurements has a 63% risk of death (95% CI 52-73%) within the same period. The model produced may be of value in predicting the life expectancy of children with severe cystic fibrosis lung disease and in optimizing the timing of lung transplantation.

Cause of Death↗
PubMed2002

The influence of intellectual disability on life expectancy.

BACKGROUND: To date, relatively few representative data have been available to health planners and advocacy groups on the life expectancy of people with intellectual disability. A study of trends in the survival profiles of people with intellectual disability was undertaken to assist in the planning of appropriate medical and support services. METHODS: Since 1953, the Disability Services Commission of Western Australia has maintained a database of persons diagnosed with intellectual disability. The database was used to calculate survival probabilities on a total of 8724 individuals, 7562 of whom were still alive at the time of sampling in December 2000. RESULTS: Kaplan-Meier survival plots showed a strong negative association between severity of intellectual disability and survival, with median life expectancies of 74.0, 67.6, and 58.6 years for people with mild, moderate, and severe levels of handicap. Significant negative associations also were observed with male gender, Indigenous Australian parentage, and individuals diagnosed with a specific genetic disorder. CONCLUSIONS: The findings indicate a major and expanding increase in the service requirements of this aging, intellectually disabled population during the past two generations.

Adult↗
PubMed2002

[Life expectancy at birth and mortality in Brazil, 1999: exploratory analysis of regional differences].

OBJECTIVE: To analyze the inequalities found using health indicators in the states and regions of Brazil, according to 1999 socioeconomic and demographic indicators. METHODS: An exploratory ecological cross-sectional study was carried out. The units of analysis were Brazilian states (n = 27) and regions (n = 5). Descriptive measures of inequality were calculated. Pearson's correlation and also linear regression analysis were used to identify associations between health indicators and selected socio-economic and demographic indicators. The health indicators analyzed were: life expectancy at birth, infant mortality rate, mortality rate for children < 5 years due to acute diarrheal diseases and to acute respiratory infections, and deaths due to homicides and traffic accidents. RESULTS: Important gains were seen in life expectancy at birth over the 1991-1999 period, especially for males. There was a trend towards larger gains in states that had had lower life expectancy at birth in 1991, which produced greater homogeneity across Brazil in this indicator in recent years. The infant mortality rate decreased by 28% between 1991 and 1999. However, this indicator still varies widely among the regions--from 52.5 per 1,000 live births in the northeast to 17.1 per 1,000 in the south--and among states--from 64.0 per 1,000 in Alagoas to 15.1 per 1,000 in Rio Grande do Sul. With respect to children < 5 years, the mortality rate due to acute diarrheal diseases was equal to or higher than the national median (4.1 per 10,000) in all the north-eastern states, and the mortality rate due to acute respiratory infections was equal to or higher than the national median (10.8 per 10,000) in all the southern, southeastern, and central-western states. The mortality rates (standardized by sex and age) due to traffic accidents and to homicides in 1999 were 17.7 and 26.0 per 100,000 inhabitants, respectively. Extreme values were found in some states for mortality due to homicide (57.8 per 100,000 in Pernambuco) and traffic accidents (54.5 per 100,000 in Roraima). The mortality rate due to homicide was strongly associated with urbanization (P = 0.001). Higher mortality rates due to traffic accidents were associated with lower poverty levels (beta = -0.93; P < 0.001), lower literacy rates (beta = -1.16; P = 0.005), and larger population growth over the past decade (beta = 3.10; P = 0.016). CONCLUSIONS: The pattern of health inequality in Brazil indicates a polarization among regions and states as well as a juxtaposition of diseases associated with under-development and diseases linked to development, suggesting the need for a health system that is committed to addressing these issues.

Adolescent↗
PubMed1984

[A study of the potential gain in Korean life expectancy according to the degree of reduction in leading causes of death].

"This study was conducted to examine potential gains in life expectancies when the three leading causes of death were partially or totally eliminated, based on the mortality situation during 1978-79 in [the Republic of] Korea. It sought to ascertain what potential gains in longevity might be reasonably achieved through efforts to reduce mortality due to accidents and adverse effects, diseases of [the] circulatory system and malignant neoplasms." In addition, the authors attempt to determine the range of potential gains that can be expected during the total life span of an individual. (summary in ENG)

Asia↗
PubMedDate not supplied

Systemic lupus erythematosus in Indian patients: prognosis, survival and life expectancy.

BACKGROUND: There have been several studies on survival patterns in Indian patients with systemic lupus erythematosus but it is still not clear as to which factors at diagnosis predict survival outcome. The impact of specific organ involvement, and of disease activity itself, needs to be studied further. METHODS: We conducted a non-concurrent prospective study of 98 lupus patients between 1981 and 1993. The clinical symptoms, signs and investigation results at onset, and at subsequent visits, were abstracted from the case notes. A systemic lupus erythematosus disease activity index (SLEDAI) was constructed at the initial presentation and for each subsequent visit. Patients not attending for at least 6 months were traced by post. The quantitative data from the SLEDAI was used to construct a Markov chain mathematical expression designed to predict life expectancy. RESULTS: The cumulative percentage survival at 1, 5 and 10 years was found to be 89%, 77% and 60%, respectively. The Markov chain predicted a life expectancy of 13.9 years. Central nervous system and renal involvement were poor prognostic factors. Proteinuria (> 0.5 g/day) caused a 50% reduction in life expectancy but increased disease activity at onset did not predispose to a poor outcome. CONCLUSION: The survival of patients with systemic lupus erythematosus continues to be poor. Central nervous system and renal disease indicate a poor outcome. Hence, new treatment strategies must be evolved to improve the survival of such patients.

Female↗
PubMed1998

Causes of death and life expectancies among dentists.

The standardised mortality ratios (SMR) were obtained for dentists in Tokyo according to the causes of their deaths, in order to compare them with those for general Tokyo citizens. Furthermore, an abridged life table was prepared and those dentists' life expectancies were estimated. The materials used were 560 death certificates for male dentists issued in the 10-year period 1985-1994. The documents were kept at the Health Insurance Co-operative Society for Tokyo Dentists, run by the Tokyo Dental Association (TDA). With the general Tokyo residents as a reference population, the SMRs for dentists were significantly higher for oesophageal and colon cancers and significantly lower for heart diseases and pneumonia/bronchitis. The life expectancy for a 25-year-old dentist in Tokyo was 51.26 years. That at birth was stochastically estimated at 75.37 years, which was some one year shorter than that for an ordinary inhabitant (76.67 years), though the difference was insignificant.

Adult↗
PubMed1989

Life expectancy in less developed countries: socioeconomic development or public health?

Various studies have enquired into the influence of socioeconomic development or public health measures on life expectancies in less developed countries. Analysis of the effect of these two groups of factors upon life expectancy, using data for 95 less developed countries, indicates that mortality is primarily influenced by such socioeconomic development measures as urbanization, industrialization, and education, and secondarily by such public health measures as access to safe water, physicians, and adequate nutrition.

Africa↗
PubMed2003

Life expectancies in the United Kingdom and Japan.

BACKGROUND: Compared with other developed countries, the United Kingdom has exhibited less of an increase in life expectancy over the past 30 years. METHODS: We compared the chronological changes in the age-adjusted mortality rates (AMRs) from all causes or major causes, and in life expectancy in the United Kingdom and Japan between 1970 and 1997. RESULTS: In both 1970 and 1997 the AMRs for most major causes were higher in the United Kingdom than in Japan; the difference in the AMR between countries was smaller in 1970 than in 1997. The difference in the AMR from all causes between the United Kingdom and Japan in 1997 was mainly due to differences in the AMR for heart diseases. The trend for an increasing difference over time between the United Kingdom and Japan in the AMR from all causes was due to the decreased rate of AMR from heart diseases from 1970 to 1997 in the United Kingdom being lower than those from cerebrovascular diseases in same period in Japan. CONCLUSIONS: These data suggest that mortality rates could be reduced by a change in focus of the National Health Service toward an emphasis on primary rather than secondary prevention and associated clinical interventions. The greatest priority should be placed on reducing the incidence of heart disease by aggressively improving primary prevention.

Adolescent↗
PubMed1998

Life expectancy after total hip arthroplasty.

A total of 3,807 patients undergoing total hip arthroplasty (THA) between the years 1970 to 1995 were evaluated for mortality. Patient age groups were designated in 10-year intervals as follows: age <40; 41-50; 51-60; 61-70; 71-80; age >80. The life expectancy estimate of the patients with THA was calculated by the Kaplan-Meier method, and that of the normal population was obtained from standard life-tables. Statistical significance was evaluated using 95% confidence limits. A significant difference in life expectancy was found in patient age groups >60 (61-70, 71-80, >80) demonstrating significantly higher survival rates among THA patients when compared with the normal population.

Adult↗
PubMed1991

Effects of long-term, low-dose growth hormone therapy on immune function and life expectancy of mice.

We have studied effects of long-term, low-dose growth hormone therapy on the immune function and life expectancy of Balb/c mice. Sixty male Balb/c mice were aged up to the time when they started showing signs of senescence and causal death (deaths started when they became 17 months old). The aged mice were divided into two groups of 26 mice each. One group received growth hormone (30 micrograms/mouse) subcutaneously twice a week for 13 weeks. The control group received an equal volume of saline for the same period. During this treatment period, 16 control mice died (61%) whereas only 2 of the hormone-treated mice died (7%). Four mice from each group were killed and immunological functions of splenocytes were evaluated. Hormone-treated mice had higher stimulation indices for pokeweed mitogen but not for Concanavalin-A. Total IgG production was decreased but IL-1, IL-2 and TNF production was increased. After a lag period of 4 weeks, growth hormone therapy was continued for another 6 weeks. One of the growth hormone treated mice died while the control group no longer existed. Splenocyte functions of the growth hormone treated mice were compared to those of young mice. The results showed no significant difference between cytokine production (IL-1, IL-2, TNF and IgG) in the young and the hormone treated groups. Stimulation induced by concanavalin-A and pokeweed mitogen however, was higher in the young group than the old group. The mortality curve obtained suggests that long-term low-dose growth hormone treatment prolongs life expectancy.

Aging↗
PubMed1993

The hemodialysis prescription and quality-adjusted life expectancy. Renal Physicians Association Working Committee on Clinical Guidelines.

What comprises an optimal prescription for uremictoxin clearance in the chronic hemodialysis setting is a much disputed issue. The dispute is underscored by the rise in mortality of the U.S. dialysis population during the 1980s and reports of significant noncompliance with minimal treatment standards recommended from the National Cooperative Dialysis Study. A decision model was developed to summarize and test assumptions about the effect of various dialytic-treatment options on patient outcomes. Treatment options included delivered fractional urea clearance (Kt/V), dialysis-treatment duration, dialysis membrane (high flux versus conventional), dialysate (bicarbonate versus acetate), and ultrafiltration (controlled versus uncontrolled). The expected outcome for any set of treatment options was calculated as a function of a representative patient's life expectancy, adjusted for the probability and assumed importance of avoiding uremia- and treatment-related complications, referred to as quality-adjusted life expectancy (QALE). QALE increased by 59 days for each 0.1-U increase in Kt/V and by 187 days with high-flux dialysis. Controlled ultrafiltration with bicarbonate dialysis increased QALE by 30 days compared with uncontrolled ultrafiltration with acetate dialysis. Sensitivity analyses showed that, under conservative assumptions, QALE increased 11 days for every 0.1 increment in Kt/V. The model afforded a framework for reviewing the literature and testing assumptions about the expected benefits of dialytic-treatment options for the development of a clinical guideline on the adequacy of dialysis.

Decision Support Techniques↗
PubMedDate not supplied

[Social position and life expectancy. A cohort-specific analysis with data of socioeconomic factors].

The impact of social position on mortality has been explained by a variety of underlying causes, among which different living conditions and life-styles of social strata, different working conditions, and a selection process are the most important. This study relies on an indirect method of evaluating cohort mortality and life expectancy. The results confirm considerable impact of social status on life expectancy. Furthermore, living conditions as well as working conditions seem of relevance, whereas a simple selection process is falsified.

Aged↗
PubMed1987

[Indicators of disability-free life expectancy. Global indicators of the health status of populations].

Disability free life expectancy (DFLE) is an index of mean length of healthy life. It aims at measuring the evolution in the populations state of health. The first calculations were achieved at the end of the 60s and about ten experimental calculations have been made until now, mostly in the United States, Canada, Japan and France. Nowadays this index is very well accepted. Its major qualities are its usefulness for setting health targets and determining the present and future needs. Is DFLE destined for becoming a conjonctural index of health state? The circumstances are undoubtedly propitious. Nevertheless, in order to be used in routine the DFLE index must answer three conditions, which the current approach does not fulfil i.e. the viability of disability measurement for comparisons in time; a registration of period data which is based on the incidence of entrance in disability; a calculation which is adapted to the disability whether it is reversible or not.

Aged↗
PubMed2003

Age-related changes in the metabolism and body composition of three dog breeds and their relationship to life expectancy.

We measured body composition and resting metabolic rates (RMR) of three dog breeds (Papillons, mean body mass 3.0 kg (n = 35), Labrador retrievers, mean body mass 29.8 kg (n = 35) and Great Danes, mean body mass 62.8 kg (n = 35)) that varied between 0.6 and 14.3 years of age. In Papillons, lean body mass (LBM) increased with age but fat mass (FBM) was constant; in Labradors, both LBM and FBM were constant with age, and in Great Danes, FBM increased with age but LBM was constant. FBM averaged 14.8% and 15.7% of body mass in Papillons and Labradors, respectively. Great Danes were leaner and averaged only 10.5% FBM. Pooling the data for all individuals, the RMR was significantly and positively associated with LBM and FBM and negatively associated with age. Once these factors had been taken into account there was still a significant breed effect on RMR, which was significantly lower in Labradors than in the other two breeds. Using the predictive multiple regression equation for RMR and the temporal trends in body composition, we modelled the expenditure of energy (at rest) over the first 8 years of life, and over the entire lifespan for each breed. Over the first 8 years of life the average expenditure of energy per kg LBM were 0.985, 0.675 and 0.662 GJ for Papillons, Labradors and Great Danes, respectively. This energy expenditure was almost 60% greater for the smallest compared with the largest breed. On average, however, the life expectancy for the smallest breed was a further 6 years (i.e. 14 years in total), whereas for the largest breed it was only another 6 months (i.e. 8.5 years in total). Total lifetime expenditure of energy at rest per kg LBM averaged 1.584, 0.918 and 0.691 GJ for Papillons, Labradors and Great Danes, respectively. In Labradors, total daily energy expenditure, measured by the doubly labelled water method in eight animals, was only 16% greater than the observed RMR. High energy expenditure in dogs appears positively linked to increased life expectancy, contrary to the finding across mammal species and within exotherms, yet resembling observations in other intra-specific studies. These contrasting correlations suggest that metabolism is affecting life expectancy in different ways at these different levels of enquiry.

Age Factors↗