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PubMed2004

Early life predictors of old-age life expectancy.

The laboratory of Richard Miller and numerous heroic collaborators are in the process of testing a variety of life span predictors on more than 1000 mice. In their most recent publication, Harper et al. show that early-adulthood measures of T cell subsets, body weight, and thyroxine can be effectively combined to provide a highly significant predictor of life expectancy. Each measure appears to be an index of largely separate parameters that affect the course of aging. This article summarizes the results, discusses implications, mentions caveats, and suggests future studies.

Aging↗
PubMed1996

[The relationship between years of life lost and life expectancy: applications to the analysis of mortality].

"This paper presents a new, continuous, version of the index of years of life lost (YLL) in the population, distinguishing different causes of death. Also, it shows the mathematical relationship between the YLL and temporary life expectancies in the discrete and continuous cases....The model is applied to the analysis of mortality of the province of Cordoba, Argentina, during 1947-1991." (SUMMARY IN ENG)

Americas↗
PubMed1997

The social determinants of the decline of life expectancy in Russia and eastern Europe: a lifestyle explanation.

This paper examines the social origins of the rise in adult mortality in Russia and selected Eastern European countries. Three explanations for this trend are considered: (1) Soviet health policy, (2) social stress, and (3) health lifestyles. The socialist states were generally characterized by a persistently poor mortality performance as part of a long-term process of deterioration, with particularly negative outcomes for the life expectancy of middle-aged, male manual workers. Soviet-style health policy was ineffective in dealing with the crisis, and stress per se does not seem to be the primary cause of the rise in mortality. Although more research is needed, the suggestion is made that poor health lifestyles--reflected especially in heavy alcohol consumption, and also in smoking, lack of exercise, and high-fat diets--are the major social determinant of the upturn in deaths.

Adult↗
PubMed1987

Selection-adjusted comparison of life-expectancy of patients on continuous ambulatory peritoneal dialysis, haemodialysis, and renal transplantation.

To investigate the controversy surrounding the life-expectancy of patients on continuous ambulatory peritoneal dialysis (CAPD) compared with that of patients on haemodialysis or transplantation mortality data from 389 patients accepted for renal replacement therapy in Leicester between July, 1974, and July, 1985, were retrospectively analysed with respect to a wide range of pre-treatment variables (6 scales and 115 binary variables), by a method (Cox's) that adjusts for the distorting influence of selection bias. 9 independent variables were identified as having a significant influence on survival. Adverse factors were age, amyloidosis, ischaemic heart disease, convulsions, and acute presentation. Beneficial variables were male sex, parenthood, pyelonephritis, and residence in Leicestershire. By correcting for the influence of these variables and using time-dependent treatment co-variates, the bias adjusted estimates of the relative risk of death were 1 for patients on CAPD, 1.30 for those on haemodialysis, and 1.09 for patients who received transplants. These risks do not differ significantly from one another and suggest that CAPD is at least as effective as haemodialysis or transplantation at preserving life.

Adult↗
PubMed1994

Changing mortality and morbidity rates and the health status and life expectancy of the older population.

This paper demonstrates the consequences of changes in mortality and health transition rates for changes in both health status life expectancy and the prevalence of health problems in the older population. A five-state multistate life table for the mid-1980s provides the baseline for estimating the effect of differing mortality and morbidity schedules. Results show that improving mortality alone implies increases in both the years and the proportion of dependent life; improving morbidity alone reduces both the years and the proportion of dependent life. Improving mortality alone leads to a higher prevalence of dependent individuals in the life table population; improving morbidity alone leads to a lower percentage of individuals with problems in functioning.

Activities of Daily Living↗
PubMedDate not supplied

Framing effects in choices between multioutcome life-expectancy lotteries.

AIM: To explore framing or editing effects and a method to debias framing in a clinical context. METHOD: Clinical scenarios using multioutcome life-expectancy lotteries of equal value required choices between two supplementary drugs that either prolonged or shortened life from the 20-year beneficial effect of a baseline drug. The effects of these supplementary drugs were presented in two conditions, using a between-subjects design. In segregated editing (n = 116) the effects were presented separately from the effects of the baseline drug. In integrated editing (n = 100), effects of supplementary and baseline drugs were combined in the lottery presentation. Each subject responded to 30 problems. To explore one method of debiasing, another 100 subjects made choices after viewing both segregated and integrated editings of 20 problems (dual framing). RESULTS: Statistically significant preference reversals between segregated and integrated editing of pure lotteries occurred only when one framing placed outcomes in the gain domain, and the other framing placed them in the loss domain. When both editings resulted in gain-domain outcomes only, there was no framing effect. There was a related relationship of framing-effect shifts from losses to gains in mixed-lottery-choice problems. Responses to the dual framing condition did not consistently coincide with responses to either single framing. In some situations, dual framing eliminated or lessened framing effects. CONCLUSION: The results support two components of prospect theory, coding outcomes as gains or losses from a reference point, and an s-shaped utility function (concave in gain, convex in loss domains). Presenting both alternative editings of a complex situation prior to choice more fully informs the decision maker and may help to reduce framing effects. Given the extent to which preferences shift in response to alternative presentations, it is unclear which choice represents the subject's "true preferences."

Adolescent↗
PubMed1991

Mortality effect of selected diseases on the life expectancy indicators in Czechoslovakian population.

Czechoslovakia is contemporarily ranged between the countries with mostly unfavourable indicators of national health. The life expectancy (LE) values at birth as achieved by 1988 in men were 67.85 years and 75.42 years in women, respectively. In Czechoslovakia this indicator is averagely 4 and more years lower than that of industrially developed countries. Such a low czechoslovakian LE value is conditioned with mainly higher mortality to the ischemic heart disease, vascular brain disease as well as malignancies and traumas. In men, the mortality due to the ischemic heart disease (IHD) is accounted for the Le decrease to 3.23 years, and 2.57 years in women, respectively. Similarly, there is a LE decrease to 3.05 years in men, and to 2.54 years in women due to the malignancies. When the IHD mortality decrease may be achieved up to 30% against the status of 1985-87, it may be resulted in LE prolongation to 0.84 in men, and 0.66 in women, respectively. The similar decrease in mortality to vascular brain disease and atherosclerosis may have resulted in LE prolongation to 0.51 in men, and 0.72 years in women. The mortality decrease to cancers for 30% may have been resulted in LE prolongation for 0.84 years in men, and for 0.73 years in women, respectively. The attempt on how to prolong the LE is resulting in fast and responsible measures of primary prevention and partly in those of secondary prevention.

Cause of Death↗
PubMed1998

Social inequalities in disability-free and healthy life expectancy in Austria.

The purpose of this study is to describe socioeconomic differences in the health status and mortality of the Austrian population. Socioeconomic differentials in disability and self-perceived health are studied on the basis of educational groups. The data are drawn from the 1991 Austrian micro-census on health and from linked death and census records for the years 1981/82. The maximum number of years lived between ages 30 and 75 is divided into years lost, years lived in disability or poor health and years lived without disability or in good health. Our findings clearly indicate a correlation between higher education and higher life expectancy and lower morbidity. Comparing the two indicators, more years are lived in poor health than in severe functional disability. The two concepts of health lead to different conclusions when results for men and women are compared: women live more years in disability than men but fewer years in poor health. Differences between educational groups are lower when the concept of self-perceived health is applied.

Activities of Daily Living↗
PubMed1997

Education-specific estimates of life expectancy and age-specific disability in the U.S. elderly population: 1982 to 1991.

The authors used mortality data for 1982 to 1991 linked to survey records from the 1982, 1984, and 1989 National Long Term Care Surveys to calculate gender differences over age in mortality and functional status for high (8 or more years of schooling) and low (less than 8 years of schooling) education subgroups. Males and females with high education maintained better functioning at later ages than those with low education. The authors also found that mortality was higher, after conditioning on disability, in both the male and female low-education than the male and female high-education groups. The size of the education effect on both disability and mortality was large, for example, about 7.6 years difference in female life expectancy at age 65; a roughly 2-year difference for males.

Activities of Daily Living↗
PubMed1996

[Life expectancy in Norway. An international perspective--causes of death].

We have shown before that Norway is experiencing an unfavourable trend in life expectancy compared with Japan, France and several other OECD countries. In this article, we discuss the cause-specific differences in mortality that explain these contrasts. Heart infarction is the predominant cause of death in Norway, with a mortality five times higher than in Japan and three times higher than in France. Both Norway and France have three times higher mortality rates for breast cancer than found in Japan, and the mortality rate for cervical cancer is twice as high in Norway as in the two other countries. Norwegian women show a mortality rate for lung cancer that is twice as high as that of their French sisters. Suicide among young Norwegians is a rapidly growing problem, and twice as common among Norwegian men aged 20-24 than among Japanese men of the same age. We challenge the health authorities and the specialists in the relevant fields to reflect again on their preventive strategies, in light of these contrasts.

Adolescent↗
PubMed1999

Life expectancy following surgery for pituitary tumours.

OBJECTIVE: Hypopituitarism, predominantly although not exclusively due to nonfunctioning pituitary tumours, has been associated with reduced life expectancy. Mortality from vascular diseases contributed significantly to the overall increase in mortality in some, but not all of the studies published to date. The aim of this study was to contribute further data to the debate regarding the putative association of vascular mortality with hypopituitarism. DESIGN AND PATIENTS: A retrospective case note review of patients undergoing pituitary surgery in Birmingham, between 1/1/70 and 1/1/92. Subjects were identified from neurosurgical and neuropathology records. 348 patients were identified of which 197 were male (median age at surgery 48.4, range 11-79 years) and 151 female (median age at surgery 47.8, range 9-78 years). All cause mortality and mortality from vascular disease was compared to the general population of the UK using the Person Years computer programme. RESULTS: There was a small increase in all cause mortality (SMR 1.2; 95% CI 0.95-1.55), but this was not statistically significant in this study (P = 0.06). Mortality from vascular disease was reduced (SMR 0.7; 95% CI 0.5-1.1; P = 0.03) particularly in the female cohort (SMR 0.5; 95% CI 0.2-1.0; P < 0.01) with the male subjects having similar mortality to that expected in an age and sex matched control population (SMR 0.9; 95% CI 0.5-1.4; P = 0.26). CONCLUSION: Although patients with pituitary deficiency may be subject to a small increase in all cause mortality, the results of this study do not support the view that hypopituitarism is associated with a significant increase in vascular disease. There is a pressing need for a large prospective study with comprehensive data collection, including both endocrine data and information regarding clinical outcome, to clarify this issue. In the interim it would seem prudent to base the need for GH replacement therapy on quality of life issues rather than any potential for increased longevity.

Adolescent↗
PubMed1985

Life expectancy analysis in patients with Chagas' disease: prognosis after one decade (1973-1983).

We studied the evolution of chronic Chagas' disease in 107 patients with a positive Guerreiro-Machado reaction and 22 non-chagasic, non-heart disease control subjects for a follow-up period of 3 to 10 years (mean follow-up of 4.9 years). After completion of invasive and non-invasive studies, chagasic patients were classified into four groups: IA (normal ECG, without heart disease; 18 patients); IB (normal ECG, early left ventricular segmental abnormalities; 13 patients); II (abnormal ECG, advanced myocardial damage, no signs of heart failure; 42 patients); and III (abnormal ECG, end-stage, congestive heart failure; 34 patients). One out of five group IA patients re-studied with invasive methods evolved to group IB (20%); 4 group IB patients evolved to group II (33%) and 6 group II patients evolved to group III (15%). The life expectancy of patients in groups IA and IB (normal ECG) was similar to that of our control group, whereas in groups II and III it was significantly decreased (P less than 0.001). Nine group II patients (23%) and 28 group III patients (82%) died during the follow-up period. Main terminal events were refractory congestive heart failure, sudden death and systemic thromboembolism. Our findings suggest that chronic Chagas' disease follows an evolutionary course from asymptomatic, normal ECG group I stage to arrhythmic (II) and congestive (III) stages. Subjects with a positive Guerreiro-Machado reaction showed a significantly lower life expectancy than our control group, but only when clinical and/or ECG abnormalities were identified.

Adult↗
PubMed1992

Risk factor dynamics, mortality and life expectancy differences between eastern and western Finland: the Finnish Cohorts of the Seven Countries Study.

Prior studies have not accounted for male mortality being higher in east than west Finland. Efforts to identify the mechanisms producing higher mortality in the east, due primarily to cardiovascular diseases (CVD), initially focused on a search for new risk factors. An alternate approach is to examine the assumptions of the analysis. This was investigated using a model which described (a) changes in risk factors over time, (b) dependency of risk factor effects on age, and (c) interactions and nonlinear effects of risk factors on mortality. The model was applied to 25-year follow-up data from cohorts of eastern (N = 823) and western (N = 888) Finnish men using pulse pressure, diastolic blood pressure, body mass index, total cholesterol, vital capacity index, cigarette smoking, and heart rate as risk factors. At age 40, men in the west had a life expectancy 2.4 years higher. Of the difference 29% (0.7 years) was associated with area differences in risk factor means, variances, and their change with age. The remainder, 1.7 years, was associated with age differences in the relation of risk factor interactions to CVD mortality. Possible reasons for these differences, such as joint elevation of several risk factors inducing rapid progression of atherogenesis, are discussed. No significant area differences were observed for mortality from either cancer or other causes.

Adult↗
PubMed2001

Summary measures of population health: methods for calculating healthy life expectancy.

This report is one of several appearing as Healthy People Statistical Notes that evaluate methodological issues pertaining to summary measures. Summary measures of population health are statistics that combine mortality and morbidity to represent overall population health in a single number--in this report, health expectancy measures. This report presents a comprehensive discussion of the methods for calculation and methodologic issues related to the interpretation of healthy life expectancy. These measures combine both mortality and morbidity using an abridged life-table procedure. Data from the National Center for Health Statistics and other sources will be used to illustrate the calculation of the statistics and the associated statistical tests.

Age Factors↗
PubMed1995

Lewis rats of the inbred strain LEW/Han: life expectancy, spectrum and incidence of spontaneous neoplasms.

Although Lewis rats are frequently used in biomedical research, little is known about their life-data and spontaneous pathology. Therefore, it was the aim of this study to determine the life expectancy, spectrum and incidence of spontaneous neoplasms of the inbred rat strain LEW/Han. A total of 629 LEW/Han rats (305 females and 324 males) from a specified pathogen-free breeding colony were kept from weaning up to their natural death under defined environmental conditions. A complete histological examination was performed on all organs and macroscopically altered tissues of all animals which died during the first three years of the study. These were 296 female (98%) and 213 male (66%) rats. The mean lifespan of the females (27.7 +/- 5.1 months) was significantly shorter than that of the males (32.5 +/- 6.6 months). In both sexes, the lifespan was mainly determined by the occurrence of neoplasms. Of the large spectrum of 52 histologically different tumour types, the highest incidences were observed for adenomas of the pituitary gland and adenomas/adenocarcinomas of the adrenal cortex in both sexes, mammary gland tumours and endometrial carcinomas in females, and C-cell adenomas/adenocarcinomas of the thyroid gland and tumours of the haemopoietic system in males. Of these, the high incidences of tumours of the haemopoietic system in males (27.7%) and of endometrial carcinomas in females (45.2%) should be considered as characteristic features of the strain.

Animals↗