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PubMed1991

Life expectancy of persons with Down syndrome.

The longevity of people with Down syndrome being served by the California Department of Developmental Services was examined in terms of a number of variables known to be related to early mortality. The findings indicated that the predictors of survival for people with Down syndrome were not different from the variables related to mortality among people with mental retardation in general. A lack of mobility or feeding skills were better predictors of an early death than were medical problems associated with congenital heart disease. Life expectancy estimates of clients with Down syndrome who lacked mobility or eating skills were found to be poor as compared to individuals who had Down syndrome but did not have these problems regardless of the presence of heart disease.

Activities of Daily Living↗
PubMed1987

Mortality, life expectancy and causes of death of mildly mentally retarded in Denmark.

Based upon the nationwide Danish registration, all cases with ICD 8 diagnoses 310 and 311 were drawn; 71% lived outside institutions. 7,134 persons were studied for the period 1 January 1976-3 March 1984 and examined in the central register for death, emigration, etc. 5.86%, 446 died during the observation period from 1 January 1976 to 31 March 1984. Mortality tables show estimated survival probability at the end of the 5-year intervals and the life expectancy at the start of the age intervals. Only small differences were found when comparing differences of mortality for sex and residence (institutions or outside institutions). By a linkage study with the Danish Central Register for causes of death in the National Health Service of Denmark, the causes of death were obtained. For males of the age 15-64 an excess mortality of malignant neoplasms, of diseases of the respiratory system, of congenital malformations, and of accidents were found. For females the pattern was less significant.

Abnormalities, Multiple↗
PubMed1998

[Why is life expectancy a problem for the Danes? The influence of smoking during the last 50 years].

The study quantifies the influence of smoking on mortality in Denmark and computes measures for the individual risk. Mortality due to lung cancer among Danish women is now the highest in Europe. Smoking-attributable deaths among men amounted to 3% in 1945, 26% in 1985, and 25% in 1995; the proportion is lower among women, but is increasing considerably. In 1995 in the age-group 35-69 years such deaths make up the same proportion among men and women. The risk that a 35-year old Dane dies before attaining the age of 70 due to other than smoking-attributable causes has decreased since 1945, most significantly among women. Women have experienced a considerable increase in smoking-attributable mortality over the last 20 years, increasing the total risk of a 35 year-old of dying before reaching the age of 70. In 1995 a little over 13,000 of a total of a little less than 63,000 deaths could be attributed to smoking. Smoking is responsible for a significant part of the adverse development in Danish life expectancy.

Adult↗
PubMed1981

Effect of population density upon life expectancy and wing retention in the common house fly, Musca domestica L.

In adult caged house flies, maintained on a complete diet of powdered whole milk, cane sugar and water, the median longevity, maximal longevity, and percentage that exhibit complete wing retention at death are increased as the number of individuals per cage is correspondingly decreased from 240 to 10 flies per cage. These effects are more marked for the shorter-lived males than for the females. Female longevities at all population densities are more significantly reduced by a restricted diet of sugar and water only. Under conditions of individual confinement, the life expectancy of the female house fly is no greater than that of the male. These results are in agreement with earlier suggestions that increased physical activity including interaction among individuals in a restricted population decreases longevity.

Animals↗
PubMed1995

Life expectancy, mortality and prognostic factors in neurofibromatosis type 1. A twelve-year follow-up of an epidemiological study in Göteborg, Sweden.

Neurofibromatosis type 1 (NF1) is a genetic disease with an extremely wide range of manifestations. As yet, the individual course of NF1 cannot be predicted, and it is uncertain to what extent the disorder is associated with increased mortality. In order to gain insights into these aspects, we have conducted a 12-year follow-up study of 70 adult NF1 patients in the city of Göteborg, Sweden, whereby life expectancy, mortality, causes of death and the prognostic value of clinical findings were investigated. Clinical examinations were made, and all available records, including medical files, death certificates, and autopsy reports were scrutinized. The survival in the NF1 cohort was compared to that in the general Swedish population. Twenty-two deaths occurred in the NF1 group, whereas 5.1 deaths were expected in the general Swedish population (p = < 0.001). The mean age at death was 61.6 years. Malignancy was found in 12 (55%) of the deceased (soft tissue sarcomas in 3, and carcinomas in 9). Severe complications related to NF1 were seen in 27%. Hypertension was significantly associated with increased mortality, as 10 out of 12 (83%) patients with hypertension died during the observation period. NF1 was associated with increased mortality due to malignancy and NF1-related complications.

Adult↗
PubMed1985

Increased life expectancy resulting from addition of L-deprenyl to Madopar treatment in Parkinson's disease: a longterm study.

In an open, uncontrolled study the longterm (9 years) effect of treatment with Madopar alone (n = 377) or in combination with l-deprenyl (selegiline, selective monoamine oxidase type B inhibitor) (n = 564) have been compared in Parkinsonian patients. In patients who lost their response to conventional Madopar therapy the addition of l-deprenyl resulted in a significant recouping of levodopa effect. The survival analysis revealed a significant increase of life expectancy in Madopar--l-deprenyl group regardless of the fact whether or not the significant demographic differences between the two groups were taken into account. Although the mechanism underlying this action of l-deprenyl is not known, the results are interpreted as indicating l-deprenyl's ability to prevent or retard the degeneration of striatal dopaminergic neurons. l-Deprenyl is the first anti-Parkinson drug having such a property. This hypothesis is not far fetched since l-deprenyl selectively prevents the degeneration of striatal dopaminergic neurons induced in animals by the illicit drug 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Since latter compound is known to cause Parkinsonism in man and primates or Parkinson-like neurochemical and pathological changes in other animals the implications of the present study involving monoamine oxidase activity and l-deprenyl are apparent.

Adult↗
PubMed2000

[Life expectancy in Down syndrome infants and children with congenital heart defects, 1974-1997].

Authors analysed 359 cases with Down's syndrome and congenital heart defects registered between 1974-1997 in Hungary. The total death rate was 19.9% (70 cases). Mortality in the operated group (85 cases) was 10.5% (9 patients), in the non-operated group (274 cases) 22.2% (61 patients). The death rate was lower in the group with early primary reconstruction (2.3%) than in the group with palliation + reconstruction (15.3%), or in the group with only palliative procedure (20%). These results indicate that the life expectancy of infants and children with Down's syndrome and congenital heart disease after early primary reconstructive procedure is the same as in Down syndrome patients without cardiac defects. The prognosis depends on the patient's social circumstances. The results after correct surgical procedure in patients with the same cardiac defect are similar to that of the patients with or without Down's syndrome.

Cardiac Surgical Procedures↗
PubMed2006

Evaluation of intensive adjuvant chemotherapy in gastric cancer using life expectancy compared with log-rank test as a measure of survival benefit.

BACKGROUND: The goal of radical cancer surgery with or without adjuvant therapy is to cure disease rather than to delay death. There is concern that the survival benefit of curative treatment may not be properly appreciated by the log-rank test (LRT), which is more sensitive to treatment that delays death than to treatment that achieves cure. To confirm this concern and to evaluate the survival benefit of adjuvant chemotherapy, the data from a previous randomized controlled trial are analyzed using both traditional and new methods. METHODS: In this trial, 1410 gastric cancer patients with serosal or subserosal invasion had been classified by nodal and serosal status into four strata and randomized to receive high-dose or low-dose adjuvant regimens (mitomycin and tegafur-uracil) after gastrectomy. The two treatment groups were compared using the LRT as well as the life expectancy (LE) derived from the Boag model and the competing risk model. RESULTS: The LRT showed no significant difference between the two groups, whereas the LE increased significantly with high-dose chemotherapy (1.4-year gain; 95% CI = 0.1-2.8). A greater gain of 4.4 years occurred exclusively in the serosa-negative node-positive stratum, associated with a 21% increase in cure rate. The gain in LE was particularly greater in younger patients. CONCLUSIONS: Parametric LE analysis offers more relevant information about curative treatment than LRT. It suggests that high-dose chemotherapy may achieve cure in a subset of patients, eradicating residual malignancies left behind after gastrectomy and providing greater survival benefit than expected from LRT.

Adult↗
PubMed1993

Life expectancy of monozygotic and dizygotic twins.

White male twins from the NAS-NRC twin sample, who were born in the U.S. between 1917 and 1927 and served in the military, are used to estimate variability in hazard functions for those twins who died during the period 1974-1990. Roughly the same number of MZ and DZ twins died during this period, but their death rates are similar. DZ twins exhibit greater within-pair variation. Using hazard and other analyses, the only statistically significant variables are found to be being a DZ twin (in level equations), date of birth, and, sometimes, wife's religious preference. Variables not significant for level or within-pair equations, include own religion, parental education, working overtime frequently, and number of children. The greater variation in life expectancy of DZ twins is hardly surprising and may say something about the lack of comparability in phenotype variance of DZ twins, which in turn may be worrying.

Aged↗
PubMed1994

Rising mortality from motor neurone disease in Sweden 1961-1990: the relative role of increased population life expectancy and environmental factors.

Recent studies of mortality from motor neurone disease (MND) in Sweden have demonstrated rising levels of mortality from the disease, especially amongst older age groups. Case-control investigations have suggested that certain environmental factors are significantly related to variations in mortality from the disease, and are associated with a probable individual susceptibility to MND. This study applies an innovative epidemiological technique to longitudinal and cohort analysis of Swedish mortality from MND during the period 1961 to 1990. Survival modelling shows that a subpopulation susceptible to MND exists in Sweden, as has been demonstrated in other countries. The increased life expectancy of the Swedish population since 1961 has resulted in more of that susceptible population living to the ages at which MND is expressed, explaining the majority of the increase in mortality from the disease. However, environmental factors may play a role in accelerating the course of MND and may affect the timing of death within the susceptible sub-population.

Adolescent↗
PubMed1994

Rising amyotrophic lateral sclerosis mortality in France 1968-1990: increased life expectancy and inter-disease competition as an explanation.

Gompertzian analysis is a statistical technique which has been successfully applied to the analysis of amyotrophic lateral sclerosis (ALS) mortality in England and Wales, Japan and the United States. This paper analyses the consistent trend of rising ALS mortality in France over the years 1968-1990, a period during which crude mortality rose from 400 deaths in 1968 to 950 deaths in 1990. The findings indicate that age-specific mortality rates have risen at ages older than 54 years for men and 53 years for women and decreased slightly at younger ages. The evolving ALS mortality pattern is attributable to changing inter-disease competition resulting from the increased life expectancy of the French population, rather than to changing environmental aetiopathogenic factors or to substantial artefact effects.

Adolescent↗
PubMed2002

Survival in Duchenne muscular dystrophy: improvements in life expectancy since 1967 and the impact of home nocturnal ventilation.

We reviewed the notes of 197 patients with Duchenne muscular dystrophy whose treatment was managed at the Newcastle muscle centre from 1967 to 2002, to determine whether survival has improved over the decades and whether the impact of nocturnal ventilation altered the pattern of survival. Patients were grouped according to the decade of death and whether or not they were ventilated. Kaplan Meier survival analyses showed significant decade on decade improvement in survival. Mean age of death in the 1960s was 14.4 years, whereas for those ventilated since 1990 it was 25.3 years. Cardiomyopathy significantly shortened life expectancy from 19 years to a mean age of 16.9 years. Better coordinated care probably improved the chances of survival to 25 years from 0% in the 1960s to 4% in the 1970s and 12% in the 1980s, but the impact of nocturnal ventilation has further improved this chance to 53% for those ventilated since 1990.

Female↗
PubMed1988

Post-1950 mortality trends and medical care: gains in life expectancy due to declines in mortality from conditions amenable to medical intervention in The Netherlands.

In order to assess the impact of medical care innovations on post-1950 mortality in The Netherlands, we analysed trends in mortality from a selection of conditions suggested by Rutstein et al.'s lists of "unnecessary untimely mortality". This selection covers 11 types of innovation, and includes 35 conditions which have become amenable to medical care. Loglinear regression analysis shows that for most of these conditions mortality declined during each of two subperiods (1950-1968; 1969-1984). Mortality decline accelerated in the second subperiod for many conditions. Reductions in mortality from these conditions between 1950/54 and 1980/84 added 2.96 and 3.95 years to life expectancy at birth of Dutch males and Dutch females respectively. A priori evidence indicates that these mortality reductions are due to some extent to 'spontaneous' incidence declines. Although the exact contribution of medical care innovations to these changes in mortality thus cannot be determined, the impact of medical care on post-1950 mortality in The Netherlands could well have been substantial.

Cause of Death↗
PubMed2004

Contribution of deaths related to alcohol or smoking to the gender difference in life expectancy: Finland in the early 1990s.

BACKGROUND: In comparison to most other countries in Western Europe, Finland ranks high with regard to male excess mortality. This study examined the contribution of smoking and alcohol to the gender difference in mortality in Finland during 1991-93 among the population aged 15 or over. METHODS: The study is based on data from linked registers. The number of alcohol-related deaths was assessed on the basis of information included in the death certificate, while the conventional method of population attributable fraction was applied to estimate the aggregated contribution of smoking. In combining the effects of alcohol and smoking, three alternative assumptions of their overlap were used. RESULTS: Approximately 51-56% of the gender difference of 7.6 years in the life expectancy at age 15 was estimated to be attributable to alcohol or smoking, depending on the assumption about the overlap of the contribution of alcohol and smoking. CONCLUSIONS: The study confirms the important role of alcohol and smoking as a mechanism contributing to the difference in mortality between men and women in Finland.

Adolescent↗
PubMed1991

[Life expectancy free of disability: global indicator of health status].

BACKGROUND: Due to the limitations of mortality and morbidity as measures of the health status in developed countries, the elaboration of health indexes which include quality of life in addition to life duration has been proposed. The aim of the present article is to report the results of the calculation for Spain in 1986 of one of these indexes, the expectancy of life free from disability (ELFD). METHODS: The life expectancy (LE) and the ELFD were calculated on the basis of data from health surveys by interview and mortality data from routine statistics. This method was proposed by Sullivan in 1971 on the basis of the procedure of life tables. RESULTS: The results showed that the difference in LE between sexes was reduced when the years lived in disability were taken into account. Thus, while LE at birth was 79.6 years in females and 73.2 in males, the ELFD was 62.6 and 60.8, respectively. CONCLUSIONS: The important reduction in the difference between sexes regarding LE when ELFD is accounted for shows that the gain in years of life in females is obtained at the expense of years lived in disability. ELFD appears as a useful index for the evaluation of needs and the planning of social health services.

Adolescent↗
PubMed2003

Life expectancy in pediatric patients with cerebral palsy and neuromuscular scoliosis who underwent spinal fusion.

The aim of this study was to document the rate of survival among 288 severely affected pediatric patients (154 females, 134 males) with spasticity and neuromuscular scoliosis who underwent spinal fusion (mean age at surgery 13 years 11 months, SD 3 years 4 months), and to identify exposure variables that could significantly predict survival times. Kaplan-Meier survival analysis was performed demonstrating a mean predicted survival of 11 years 2 months after spinal surgery for this group of globally involved children with cerebral palsy (CP). Cox's proportional hazards model was used to evaluate predictive efficacy of exposure variables, such as sex, age at surgery, level of ambulation, cognitive ability, degree of coronal and sagittal plane spinal deformity, intraoperative blood loss, surgical time, days in hospital, and days in the intensive care unit. Number of days in intensive care unit after surgery and the presence of severe preoperative thoracic hyperkyphosis were the only factors affecting survival rates. This demonstrated statistically significant predictability for decreased life expectancy after spinal fusion in children with CP.

Adolescent↗
PubMed1993

[Life expectancy of clinically occult breast cancer. Study of a comparative patient sample since 1975].

We have been observing 2 groups of 50 female patients with occult or clinical breast cancer each of whom was initially treated at the Gynaecologic Hospital of the University of Erlangen-Nürnberg between 1975 and 1978. During the follow-up period, 2 patients out of the group of occult cancer and 13 out of the group of clinical carcinoma died of their primary disease. Four women out of the group of occult cancer and 3 from the group of "clinical carcinoma" have developed recurrences. The differences in survival times according to Kaplan-Meier are immense, even if they are not significant owing to the small number of patients. But it is difficult to obtain and to evaluate larger groups of patients and longer follow-up periods due to the low percentage of occult cancer (7.7 to 10.5% only). There are 30 women out of the group of occult breast cancer living without relapse after an observation period up to 15 years. 27 patients out of the group of "clinical cancer" have not shown any evidence of recurrence up to now. This small difference after such a long follow-up period can be explained by the general life expectancy and by the age at initial treatment.

Adult↗