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2. Trends in old-age mortality in seven European countries, 1950-1999

Author

F Janssen, J.P Mackenbach, A.E Kunst, null for NEDCOM, Urban and Regional Studies Institute, Other departments, and Public Health

Subjects
Mortality Decline, Male, trends, medicine.medical_specialty, Epidemiology, NETHERLANDS, Population, causes of death, ISCHEMIC-HEART-DISEASE, elderly, smoking, symbols.namesake, LIMITS, Cause of Death, medicine, DEMOGRAPHY, Humans, LIFE EXPECTANCY, Poisson regression, education, POPULATION, Aged, Aged, 80 and over, education.field_of_study, business.industry, Public health, DISABILITY, Age Factors, Old age mortality, mortality, Europe, Mortality data, Life expectancy, symbols, RISK-FACTORS, Regression Analysis, Female, business, HUMAN LONGEVITY, Demography
Abstract

Objective: Different from the general observed decline in old-age mortality, for The Netherlands and Norway there have been reports of stagnation in the decline since the 1980s. We detect periods of stagnation in recent old-age mortality trends, and explore for which causes of death the recent stagnation is most apparent.Study Design and Setting: We applied Poisson regression analysis to total and cause-specific mortality data by age (80+), period (1950-1999), and sex for seven European low-mortality countries.Results: We found large heterogeneity in the pace of decline in the countries under investigation, with periods of stagnation being widespread. In the 1980s and 1990s, stagnation was observed in Denmark, The Netherlands, and Norway (males). Continued mortality decline was observed especially in France. Although smoking has had a marked influence on the trends in old-age mortality, the role of smoking in the recent stagnation seems only modest and restricted to Norway. Mortality from cardiovascular diseases showed important crossnational variations in the pace of decline. Mortality from diseases specifically related to old age increased recently in all countries, except France.Conclusion: Old-age mortality seems highly plastic and susceptible to many factors, with both favorable and unfavorable effects on trends over time. (C) 2004 Elsevier Inc. All rights reserved.

Published
2004

3. Obesity in adulthood and its consequences for life expectancy: a life-table analysis.

Author

Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L, Netherlands Epidemiology and Demography Compression of Morbidity (NEDCOM) Research Group, Peeters, Anna, Barendregt, Jan J, Willekens, Frans, Mackenbach, Johan P, Al Mamun, Abdullah, Bonneux, Luc, and NEDCOM, the Netherlands Epidemiology and Demography Compression of Morbidity Research Group

Abstract

Background: Overweight and obesity in adulthood are linked to an increased risk for death and disease. Their potential effect on life expectancy and premature death has not yet been described.Objective: To analyze reductions in life expectancy and increases in premature death associated with overweight and obesity at 40 years of age.Design: Prospective cohort study.Setting: The Framingham Heart Study with follow-up from 1948 to 1990.Participants: 3457 Framingham Heart Study participants who were 30 to 49 years of age at baseline.Measurements: Mortality rates specific for age and body mass index group (normal weight, overweight, or obese at baseline) were derived within sex and smoking status strata. Life expectancy and the probability of death before 70 years of age were analyzed by using life tables.Results: Large decreases in life expectancy were associated with overweight and obesity. Forty-year-old female nonsmokers lost 3.3 years and 40-year-old male nonsmokers lost 3.1 years of life expectancy because of overweight. Forty-year-old female nonsmokers lost 7.1 years and 40-year-old male nonsmokers lost 5.8 years because of obesity. Obese female smokers lost 7.2 years and obese male smokers lost 6.7 years of life expectancy compared with normal-weight smokers. Obese female smokers lost 13.3 years and obese male smokers lost 13.7 years compared with normal-weight nonsmokers. Body mass index at ages 30 to 49 years predicted mortality after ages 50 to 69 years, even after adjustment for body mass index at age 50 to 69 years.Conclusions: Obesity and overweight in adulthood are associated with large decreases in life expectancy and increases in early mortality. These decreases are similar to those seen with smoking. Obesity in adulthood is a powerful predictor of death at older ages. Because of the increasing prevalence of obesity, more efficient prevention and treatment should become high priorities in public health. [ABSTRACT FROM AUTHOR]

Published
2003
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