43412 Exploring the link between allostatic load and mortality risk in U.S. Black men of different age groups

Colorectal cancer is one of the most frequent malignant neoplasms in both sexes within developed countries. In the Republic of Serbia(Serbia) colorectal cancer mortality in 1971 ranged 5 in females, and 4 in males; it became the second leading malignancy in 1982 in females (after breast cancer), and in 1992 in males (after lung cancer). The objective of this descriptive-epidemiological study was to examine colorectal cancer mortality in Serbian population, particularly the effect of cohort variations on death rates in defined age groups over the period 1971-1996. Mortality rates were calculated from unpublished national vital statistics data of the Institute of Statistics of the Republic of Serbia. To estimate the age effect on colorectal cancer mortality, specific death rates were computed for cohorts born between 1892-96 and 1972-76, and died at subsequent time periods. The mortality rates were adjusted by direct method, using the world standard population. Confidence intervals (CI) for death rates were assessed with 95% level of probability. In time trend analysis of mortality, Fisher's test was used as a significance test for linear regression coefficient. In the study period (1971-1996), a share of all digestive tumors in cancer mortality has decreased from 42.0% to 32.3%. However, the mortality risk of colorectal cancer and its share in cancer mortality have increased. For example, in men, the share of colorectal cancer in digestive cancer mortality increased from 20.7% (1971) to 32.8% (1996) and in overall cancer mortality from 7.5% to 10.5%. In women, the share of colorectal cancer in digestive cancer mortality increased from 23.0%(1971) to 35.6%(1996), and in overall cancer mortality from 8.5% to 11.6%. The average colorectal cancer age-adjusted death rates (1971-1996) were 11.2 per 100,000 men (95% CI: 10.1-12.3), and 8.3 per 100,000 women (95% CI: 7.7-8.9). The secular linear mortality trends showed significant increase both in males (y = 11.2 + 0.2x; ? = 0.000), and females (y = 8.3 + 0.1 ?; ? = 0.000). The highest rise in age-specific death rates, according to linear mortality trends, was observed in males over 65 years (7.8% annually), and females between 60 and 69 years (5.9% annually). In cohort analysis of age-specific rates in males, younger birth cohorts were compared with older ones. The increasing colorectal cancer mortality risk has been observed for ages over 40, with statistical significance in age groups over 45. In ages between 45 and 59, and over 60, the youngest birth cohorts were at 2 and 2.5-fold higher cancer mortality risk than birth cohorts of the oldest generations. For example, the age specific colorectal cancer death rates in a 70-74 year group were 2.5-fold higher in men born between 1922 and 1926 (139.3/100,000) than in cohorts born 25 years earlier (58.7/100,000). In cohort analysis of age-specific rates in females, changes in the age under 50 were not so expressive. In all age groups over 50, women of younger generations were at 2-fold higher cancer mortality risk than the oldest ones. The age specific colorectal cancer death rates in a 65-69 year group were doubled in women born between 1927 and 1931 (61.0/100 000), than in cohorts born 25 years earlier (30.5/100 000). According to the present mortality trends, the further increase in colorectal cancer death rates especially in the ages over 40, should be expected in future generations. Consistent increase in mortality risk in all younger birth cohorts of older ages, as well as in successive five-year age groups of the observed generations, could reflect the continuous increase in colorectal cancer incidence attributed to predominantly environmental exposures.

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Estimates of mortality rates in people with diabetes and cardiovascular disease using administrative pharmaceutical data

International Journal for Population Data Science ◽

10.23889/ijpds.v4i3.1166 ◽

2019 ◽

Vol 4 (3) ◽

Author(s):

Shaun Purkiss ◽

Tessa Keegel ◽

Hassan Vally ◽

Dennis Wollersheim

Keyword(s):

Cardiovascular Disease ◽

Mortality Risk ◽

Age Groups ◽

Mortality Rates ◽

World Health ◽

Data Set ◽

Medication Discontinuation ◽

Disease Mortality ◽

Health Organization

BackgroundQuantifying the mortality risk for people with diabetes is challenging because of associated comorbidities. The recording of cause specific mortality from accompanying cardiovascular disease in death certificate notifications has been considered to underestimate the overall mortality risk in persons with diabetes. Main AimDevelop a technique to quantify mortality risk from pharmaceutical administrative data and apply it to persons diagnosed with diabetes, and associated cardiovascular disease and dyslipidaemia before death. MethodsPersons with diabetes, cardiovascular disease and dyslipidaemia were identified in a publicly available Australian Pharmaceutical data set using World Health Organization anatomic therapeutic codes assigned to medications received. Diabetes associated multi-morbidity cohorts were constructed and a proxy mortality (PM) event determined from medication and service discontinuation. Estimates of mortality rates were calculated from 2004 for 10 years and compared persons with diabetes alone and associated cardiovascular disease and dyslipidemia. ResultsThis study identified 346,201 individuals within the 2004 calendar year as having received treatments for diabetes (n=51,422), dyslipidaemia (n=169,323) and cardiovascular disease including hypertension (n=280,105). Follow up was 3.3 x 106 person-years. Overall crude PM was 26.1 per 1000 person-years. PM rates were highest in persons with cardiovascular disease and diabetes in combination (47.5 per 100 person years). Statin treatments significantly improved the mortality rates in all persons with diabetes and cardiovascular disease alone and in combination over age groups >44 years (p<.001). Age specific diabetes PM rates using pharmaceutical data correlated well with Australian data from the National Diabetes Service Scheme (r=0.82) ConclusionProxy mortality events calculated from medication discontinuation in persons with chronic conditions can provide an alternative method to estimate disease mortality rates. The technique also allows the assessment of mortality risk in persons with chronic disease multi-morbidity.

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THE STUDY OF RUSSIAN CIVILIAN AVIATION PILOTS’ MORTALITY

10.31089/978-5-6042929-2-1-2021-1-82-86 ◽

2021 ◽

Author(s):

I.V. Bukhtiyarov ◽

◽

E.V. Zibarev ◽

K.V. Betts

Keyword(s):

Working Conditions ◽

Mortality Risk ◽

Age Groups ◽

Mortality Rates ◽

Russian Population ◽

Standardized Mortality Ratio ◽

Long Term Effects ◽

Specific Mortality ◽

Aviation Pilots

Abstract. Introduction. The work of civilian aviation pilots is characterized by heavy psychological and emotional stress in combination with other occupational factors. Such complex of adverse working conditions appears to be a risk for functional and somatic disorders, which may subsequently be reflected in the causes and rates of mortality in the distant period. The aim of this work is to study the mortality of retired civilian aviation pilots. Methods. A prospective cohort epidemiological study of civilian aviation pilots’ mortality. The cohort included 4513 male civilian aviation pilots of Russia who completed their employment and received employment pension. The follow-up period was 10 years (01.01.2010-31.12.2019), with 22156.9 person-years obtained. The age-specific mortality rates were calculated for 5-year age groups, the mortality risk was assessed using standardized mortality ratio (SMR) with 95% confidence interval (95% CI). The comparison group was the male Russian population. Results. As of 31.12.2019, out of 4513 civilian aviation pilots, 150 people deceased (3.3%). The age-specific mortality rates in the retired pilots’ cohort were lower in all age groups compared to the male Russian population, except for the 35-39 age group. The all-cause mortality risk for civilian aviation pilots was significantly lower compared to the male Russian population, SMR=0.31 (95%CL 0.26-0.36). Conclusion. Further research is required to determine the long-term effects of working conditions on civilian aviation pilots’ health. The follow-up period for the pilots’ cohort should be increases to 20 years and more.

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Abstract 15: Trends in Atrial Fibrillation-related Cardiovascular Mortality Rates in The United States: 1999-2017

Circulation ◽

10.1161/circ.141.suppl_1.15 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Cited By ~ 1

Author(s):

Yoshihiro Tanaka ◽

Nilay Shah ◽

Rod Passman ◽

Philip Greenland ◽

Sadiya Khan

Keyword(s):

United States ◽

Atrial Fibrillation ◽

Black Men ◽

Cause Of Death ◽

Age Groups ◽

White Men ◽

The United States ◽

Mortality Rates ◽

Men And Women ◽

Black And White

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and the prevalence is increasing due to the aging of the population and the growing burden of vascular risk factors. Although deaths due to cardiovascular disease (CVD) death have dramatically decreased in recent years, trends in AF-related CVD death has not been previously investigated. Purpose: We sought to quantify trends in AF-related CVD death rates in the United States. Methods: AF-related CVD death was ascertained using the CDC WONDER online database. AF-related CVD deaths were identified by listing CVD (I00-I78) as underlying cause of death and AF (I48) as contributing cause of death among persons aged 35 to 84 years. We calculated age-adjusted mortality rates (AAMR) per 100,000 population, and examined trends over time estimating average annual percent change (AAPC) using Joinpoint Regression Program (National Cancer Institute). Subgroup analyses were performed to compare AAMRs by sex-race (black and white men and women) and across two age groups (younger: 35-64 years, older 65-84 years). Results: A total of 522,104 AF-related CVD deaths were identified between 1999 and 2017. AAMR increased from 16.0 to 22.2 per 100,000 from 1999 to 2017 with an acceleration following an inflection point in 2009. AAPC before 2009 was significantly lower than that after 2009 [0.4% (95% CI, 0.0 - 0.7) vs 3.5% (95% CI, 3.1 - 3.9), p < 0.001). The increase of AAMR was observed across black and white men and women overall and in both age groups (FIGURE), with a more pronounced increase in black men and white men. Black men had the highest AAMR among the younger decedents, whereas white men had the highest AAMR among the older decedents. Conclusion: This study revealed that death rate for AF-related CVD has increased over the last two decades and that there are greater black-white disparities in younger decedents (<65 years). Targeting equitable risk factor reduction that predisposes to AF and CVD mortality is needed to reduce observed health inequities.

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Racial/ethnic inequities in the associations of allostatic load with all-cause and cardiovascular-specific mortality risk in U.S. adults

PLoS ONE ◽

10.1371/journal.pone.0228336 ◽

2020 ◽

Vol 15 (2) ◽

pp. e0228336

Author(s):

Luisa N. Borrell ◽

Elena Rodríguez-Álvarez ◽

Florence J. Dallo

Keyword(s):

Mortality Risk ◽

Allostatic Load ◽

Specific Mortality ◽

Racial Ethnic

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Allostatic Load Indices With Cholesterol and Triglycerides Predict Disease and Mortality Risk in Zoo-Housed Western Lowland Gorillas (Gorilla gorilla gorilla)

Biomarker Insights ◽

10.1177/1177271920914585 ◽

2020 ◽

Vol 15 ◽

pp. 117727192091458

Author(s):

Ashley N Edes ◽

Katie L Edwards ◽

Barbara A Wolfe ◽

Janine L Brown ◽

Douglas E Crews

Keyword(s):

Mortality Risk ◽

Cardiac Disease ◽

Allostatic Load ◽

Morbidity And Mortality ◽

Physiological Dysregulation ◽

Unit Increase ◽

Western Lowland Gorillas ◽

Load Indices ◽

Best Fit ◽

Lowland Gorillas

Allostatic load, or the physiological dysregulation accumulated due to senescence and stress, is an established predictor of human morbidity and mortality and has been proposed as a tool for monitoring health and welfare in captive wildlife. It is estimated by combining biomarkers from multiple somatic systems into allostatic load indices (ALIs), providing a score representing overall physiological dysregulation. Such ALIs have been shown to predict disease and mortality risk in western lowland gorillas. In these prior analyses, we were unable to include lipid markers, a potential limitation as they are key biomarkers in human models. Recently, we were able to assay serum cholesterol and triglycerides and add them to our previous ALI. We then re-examined associations with health outcomes using binomial generalized linear models. We constructed ALIs using 2 pooling strategies and 2 methods. By itself, a 1-unit increase in allostatic load was associated with higher odds of all-cause morbidity and mortality, but results were mixed for cardiac disease. However, the best fit models for all-cause morbidity and cardiac disease included only age and sex. Allostatic load was retained alongside age in the best fit models for mortality, with a 1-unit increase associated with 23% to 45% higher odds of death. Compared with previous results, ALIs containing cholesterol and triglycerides better predict disease risk in zoo-housed western lowland gorillas, as evidenced by larger effect sizes for some models and better goodness of fit for all ALIs. Based on these results, we address methodology for future allostatic load research on wildlife.

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Impact of Sex and Metabolic Comorbidities on COVID-19 Mortality Risk Across Age Groups: 66,646 Inpatients Across 613 U.S. Hospitals

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1787 ◽

2020 ◽

Author(s):

Katherine E Goodman ◽

Laurence S Magder ◽

Jonathan D Baghdadi ◽

Lisa Pineles ◽

Andrea R Levine ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Mortality Risk ◽

Age Groups ◽

Patient Characteristics ◽

Chronic Complications ◽

Risk Of Death ◽

Relative Risks ◽

Increased Risk ◽

Metabolic Comorbidities

Abstract Background The relationship between common patient characteristics, such as sex and metabolic comorbidities, and mortality from COVID-19 remains incompletely understood. Emerging evidence suggests that metabolic risk factors may also vary by age. This study aimed to determine the association between common patient characteristics and mortality across age-groups among COVID-19 inpatients. Methods We performed a retrospective cohort study of patients discharged from hospitals in the Premier Healthcare Database between April – June 2020. Inpatients were identified using COVID-19 ICD-10-CM diagnosis codes. A priori-defined exposures were sex and present-on-admission hypertension, diabetes, obesity, and interactions between age and these comorbidities. Controlling for additional confounders, we evaluated relationships between these variables and in-hospital mortality in a log-binomial model. Results Among 66,646 (6.5%) admissions with a COVID-19 diagnosis, across 613 U.S. hospitals, 12,388 (18.6%) died in-hospital. In multivariable analysis, male sex was independently associated with 30% higher mortality risk (aRR, 1.30, 95% CI: 1.26 – 1.34). Diabetes without chronic complications was not a risk factor at any age (aRR 1.01, 95% CI: 0.96 – 1.06), and hypertension without chronic complications was only a risk factor in 20-39 year-olds (aRR, 1.68, 95% CI: 1.17 – 2.40). Diabetes with chronic complications, hypertension with chronic complications, and obesity were risk factors in most age-groups, with highest relative risks among 20-39 year-olds (respective aRRs 1.79, 2.33, 1.92; p-values ≤ 0.002). Conclusions Hospitalized men with COVID-19 are at increased risk of death across all ages. Hypertension, diabetes with chronic complications, and obesity demonstrated age-dependent effects, with the highest relative risks among adults aged 20-39.

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Co- and multimorbidity patterns in an unselected Norwegian population: cross-sectional analysis based on the HUNT Study and theoretical reflections concerning basic medical models

European Journal for Person Centered Healthcare ◽

10.5750/ejpch.v2i3.734 ◽

2014 ◽

Vol 2 (3) ◽

pp. 335 ◽

Cited By ~ 17

Author(s):

Margret Olafia Tomasdottir ◽

Linn Getz ◽

Johann A Sigurdsson ◽

Halfdan Petursson ◽

Anna Luise Kirkengen ◽

...

Keyword(s):

Allostatic Load ◽

Age Groups ◽

Population Based ◽

Health Study ◽

Cross Sectional ◽

Disease Clusters ◽

Diagnostic Categories ◽

Norwegian Population ◽

Somatic Diseases ◽

Sectional Analysis

Rationale and aims: Accumulating evidence shows that diseases tend to cluster in diseased individuals, so-called multimorbidity. The aim of this study was to analyze multimorbidity patterns, empirically and theoretically, to better understand the phenomenon. Population and methods: The Norwegian population-based Nord-Trøndelag Health Study HUNT 3 (2006-8), with 47,959 individuals aged 20-79 years. A total of 21 relevant, longstanding diseases/malfunctions were eligible for counting in each participant. Multimorbidity was defined as two or more chronic conditions.Results: Multimorbidity was found in 18% of individuals aged 20 years. The prevalence increased with age in both sexes. The overall age-standardized prevalence was 42% (39% for men, 46% for women). ‘Musculoskeletal disorders’ was the disease-group most frequently associated with multimorbidity. Three conditions, strategically selected to represent different diagnostic domains according to biomedical tradition; gastro-esophageal reflux, thyroid disease and dental problems, were all associated with both mental and somatic comorbid conditions. Conclusions and implications: Multimorbidity appears to be prevalent in both genders and across age-groups, even in the affluent and relatively equitable Norwegian society. The disease clusters typically transcend biomedicine’s traditional demarcations between mental and somatic diseases and between diagnostic categories within each of these domains. A new theoretical approach to disease development and recovery is warranted, in order to adequately tackle ‘the challenge of multimorbidity’, both empirically and clinically. We think the concept allostatic load can be systematically developed to “capture” the interrelatedness of biography and biology and to address the fundamental significance of “that, which gains” versus “that, which drains” any given human being.

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Impact of hypertension, overweight, hypertriglyceridemia and their combination for mortality rate according to the results of a 27-year cohort prospective study

Kardiologiia ◽

10.18087/cardio.n344 ◽

2019 ◽

Vol 59 (11S) ◽

pp. 44-52

Author(s):

I. V. Dolgalev ◽

N. G. Brazovskaya ◽

A. Yu. Ivanova ◽

A. Yu. Shipkhineeva ◽

P. M. Bogajchuk

Keyword(s):

Relative Risk ◽

Prospective Study ◽

Mortality Risk ◽

Cardiovascular Mortality ◽

Age Groups ◽

Significant Risk ◽

Additional Risk ◽

Overweight People ◽

All Cause Mortality ◽

Cardiovascular Mortality Risk

Aim. To study influence of hypertension, overweight, hypertriglyceridemia and their combinations for all-cause and cardiovascular mortality risk formation. Methods. The prevalence of hypertension, overweight and hypertriglyceridemia was studied (1988-1991) by 27-year prospective cohort study of unorganized population of Tomsk (1546 persons – 916 female and 630 male). The predictive value of these risk factors for all-cause and cardiovascular mortality risk formation were researched in 2015. Hypertension was diagnosed in persons with blood pressure greater or equal to 140/90 mm Hg, overweight was diagnosed in people with body mass index 25 kg/m2, hypertriglyceridemia was diagnosed in individuals having high blood level of triglycerides (greater or equal to 1.7). Results. Influence of hypertension for all-cause (relative risk (RR) 2.2) and cardiovascular mortality (RR 3.38) risk formation was detected. A hypertension related elevation of mortality risk was observed both among women and men and in all age groups with the exception of men 40-59 years (the results for cardiovascular mortality in these persons was statistically insignificant). We established that hypertension had the independent significant contribution for mortality risk formation. It is shown that RR of all-cause mortality 1.25 times (cardiovascular mortality 1.8 times) more in overweight persons. Increase of relative mortality risk was detected in overweight women, especially in women 20-39 years old. Hypertriglyceridemia increases relative risk of all-cause mortality 1.46 times, relative risk of cardiovascular mortality 2.15 times, especially in individuals 40-59 years old. It was revealed that hypertriglyceridemia is significant risk factor for all-cause mortality formation only in women. Combination of hypertension and overweight increases the risk of all-cause mortality 2.23 times and the risk of cardiovascular mortality 4.0 times, combination of hypertension and hypertriglyceridemia – 2.83 and 5.06 times, combination of overweight and hypertriglyceridemia – 1.73 and 2.99 times, respectively. We detected the additional risk of hypertriglyceridemia in individuals with overweight for all-cause (RR 1.53) and cardiovascular (RR 2.18) mortality risk formation compared with overweight persons with normal level of triglycerides and also the additional risk of hypertriglyceridemia (RR 1.51 and 2.04, respectively) in individuals with hypertension compared with normotensive persons (p<0,05). The additional risk of overweight in individuals with hypertension for all-cause mortality was found only in women (RR 3.23). Conclusion. The independent significant impact of hypertension for all-cause and cardiovascular mortality risk formation was revealed by the results of 27-year prospective study. Combination of hypertension and hypertriglyceridemia increases the risk of all-cause mortality 2.8 times and the risk of cardiovascular mortality 5.1 times, combination of hypertension and overweight – 2.2 and 4 times, combination of overweight and hypertriglyceridemia – 1.7 and 3 times, respectively. We detected the additional risk of hypertriglyceridemia for all-cause mortality in overweight people (RR 1.5) and in individuals with hypertension (RR 1.5). Also, the additional risk of hypertriglyceridemia for cardiovascular mortality risk formation in overweight people (RR 2.2) and in persons with hypertension (RR 2.0) was found.

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Mild anemia and 11- to 15-year mortality risk in young-old and old-old: Results from two population-based cohort studies

PLoS ONE ◽

10.1371/journal.pone.0261899 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0261899

Author(s):

Alessia A. Galbussera ◽

Sara Mandelli ◽

Stefano Rosso ◽

Roberto Zanetti ◽

Marianna Rossi ◽

...

Keyword(s):

Sex Education ◽

Mortality Risk ◽

Age Groups ◽

Population Based ◽

Adverse Outcomes ◽

Smoking History ◽

Time Varying ◽

Mild Anemia ◽

Time Varying Covariates ◽

Young Old

Background Mild anemia is a frequent although often overlooked finding in old age. Nevertheless, in recent years anemia has been linked to several adverse outcomes in the elderly population. Objective of the study was to investigate the association of mild anemia (hemoglobin concentrations: 10.0–11.9/12.9 g/dL in women/men) with all-cause mortality over 11–15 years and the effect of change in anemia status on mortality in young-old (65–84 years) and old-old (80+ years). Methods The Health and Anemia and Monzino 80-plus are two door-to-door, prospective population-based studies that included residents aged 65-plus years in Biella municipality and 80-plus years in Varese province, Italy. No exclusion criteria were used. Results Among 4,494 young-old and 1,842 old-old, mortality risk over 15/11 years was significantly higher in individuals with mild anemia compared with those without (young-old: fully-adjusted HR: 1.35, 95%CI, 1.15–1.58; old-old: fully-adjusted HR: 1.28, 95%CI, 1.14–1.44). Results were similar in the disease-free subpopulation (age, sex, education, smoking history, and alcohol consumption adjusted HR: 1.54, 95%CI, 1.02–2.34). Both age groups showed a dose-response relationship between anemia severity and mortality (P for trend <0.0001). Mortality risk was significantly associated with chronic disease and chronic kidney disease mild anemia in both age groups, and with vitamin B12/folate deficiency and unexplained mild anemia in young-old. In participants with two hemoglobin determinations, seven-year mortality risk was significantly higher in incident and persistent anemic cases compared to constant non-anemic individuals in both age groups. In participants without anemia at baseline also hemoglobin decline was significantly associated with an increased mortality risk over seven years in both young-old and old-old. Limited to the Monzino 80-plus study, the association remained significant also when the risk was further adjusted also for time-varying covariates and time-varying anemia status over time. Conclusions Findings from these two large prospective population-based studies consistently suggest an independent, long-term impact of mild anemia on survival at older ages.

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