Socioeconomic differences in healthy and disease-free life expectancy between ages 50 and 75: a multi-cohort study

Abstract Background Aim: To examine the association of work stress with future chronic disease incidence and loss of chronic disease-free life years in the Danish workforce. Method A population-based prospective register-based cohort study of all employees aged 30-59 in 2000 in Denmark, without chronic diseases at baseline (n = 1,592,491). Using job exposure matrices, we assessed exposure to work stress by a combined measure of job strain and effort-reward imbalance. We estimated the risk of incident hospital-diagnosed chronic disease or death (i.e., type 2 diabetes, coronary heart disease, stroke, cancer, asthma, chronic obstructive pulmonary disease, heart failure, and dementia) during 18 years of follow-up and corresponding chronic disease-free life expectancy. Results Individuals working in occupations with high risk of both job strain and effort-reward imbalance had a slightly higher risk of future incident chronic disease compared to those in occupations with low risk of both stressors. The hazard ratio was 1.04 (95% CI 1.02 to 1.05) in women and 1.12 (95% CI 1.11 to 1.14) in men. The corresponding loss in chronic disease-free life expectancy was 0.25 years in women and 0.84 years in men. Conclusion Working in occupations with a high risk of work stress was associated with a small loss of years lived without chronic disease compared to working in occupations with low risk of work stress. Key messages According to our findings, employees in occupations with high risk of work stress live slightly shorter lives free of chronic diseases compared to employees in occupations with low risk of work stress.

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Lifetime risk and multimorbidity of non-communicable diseases and disease-free life expectancy in the general population: A population-based cohort study

PLoS Medicine ◽

10.1371/journal.pmed.1002741 ◽

2019 ◽

Vol 16 (2) ◽

pp. e1002741 ◽

Cited By ~ 24

Author(s):

Silvan Licher ◽

Alis Heshmatollah ◽

Kimberly D. van der Willik ◽

Bruno H. Ch. Stricker ◽

Rikje Ruiter ◽

...

Keyword(s):

Cohort Study ◽

General Population ◽

Life Expectancy ◽

Population Based ◽

Communicable Diseases ◽

Lifetime Risk ◽

Non Communicable Diseases ◽

Disease Free

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Diet quality as a predictor of cardiometabolic disease–free life expectancy: the Whitehall II cohort study

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqz329 ◽

2020 ◽

Vol 111 (4) ◽

pp. 787-794 ◽

Cited By ~ 5

Author(s):

Hanna Lagström ◽

Sari Stenholm ◽

Tasnime Akbaraly ◽

Jaana Pentti ◽

Jussi Vahtera ◽

...

Keyword(s):

Physical Activity ◽

Cohort Study ◽

Life Expectancy ◽

Diet Quality ◽

Dietary Habits ◽

Healthy Eating Index ◽

Activity Level ◽

Cardiometabolic Disease ◽

Occupational Position ◽

Disease Free

ABSTRACT Background Poor diet quality has been linked to increased risk of many chronic diseases and premature mortality. Less research has considered dietary habits in relation to disease-free life expectancy. Objectives Our objective was to investigate the association of diet quality with cardiometabolic disease–free life expectancy between ages 50 and 85 y. Methods Diet quality of 8041 participants of the Whitehall II cohort study was assessed with the Alternative Healthy Eating Index 2010 (AHEI-2010) in 1991–1994, 1997–1999, and 2002–2004. The measurement of diet quality closest to age 50 for each participant was used. We utilized repeat measures of cardiometabolic disease (coronary heart disease, stroke, and type 2 diabetes) from the first observation when participants were aged ≥50 y. Multistate life table models with covariates age, gender, occupational position, smoking, physical activity, and alcohol consumption were used to estimate total and sex-specific cardiometabolic disease–free life expectancy from age 50 to 85 y for each AHEI-2010 quintile, where the lowest quintile represents unhealthiest dietary habits and the highest quintile the healthiest habits. Results The number of cardiometabolic disease–free life-years after age 50 was 23.9 y (95% CI: 23.0, 24.9 y) for participants with the healthiest diet, that is, a higher score on the AHEI-2010, and 21.4 y (95% CI: 20.6, 22.3 y) for participants with the unhealthiest diet. The association between diet quality and cardiometabolic disease–free life expectancy followed a dose–response pattern and was observed in subgroups of participants of different occupational position, BMI, physical activity level, and smoking habit, as well as when participants without cardiometabolic disease at baseline were excluded from analyses. Conclusions Healthier dietary habits are associated with cardiometabolic disease–free life expectancy between ages 50 and 85.

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Geographical variation and clustering are found in atrial fibrillation beyond socioeconomic differences: a Danish cohort study, 1987–2015

International Journal of Health Geographics ◽

10.1186/s12942-021-00264-2 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Kirstine Wodschow ◽

Kristine Bihrmann ◽

Mogens Lytken Larsen ◽

Gunnar Gislason ◽

Annette Kjær Ersbøll

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Cohort Study ◽

Incidence Rate ◽

Socioeconomic Position ◽

Geographical Variation ◽

Incidence Rates ◽

Socioeconomic Differences ◽

Individual Level ◽

Geographical Variations

Abstract Background The prevalence and incidence rate of atrial fibrillation (AF) increase worldwide and AF is a risk factor for more adverse cardiovascular diseases including stroke. Approximately 44% of AF cases cannot be explained by common individual risk factors and risk might therefore also be related to the environment. By studying geographical variation and clustering in risk of incident AF adjusted for socioeconomic position at an individual level, potential neighbourhood risk factors could be revealed. Methods Initially, yearly AF incidence rates 1987–2015 were estimated overall and stratified by income in a register-based cohort study. To examine geographical variation and clustering in AF, we used both spatial scan statistics and a hierarchical Bayesian Poisson regression analysis of AF incidence rates with random effect of municipalities (n = 98) in Denmark in 2011–2015. Results The 1987–2015 cohort included 5,453,639 individuals whereof 369,800 were diagnosed with an incident AF. AF incidence rate increased from 174 to 576 per 100,000 person-years from 1987 to 2015. Inequality in AF incidence rate ratio between highest and lowest income groups increased from 23% in 1987 to 38% in 2015. We found clustering and geographical variation in AF incidence rates, with incidence rates at municipality level being up to 34% higher than the country mean after adjusting for socioeconomic position. Conclusions Geographical variations and clustering in AF incidence rates exist. Compared to previous studies from Alberta, Canada and the United States, we show that geographical variations exist in a country with free access to healthcare and even when accounting for socioeconomic differences at an individual level. An increasing social inequality in AF was seen from 1987 to 2015. Therefore, when planning prevention strategies, attention to individuals with low income should be given. Further studies focusing on identification of neighbourhood risk factors for AF are needed.

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Estimating life expectancy among older multimorbid adults to personalize preventive care

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1134 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

V Gastens ◽

C Del Giovane ◽

D Anker ◽

L Syrogiannouli ◽

N Schwab ◽

...

Keyword(s):

Cohort Study ◽

Cancer Screening ◽

Life Expectancy ◽

Preventive Care ◽

Hospital Admissions ◽

Prognostic Index ◽

Preventive Treatment ◽

Prognostic Indices ◽

Multimorbid Patients

Abstract Background Providing high value care and avoiding care overuse is a challenge among older multimorbid adults. There is evidence on benefits and harms of cancer screening and cardiovascular diseases (CVD) preventive treatment up to the age of 75. However, this evidence is not directly applicable to older multimorbid patients. Because each cancer and CVD preventive care has a specific lagtime to benefit, many guidelines recommend tailoring preventive care according to the estimated life expectancy (LE). However, there is no tool to estimate LE among multimorbid patients. Our objectives are therefore to develop new mortality risk prognostic indices and to derive a new LE estimator, what will help clinicians tailoring preventive care in older multimorbid adults. Methods and Results We conduct a prospective cohort study by extending the follow-up of 822 patients in Bern, Switzerland, included in the OPtimising thERapy to prevent Avoidable hospital admissions in Mulitmorbid older people (OPERAM) study over 3 years. Detailed information about cancer screening and CVD preventive treatment will be collected. We will identify variables independently associated with mortality and weight the variables to create 1 year and 3 year mortality prognostic indices. We will transform the 3 year prognostic index into a LE estimator. Preliminary results will be presented at the congress. Conclusions We will develop the first life expectancy estimator specifically for older multimorbid adults. This tool will help clinicians to tailor cardiovascular and cancer preventive care in older multimorbid adults. Key messages Because of the lagtime to benefit, personalizing preventive care by estimated life expectancy is recommended. We will provide the first life expectancy estimator for older multimorbid adults.

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Postoperative and long-term survival in relation to life-expectancy after pancreatic surgery in elderly patients (cohort study)

Annals of Medicine and Surgery ◽

10.1016/j.amsu.2021.102724 ◽

2021 ◽

pp. 102724

Author(s):

S.K. Burgdorf ◽

J.H. Storkholm ◽

I.M. Chen ◽

C.P. Hansen

Keyword(s):

Cohort Study ◽

Life Expectancy ◽

Elderly Patients ◽

Pancreatic Surgery ◽

Term Survival ◽

Long Term Survival ◽

Surgery In Elderly

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417 Biochemical disease-free and overall survival of treatments for localized prostate cancer: Cohort study with a 7 year follow-up

European Urology Supplements ◽

10.1016/s1569-9056(14)60411-5 ◽

2014 ◽

Vol 13 (1) ◽

pp. e417

Author(s):

X. Bonet ◽

J.F. Suárez ◽

M. Castells ◽

A.J. Vicéns ◽

E. Franco ◽

...

Keyword(s):

Prostate Cancer ◽

Overall Survival ◽

Cohort Study ◽

Localized Prostate Cancer ◽

Disease Free

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Laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma in 158 patients: A prospective cohort study

10.21203/rs.3.rs-58070/v1 ◽

2020 ◽

Author(s):

Jiao Yuan ◽

Li Zeng ◽

min tian ◽

Sisi Chen ◽

Huai yi Yao ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Cohort Study ◽

Survival Rate ◽

Liver Cancer ◽

Laparoscopic Hepatectomy ◽

Rank Test ◽

Log Rank Test ◽

Open Hepatectomy ◽

Disease Free

Abstract BackgroundHepatocellular carcinoma (HCC) ranks as the fourth most common cancer and the third leading cause of cancer-related mortality worldwide. With the development of minimally invasive surgical techniques, laparoscopic hepatectomy is becoming more prevalent in liver surgery. There are multiple reports to evaluate the safety and feasibility of laparoscopic liver resection. Unfortunately, the jury is still out on whether laparoscopic hepatectomy is better than open hepatectomy. The aim of this study is to compare the perioperative and postoperative long-term outcomes of open hepatectomy and laparoscopic hepatectomy for hepatocellular carcinoma, and to evaluate the safety and efficacy of the two surgical methods for hepatocellular carcinoma.MethodsA prospective cohort study of patients who underwent major hepatectomy for hepatocellular carcinoma between October 2017 and September2018 was performed. And these patients were followed for 24 months after surgery. There are158 patients involved in the present study and they were randomly divided into two groups, LH group (n=60), and OH group (n=98). And all of 158 patients underwent hepatectomy. Continuous data were compared by one-way ANOVA, and categorical data were compared by Fisher’s exact test or the c2 test. Survival curves were calculated by the Kaplan–Meier method and compared using the log-rank test. The study was approved by the ethics committee of Union Hospital. (No. WHUH2018S002) and registered in the International Clinical Trial Registry (No. NCT03585166). Informed consent was signed by all patients.ResultsIncision lengths of LH (5.14±3.11cm) were shorter than OH(20.92±6.44cm), P<0.001. Operating time of LH (398.53±170.51 minutes) were longer than OH(257.74±91.31 minutes), P=0.003. Hospital stay of LH(17.72±5.82 days) were shorter than OH(21.42±8.44 days), P<0.001. The average hospitalization costs of LH group (82741.18±26128.81￥) were significantly less than OH group (94998.75±30499.64￥), p=0.011<0.05. The incidence of total complications was also lower in LH group than in OH group (P<0.001). Postoperatively, the leukocyte was significantly lower at 1st day in LH group (9.79±2.92G/L) than in OH group (12.6±4.85 G/L), p<0.001.The aspartate aminotransferase (AST) was significantly lower at 7th day in LH group (39.25±16.63 U/L) than in OH group (62.49±67.77 U/L), p=0.01<0.05. The albumin was significantly higher at 3rd day in LH group (34.21±3.94 g/L) than in OH group (31.24±5.23 g/L), p<0.001. The albumin was significantly higher at 7th day in LH group (35.26±3.73 g/L) than in OH group (33.31±4.51 g/L), p=0.006<0.05. Direct bilirubin was significantly higher at 1st day in LH group (10.28±10.70 µmol /L) than in OH group (315.03±15.71 µmol /L), p=0.04<0.05. The follow-up time after surgery was 24 months (1-24). The mean follow-up time after surgery was 17.94±9.132. Log rank test was performed to compare overall survival rates between the two groups. There were no statistically significant differences with 2-year survival rate between LH and OH group for liver cancer patients, nor was disease-free survival.ConclusionsLaparoscopic hepatectomy surgery supplied a lower incision lengths, hospital stay and incidence of total complications. Laparoscopic hepatectomy was cheaper the open hepatectomy.There were no statistically significant differences with 2-year survival rate between the two group for liver cancer patients, nor was disease-free survival.

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