Hearing Impairment, Household Composition, Marital Status, and Mortality Among U.S. Adults

2019 ◽  
Vol 76 (1) ◽  
pp. 201-208
Author(s):  
Justin T Denney ◽  
Jason D Boardman
Keyword(s):  
Marital Status ◽  
Hearing Impairment ◽  
Household Composition ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Deaf Adults ◽  
Cox Proportional Hazard Models ◽  
Length Of Life ◽  
Social Support Systems

Abstract Objectives This study investigates associations between hearing impairment, household composition, marital status, and all-cause mortality for a representative sample of United States adults aged 40 and older (N = 198,902). Methods We use data from 11 waves of the National Health Interview Survey (2004–2014) linked to prospective mortality status through 2015. The risk of mortality over the follow-up period is estimated using Cox proportional hazard models. Results Compared to those with good to excellent hearing, adults with moderate to severe hearing impairments and deaf adults had 11% and 21% higher risk of death from any cause over the follow-up period, respectively. Household composition and marital status, as indicators of household social support systems, associated independently with the risk of mortality but did not substantively change the association between hearing impairment and mortality. Discussion Hearing impairment represents an important contributor to the length of life for adults age 40 and older, independent of other important and established determinants of mortality.

scholarly journals Self-Rated Health Predicts Mortality in Very Old Men—the Manitoba Follow-Up Study

2019 ◽  
Vol 22 (4) ◽  
pp. 199-204
Author(s):  
Christian R. Hanson ◽  
Philip D. St John ◽  
Robert B. Tate
Keyword(s):  
Very Old ◽  
Time To Death ◽  
Risk Of Death ◽  
Cox Proportional Hazard ◽  
Specific Distribution ◽  
Long Time ◽  
Cox Proportional Hazard Models ◽  
Old Men ◽  
Second World

BackgroundSelf-rated health (SRH) predicts death, but there are few studies over long-time horizons that are able to explore the effect age may have on the relationship between SRH and mortality.Objectives1. To determine how SRH evolves over 20 years; and 2. To determine if SRH predicts death in very old men.MethodsWe analyzed a prospective cohort study of men who were fit for air crew training in the Second World War. In 1996, a regular questionnaire was administered to the 1,779 surviving participants. SRH was elicited with a 5-point Likert Scale with the categories: excellent, very good, good, fair and poor/bad. We examined the age-specific distribution of SRH in these categories from the age of 75 to 95 years, to the end of the follow-up period in 2018. We constructed age-specific Cox proportional hazard models with an outcome of time to death. ResultsSRH declined with age. The gradient in risk of death persisted across all ages; those with poor/fair/bad SRH had consistently higher mortality rates. However, the discrimination between good and excellent was less in those aged 85+. ConclusionsSRH declines with advancing age, but continues to predict death in older men.

scholarly journals Multimorbidity, ageing and mortality: normative data and cohort study in an American population

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042633
Author(s):  
Walter A Rocca ◽  
Brandon R Grossardt ◽  
Cynthia M Boyd ◽  
Alanna M Chamberlain ◽  
William V Bobo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Race And Ethnicity ◽  
Age Groups ◽  
Population Based ◽  
Olmsted County ◽  
Risk Of Death ◽  
Rochester Epidemiology Project ◽  
Risk Of Mortality ◽  
Increased Risk

ObjectivesTo describe the percentile distribution of multimorbidity across age by sex, race and ethnicity, and to demonstrate the utility of multimorbidity percentiles to predict mortality.DesignPopulation-based descriptive study and cohort study.SettingOlmsted County, Minnesota (USA).ParticipantsWe used the medical records-linkage system of the Rochester Epidemiology Project (REP; http://www.rochesterproject.org) to identify all residents of Olmsted County, Minnesota who reached one or more birthdays between 1 January 2005 and 31 December 2014 (10 years).MethodsFor each person, we obtained the count of chronic conditions (out of 20 conditions) present on each birthday by extracting all of the diagnostic codes received in the 5 years before the index birthday from the electronic indexes of the REP. To compare each person’s count to peers of same age, the counts were transformed into percentiles of the total population and displayed graphically across age by sex, race and ethnicity. In addition, quintiles 1, 2, 4 and 5 were compared with quintile 3 (reference) to predict the risk of death at 1 year, 5 years and through end of follow-up using time-to-event analyses. Follow-up was passive using the REP.ResultsWe identified 238 010 persons who experienced a total of 1 458 094 birthdays during the study period (median of 6 birthdays per person; IQR 3–10). The percentiles of multimorbidity across age did not vary noticeably by sex, race or ethnicity. In general, there was an increased risk of mortality at 1 and 5 years for quintiles 4 and 5 of multimorbidity. The risk of mortality for quintile 5 was greater for younger age groups and for women.ConclusionsThe assignment of multimorbidity percentiles to persons in a population may be a simple and intuitive tool to assess relative health status, and to predict short-term mortality, especially in younger persons and in women.

scholarly journals Loneliness, health and mortality

2017 ◽  
Vol 28 (2) ◽  
pp. 234-239 ◽  
Author(s):  
J. Henriksen ◽  
E. R. Larsen ◽  
C. Mattisson ◽  
N. W. Andersson
Keyword(s):  
Mortality Risk ◽  
Structured Interviews ◽  
Community Based ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Relative Risk Of Death ◽  
The Relationship ◽  
Health And Mortality

Aims.Literature suggests an association between loneliness and mortality for both males and females. Yet, the linkage of loneliness to mortality is not thoroughly examined, and need to be replicated with a long follow-up time. This study assessed the association between loneliness and mortality, including associations to gender, in 1363 adult swedes.Methods.This community-based prospective cohort study from the Swedish Lundby Study included 1363 individuals of whom 296 individuals (21.7%) were identified as lonely with use of semi-structured interviews in 1997. The cohort was followed until 2011 and survival analyses were used to estimate the relative risk of death.Results.Death occurred with an incidence rate of 2.63 per 100 person-years and 2.09 per 100 person-years for lonely and non-lonely individuals, respectively. In crude analysis, loneliness was associated with a significant increased mortality risk of 27% compared with non-lonely individuals [hazard ratio (HR) 1.27; 95% CI 1.01–1.60]. Unadjusted, lonely females had a significant increased risk (HR 1.76; 95% CI 1.31–2.34) and adjusted insignificant increased mortality risk of 27% (HR 1.27; 95% CI 0.92–1.74), compared with non-lonely females. Lonely males were found to have an adjusted significant decreased risk of mortality (HR 0.50; 95% CI 0.32–0.80), compared with non-lonely males.Conclusions.Findings suggest an association between loneliness and increased risk of mortality and that gender differences may exist, which have not been previously reported. If replicated, our results indicate that loneliness may have differential physical implications in some subgroups. Future studies are needed to further investigate the influence of gender on the relationship.

scholarly journals Effect of Marital Status on Depression and Mortality among Patients with Chronic Kidney Disease from National Health and Nutrition Examination Survey 2005–2014

2021 ◽  
pp. 1-10
Author(s):  
Zu-feng Wang ◽  
Yi-chun Cheng ◽  
Nan-Hui Zhang ◽  
Ran Luo ◽  
Kang-lin Guo ◽  
...  
Keyword(s):  
Marital Status ◽  
College Education ◽  
Logistic Regression Models ◽  
Risk Of Death ◽  
Health And Nutrition ◽  
Large Numbers ◽  
Increased Risk ◽  
Cox Proportional Hazard Models ◽  
Male Patients ◽  
The Relationship

<b><i>Background:</i></b> The relationship between marital status and CKD is rarely studied. We aimed to explore the effect of marital status on the depression and mortality of patients with CKD. <b><i>Methods:</i></b> The data sources came from the NHANES database during 2005–2014 and 3,865 participants were included in this study. We used logistic regression models to examine the relationship between marital status and depression of CKD patients. The Cox proportional hazard models were used to evaluate the association between marital status and mortality of CKD patients. <b><i>Results:</i></b> In terms of depression in CKD patients, unmarried patients had a worse situation than married patients. Meanwhile, after adjusting the covariables, unmarried patients had increased risk of depression (OR = 1.26, 95% CI: 1.01–1.57) compared with married CKD patients, especially in males (OR = 1.45, 95% CI: 1.02–2.06) and patients with more than college education level (OR = 12.4, 95% CI: 3.75–41.02). There was a significant relationship between marital status and mortality of general CKD patients (HR = 1.36, 95% CI: 1.17–1.58). Moreover, marriage showed a protective effect against death among male patients, patients with school graduate or less and more than college educational level, patients with high income, and patients in different estimated glomerular filtration rate groups. <b><i>Conclusions:</i></b> The use of large numbers of participants has revealed the effect of marital status on CKD patients. Unmarried ones had a higher risk of depression than married ones among CKD patients. Meanwhile, the risk of death was higher in unmarried ones than married ones among CKD patients in this study.

scholarly journals Assessment of the CHA2DS2-VASc Score for the Prediction of Death in Elderly Patients With Coronary Artery Disease and Atrial Fibrillation

2021 ◽  
Vol 8 ◽  
Author(s):  
Yangxun Wu ◽  
Guanyun Wang ◽  
Lisha Dong ◽  
Liu'an Qin ◽  
Jian Li ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Elderly Patients ◽  
The Elderly ◽  
Predictive Values ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Artery Disease

Purpose: Coronary artery disease (CAD) and atrial fibrillation (AF) often coexist and lead to a much higher risk of mortality in the elderly population. The aim of this study was to investigate whether the CHA2DS2-VASc score could predict the risk of death in elderly patients with CAD and AF.Methods: Hospitalized patients aged ≥65 years with a diagnosis of CAD and AF were recruited consecutively. Patients were divided into 5 groups according to the CHA2DS2-VASc score (≤2, =3, =4, =5, and ≥6). At least a 1-year follow-up was carried out for the assessment of all-cause death.Results: A total of 1,579 eligible patients were recruited, with 582 all-cause deaths (6.86 per 100 patient-years) occurring during a follow-up of at least 1 year. With the increase in the CHA2DS2-VASc score, the 1-year and 5-year survival rate decreased (96.4% vs. 95.7% vs. 94.0% vs. 86.5% vs. 85.7%, respectively, P &lt; 0.001; 78.4% vs. 68.9% vs. 64.6% vs. 55.5% vs. 50.0%, respectively, P &lt; 0.001). Compared with the patients with CHA2DS2-VASc score &lt;5, for patients with CHA2DS2-VASc score ≥5, the adjusted hazard ratio for death was 1.78 (95% CI: 1.45–2.18, P &lt; 0.001). The predictive values of the CHA2DS2-VASc score ≥5 for in-hospital (C-index = 0.66, 95% CI: 0.62–0.69, P &lt; 0.001), 1-year (C-index = 0.65, 95% CI: 0.63–0.67, P &lt; 0.001) and 5-year (C-index = 0.60, 95% CI: 0.59–0.61, P &lt; 0.001) death were in comparable.Conclusion: In elderly patients with concomitant CAD and AF, the CHA2DS2-VASc score can be used to predict death with moderate accuracy.

scholarly journals Perceived Physical Fatigability Predicts All-Cause Mortality in Older Adults

2021 ◽  
Author(s):  
Nancy W Glynn ◽  
Theresa Gmelin ◽  
Sharon W Renner ◽  
Yujia Susanna QiaoScM ◽  
Robert M Boudreau ◽  
...  
Keyword(s):  
Older Adults ◽  
Prognostic Indicator ◽  
Underlying Disease ◽  
Registration System ◽  
Civil Registration ◽  
Risk Of Death ◽  
Validated Questionnaire ◽  
Patient Reported ◽  
Cox Proportional Hazard Models

Abstract Background Perceived physical fatigability is highly prevalent in older adults and associated with mobility decline and other health consequences. We examined the prognostic value of perceived physical fatigability as an independent predictor of risk of death among older adults. Methods Participants (N = 2,906), mean age 73.5 [SD, 10.4] years, 54.2% women, 99.7% white enrolled in the Long Life Family Study were assessed at Visit 2 (2014-2017) with 2.7 [SD, 1.0] years follow-up. The Pittsburgh Fatigability Scale (PFS), a 10-item, self-administered validated questionnaire (score range 0-50, higher=greater fatigability) measured perceived physical fatigability at Visit 2. Deaths post-Visit 2 through December 31, 2019 were identified by: family members notifying field centers, reporting during another family member’s annual phone follow-up, an obituary, or Civil Registration System (Denmark). We censored all other participants at their last contact. Cox proportional hazard models predicted mortality by fatigability severity, adjusted for family relatedness and other covariates. Results Age-adjusted PFS Physical scores were higher for those who died (19.1 [SE, 0.8]) compared to alive (12.2, [SE, 0.4]) overall, as well as across age strata (P&lt;.001), except for those 60-69 years (P=.79). Participants with the most severe fatigability (PFS Physical scores ≥25) were over twice as likely to die (HR, 2.33 [95% CI, 1.65 to 3.28]) compared to those with less severe fatigability (PFS Physical scores &lt;25) after adjustment. Conclusions This work underscores the utility of the PFS as a novel patient-reported prognostic indicator of phenotypic aging that captures both overt and underlying disease burden that predicts death.

scholarly journals Longitudinal FGF23 Trajectories and Mortality in Patients with CKD

2017 ◽  
Vol 29 (2) ◽  
pp. 579-590 ◽  
Author(s):  
Tamara Isakova ◽  
Xuan Cai ◽  
Jungwha Lee ◽  
Dawei Xie ◽  
Xue Wang ◽  
...  
Keyword(s):  
Trajectory Analysis ◽  
Fibroblast Growth Factor 23 ◽  
Skewed Distribution ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Minimal Data ◽  
Serial Measurements ◽  
Annual Time

Elevated fibroblast growth factor 23 (FGF23) levels, measured at a single time, are strongly associated with increased risk of mortality in patients with CKD. There are minimal data on serial FGF23 measurements in CKD. In a prospective case-cohort study of the Chronic Renal Insufficiency Cohort, we measured FGF23 at two to five annual time points (mean 4.0±1.2) in a randomly selected subcohort of 1135 participants, of whom 203 died, and all remaining 390 participants who died through mid-2013. Higher FGF23 was independently associated with increased risk of death in multivariable-adjusted analyses of time-varying FGF23 (hazard ratio per 1-SD increase in ln-transformed FGF23, 1.84; 95% CI, 1.67 to 2.03). Median FGF23 was stable over 5 years of follow-up, but its gradually right-skewed distribution suggested a subpopulation with markedly elevated FGF23. Trajectory analysis revealed three distinct trajectories: stable FGF23 in the majority of participants (slope of lnFGF23 per year =0.03, 95% CI, 0.02 to 0.04, n=724) and smaller subpopulations with slowly (slope=0.14, 95% CI, 0.12 to 0.16, n=486) or rapidly (slope=0.46, 95% CI, 0.38 to 0.54, n=99) rising levels. Compared with stable FGF23, participants with slowly rising FGF23 trajectories were at 4.49-fold higher risk of death (95% CI, 3.17 to 6.35) and individuals with rapidly rising FGF23 trajectories were at 15.23-fold higher risk of death (95% CI, 8.24 to 28.14) in fully adjusted analyses. Trajectory analyses that used four or three annual FGF23 measurements yielded qualitatively similar results. In conclusion, FGF23 levels are stable over time in the majority of patients with CKD, but serial measurements identify subpopulations with rising levels and exceptionally high risk of death.

scholarly journals Subsequent Dyslipidemia and Factors Associated with Mortality in Schizophrenia: A Population-Based Study in Taiwan

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 545
Author(s):  
Mei-Chi Hsu ◽  
Wen-Chen Ouyang
Keyword(s):  
Survival Rates ◽  
Population Based ◽  
Research Database ◽  
Factors Associated ◽  
Risk Of Death ◽  
Hazard Ratios ◽  
Risk Of Mortality ◽  
Taiwan National Health Insurance ◽  
Persons With Schizophrenia

Background: Persons with schizophrenia are at greater risk of developing subsequent medical conditions. To date, few studies have examined comprehensively the risks, mortality and survival rates in schizophrenia and subsequent dyslipidemia over different time periods. The objective of this study was to evaluate the occurrence of subsequent dyslipidemia after the diagnosis of schizophrenia, and factors associated with mortality and survival rate in patients with schizophrenia. Methods: We used a population-based cohort from Taiwan National Health Insurance Research Database, to investigate in patients whom were first diagnosed with schizophrenia during the period from 1997 through 2009, the risk of subsequent dyslipidemia during follow-up. Cumulative incidences and hazard ratios after adjusting for competing mortality risks were calculated. Results: A total of 20,964 eligible patients were included. Risks (i.e., comorbidity) and protective factors (i.e., statin use) have significant impacts on mortality. The mortality exhibits a U-shaped pattern by age. After 50, the risk of death increases with age. Risk of mortality before 50 increases with a decrease in age. Risks differed by the duration time to subsequent dyslipidemia after schizophrenia. Mean duration was 63.55 months in the survive group, and 43.19 months in the deceased group. The 5-, 10-, and 15-year survival rates for patients with schizophrenia and subsequent dyslipidemia were 97.5, 90, and 79.18%, respectively. Conclusion: Early occurrence of subsequent dyslipidemia is associated with increased overall mortality in patients with schizophrenia.

scholarly journals The Influence of Education and Apolipoprotein ε4 on Mortality in Community-Dwelling Elderly Men and Women

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Duke Appiah ◽  
Richard N. Baumgartner
Keyword(s):  
College Education ◽  
The Elderly ◽  
Community Dwelling ◽  
Elderly Men ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
Mortality Hazard Ratio ◽  
Apolipoprotein E Genotype

We investigated the risk of death in relation to the apolipoprotein ε4 allele and evaluated how it interacts with education in 504 elderly adults (mean age 73 years, 65.3% women) who were enrolled in 1993 into the New Mexico Aging Process Study. During 9 years of follow-up, apolipoprotein ε2 appeared to be associated with a lower risk for all-cause mortality (hazard ratio (HR) = 0.73, 95% confidence interval (CI): 0.30–1.71) compared to apolipoprotein ε3 carriers in models adjusted for age, sociodemographic variables, medical conditions, adiposity, and lifestyle factors. The apolipoprotein ε4 allele conferred almost a threefold elevated risk of mortality (HR = 2.76, CI: 1.42–5.37). An interaction between education and apolipoprotein e4 (p=0.027) was observed with the HR of mortality among e4 carriers compared to noncarriers being 1.59 (0.64–3.96) for those with ≥college education; 6.66 (1.90–23.4) for those with some college or trade; and 14.1 (3.03–65.6) for participants with ≤high school education. No significant interaction was identified between apolipoprotein E genotype and cognitive function for mortality risk. These findings suggest that genetic (apolipoprotein ε4) and environmental (education) factors act interactively to influences survival in the elderly with higher education attenuating the adverse effect of apolipoprotein ε4 on mortality.

Abstract 11097: Racial Differences in Clinical Outcomes in Elderly Patients With Atrial Fibrillation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Rajesh Kabra ◽  
Peter Cram ◽  
Saket Girotra ◽  
Mary Vaughan-Sarrazin
Keyword(s):  
Atrial Fibrillation ◽  
Racial Differences ◽  
Proportional Hazard ◽  
Composite Outcome ◽  
Newly Diagnosed ◽  
Relative Hazard ◽  
Risk Of Death ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models

Introduction: Atrial fibrillation (AF) is associated with stroke and death, but the effect of race on these outcomes is not known. Methods: Medicare administrative data from 2010-2011 were used to identify patients with newly diagnosed AF who were categorized based on race as white, black and Hispanic. Racial differences in the primary outcome of death and secondary outcomes of stroke and the composite of stroke and death were assessed using Cox proportional hazard models. Results: Among 517,941 patients with newly diagnosed AF, 452,986 (87%) were whites, 36,425 (7%) were blacks and 28,530 (6%) were Hispanics. The mean age was 79 ± 8 years and 40.5% were males. Over a mean follow-up period of 0.9 years per patient, 68,250 (15.1%) whites, 7665 (20%) blacks and 4814 (16.9%) Hispanics died. Stroke was diagnosed in 6,509 (1.4%) whites, 843 (2.3%) blacks and 507 (1.8%) Hispanics. Compared to whites, blacks had a significantly higher hazard of death (Hazard Ratio [HR] =1.43; 95% CI 1.40-1.47; p<0.001), stroke (HR=1.69; 95% CI 1.57-1.81; p<0.001), and the composite outcome (HR= 1.46; 95% CI 1.43-1.49; p<0.001). After controlling for pre-existing co-morbidities, the higher hazard of death (HR 0.99; 95% CI 0.97-1.01; p=0.41) and the composite outcome (HR=1.02; 95% CI 0.99-1.04; p=0.135) in blacks were eliminated and the relative hazard of stroke (HR=1.44; 95% CI 1.34-1.55; p<0.001) was reduced compared to the whites. Similarly, Hispanics had a higher risk of death (HR= 1.13; 95% CI 1.10-1.17; p<0.001), stroke (HR=1.26; 95% CI, 1.15-1.38; p<0.001) and the composite outcome (HR= 1.15; 95% CI 1.12-1.18; p<0.001), as compared to whites. The relative hazard of death and the composite outcome were noted to be lower in Hispanics, compared to whites, after controlling for pre-existing co- morbidities (HR= 0.93; 95% CI 0.92-0.96; p<0.001 and HR= 0.95; 95% CI 0.92-0.97; p<0.001 respectively). The relative hazard of stroke was also attenuated (HR=1.15; 95% CI 1.05-1.26; p=0.002). Conclusions: In an elderly Medicare population with newly diagnosed AF, the risks of death and stroke are higher in blacks and Hispanics, as compared to whites. This is likely due to increased co-morbidities in blacks and Hispanics.

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