scholarly journals Self-reported disability in relation to mortality in rural Malawi: a longitudinal study of over 16 000 adults

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e034802
Author(s):  
Josephine E Prynn ◽  
Albert Dube ◽  
Joseph Mkandawire ◽  
Olivier Koole ◽  
Steffen Geis ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Adult Mortality ◽  
Secondary Outcome ◽  
Mortality Data ◽  
Surveillance Site ◽  
All Cause Mortality ◽  
Obesity Hypertension ◽  
The Relationship ◽  
Experienced Difficulty ◽  
Improve Access

ObjectivesWe investigated whether self-reported disability was associated with mortality in adults in rural Malawi.SettingKaronga Health and Demographic Surveillance Site (HDSS), Northern Malawi.ParticipantsAll adults aged 18 and over residing in the HDSS were eligible to participate. During annual censuses in 2014 and 2015, participants were asked if they experienced difficulty in any of six functional domains and were classified as having disabilities if they reported ‘a lot of difficulty’ or ‘can’t do at all’ in any domain. Mortality data were collected until 31 December 2017. 16 748 participants (10 153 women and 6595 men) were followed up for a median of 29 months.Primary and secondary outcome measuresWe used Poisson regression to examine the relationship between disability and all-cause mortality adjusting for confounders. We assessed whether this relationship altered in the context of obesity, hypertension, diabetes or HIV. We also evaluated whether mortality from non-communicable diseases (NCD) was higher among people who had reported disability, as determined by verbal autopsy.ResultsAt baseline, 7.6% reported a disability and the overall adult mortality rate was 9.1/1000 person-years. Adults reporting disability had an all-cause mortality rate 2.70 times higher than those without, and mortality rate from NCDs 2.33 times higher than those without.ConclusionsSelf-reported disability predicts mortality at all adult ages in rural Malawi. Interventions to improve access to healthcare and other services are needed.

Sarcopenia and Frailty in PD: Impact on Mortality, Malnutrition, and Inflammation

2018 ◽  
Vol 38 (6) ◽  
pp. 447-454 ◽  
Author(s):  
Yuka Kamijo ◽  
Eiichiro Kanda ◽  
Yoshitaka Ishibashi ◽  
Masayuki Yoshida
Keyword(s):  
Muscle Mass ◽  
Secondary Outcome ◽  
Related Factors ◽  
Clinical Frailty Scale ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
Comorbidity Index ◽  
The Relationship ◽  
Worse Prognosis

Background It is known that sarcopenia is related to malnutrition-inflammation-atherosclerosis (MIA) syndrome and is an important problem in dialysis patients. The notion of frailty includes various physical, psychological, and social aspects. Although it has been reported that sarcopenia is associated with poor prognosis in patients with hemodialysis, reports on peritoneal dialysis (PD) patients are rare. In this study, we examined the morbidity and mortality of sarcopenia and frailty in PD patients. We also investigated the MIA-related factors. Methods We evaluated 119 patients cross-sectionally and longitudinally. The Asian Working Group for Sarcopenia criteria and the Clinical Frailty Scale (CFS) were used to diagnose sarcopenia and frailty. The primary outcome is all-cause mortality with sarcopenia and frailty. The secondary outcome is the relationship between various MIA-related factors. Results Morbidity of sarcopenia and frailty in PD patients was 8.4% and 10.9%, respectively. Old age, high values of Barthel Index, Charlson Comorbidity Index, CFS, and low values of body mass index (BMI), muscle strength, muscle mass, and slow walking were associated with sarcopenia. Interleukin-6, albumin, and prealbumin were significantly correlated with muscle mass. During follow-up, the presence of sarcopenia or frailty was associated with the risk of mortality. In multivariate analysis, CFS was related to the mortality rate of PD patients. Conclusions The presence of sarcopenia or frailty was associated with a worse prognosis.

scholarly journals Adherence to dietary guidelines and 15-year risk of all-cause mortality

2012 ◽  
Vol 109 (3) ◽  
pp. 547-555 ◽  
Author(s):  
Joanna Russell ◽  
Victoria Flood ◽  
Elena Rochtchina ◽  
Bamini Gopinath ◽  
Margaret Allman-Farinelli ◽  
...  
Keyword(s):  
Diet Quality ◽  
Population Based ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Mortality Data ◽  
Food Groups ◽  
Multiple Data ◽  
All Cause Mortality ◽  
The Relationship ◽  
Reduced Risk

Past investigation of diet in relation to disease or mortality has tended to focus on individual nutrients. However, there has been a recent shift to now focus on overall patterns of food intake. The present study aims to investigate the relationship between diet quality reflecting adherence to dietary guidelines and mortality in a sample of older Australians, and to report on the relationship between core food groups and diet quality. This was a population-based cohort study of persons aged 49 years or older at baseline, living in two postcode areas west of Sydney, Australia. Baseline dietary data were collected during 1992–4, from 2897 people using a 145-item Willett-derived FFQ. A modified version of the Healthy Eating Index for Australians was developed to determine diet quality scores. The Australian National Death Index provided 15-year mortality data using multiple data linkage steps. Hazard risk (HR) ratios and 95 % CI for mortality were assessed for diet quality. Subjects in quintile 5 (highest) of the Total Diet Score had a 21 % reduced risk of all-cause mortality (HR 0·79, 95 % CI 0·63, 0·98, Ptrend= 0·04) compared with those in quintile 1 (lowest) after multivariate adjustment. The present study provides longitudinal support for a reduced risk of all-cause mortality in an older population who have greater compliance with published dietary guidelines.

scholarly journals Association between homicide rates and suicide rates: a countrywide longitudinal analysis of 5507 Brazilian municipalities

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040069
Author(s):  
Daiane Borges Machado ◽  
Keltie McDonald ◽  
Luis F S Castro-de-Araujo ◽  
Delan Devakumar ◽  
Flávia Jôse Oliveira Alves ◽  
...  
Keyword(s):  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Sensitivity Analyses ◽  
Secondary Outcome ◽  
Mortality Data ◽  
Homicide Rates ◽  
Suicide Rates ◽  
Socioeconomic And Demographic Factors ◽  
The Relationship

ObjectiveTo estimate the association between homicide and suicide rates in Brazilian municipalities over a period of 7 years.DesignWe conducted a longitudinal ecological study using annual mortality data from 5507 Brazilian municipalities between 2008 and 2014. Multivariable negative binomial regression models were used to examine the relationship between homicide and suicide rates. Robustness of results was explored using sensitivity analyses to examine the influence of data quality, population size, age and sex on the relationship between homicide and suicide rates.SettingA nationwide study of municipality-level data.ParticipantsMortality data and corresponding population estimates for municipal populations aged 10 years and older.Primary and secondary outcome measuresAge-standardised suicide rates per 100 000.ResultsMunicipal suicide rates were positively associated with municipal homicide rates; after adjusting for socioeconomic and demographic factors, a doubling of the homicide rate was associated with 22% increase in suicide rate (rate ratio=1.22, 95% CI: 1.13 to 1.33). A dose–response effect was observed with 4% increase in suicide rates at the third quintile, 9% at the fourth quintile and 12% at the highest quintile of homicide rates compared with the lowest quintile. The observed effect estimates were robust to sensitivity analyses.ConclusionsMunicipalities with higher homicide rates have higher suicide rates and the relationship between homicide and suicide rates in Brazil exists independently of many sociodemographic and socioeconomic factors. Our results are in line with the hypothesis that changes in homicide rates lead to changes in suicide rates, although a causal association cannot be established from this study. Suicide and homicide rates have increased in Brazil despite increased community mental health support and incarceration, respectively; therefore, new avenues for intervention are needed. The identification of a positive relationship between homicide and suicide rates suggests that population-based interventions to reduce homicide rates may also reduce suicide rates in Brazil.

The Association of Psoriatic Arthritis with All-Cause Mortality and Leading Causes of Death in Psoriatic Arthritis

2021 ◽  
pp. jrheum.210159
Author(s):  
Amir Haddad ◽  
Walid Saliba ◽  
Idit Lavi ◽  
Amin Batheesh ◽  
Samir Kasem ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Mortality Rate ◽  
General Population ◽  
Causes Of Death ◽  
Mortality Data ◽  
Control Group ◽  
Lower Socioeconomic ◽  
All Cause Mortality ◽  
Health Database ◽  
Cox Proportional Hazard Regression

Objective To examine the association between PsA and all-cause mortality from a populationbased large database. Methods PsA Patients from the Clalit Health database were identified between 2003-2018 and matched to 4 controls by age, sex, ethnicity and index date. Patient's Demographics, comorbidities and treatments were extracted. Mortality data was obtained from the Notification of Death form. The proportionate mortality rate (PMR) of the leading causes of death was calculated and compared to the general population. Cox-proportional hazard regression models were used to estimate the crude and the multivariate adjusted hazard ratio (HR) for the association between PsA and all-cause mortality and for factors associated with mortality within the PsA group. Results 5275 PsA patients and 21,011 controls were included and followed for 7.2±4.4 years. The mean age was 51.7±15.4 years, and 53% were females. 38.2% of PsA patients were on biologics. 471(8.9%) patients died in the PsA group compared to 1,668(7.9%) in the control group. The crude HR for the association of PsA and allcause mortality was 1.16 (95%CI 1.042-1.29) and 1.02 (95%CI 0.90-1.15) on multivariate analysis. Malignancy was the leading cause of death (26%), followed by ischemic heart disease (15.8%) in keeping with the order in the general population. Older age, male sex, lower socioeconomic status, increased body mass index, Charlson comorbidity index scores and history psoriasis or hospitalization during 1- year prior to entry were positive predictors for mortality. Conclusion No clinically relevant increase in mortality rate was observed in PsA patients, specific PMRs were similar to the general population.

scholarly journals All-cause mortality supports the COVID-19 mortality in Belgium and comparison with major fatal events of the last century

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Natalia Bustos Sierra ◽  
Nathalie Bossuyt ◽  
Toon Braeye ◽  
Mathias Leroy ◽  
Isabelle Moyersoen ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Nursing Homes ◽  
Excess Mortality ◽  
Influenza Pandemic ◽  
Mortality Rates ◽  
Mortality Data ◽  
Term Care ◽  
All Cause Mortality ◽  
Hospital Deaths ◽  
Mortality Surveillance

Abstract Background The COVID-19 mortality rate in Belgium has been ranked among the highest in the world. To assess the appropriateness of the country’s COVID-19 mortality surveillance, that includes long-term care facilities deaths and deaths in possible cases, the number of COVID-19 deaths was compared with the number of deaths from all-cause mortality. Mortality during the COVID-19 pandemic was also compared with historical mortality rates from the last century including those of the Spanish influenza pandemic. Methods Excess mortality predictions and COVID-19 mortality data were analysed for the period March 10th to June 21st 2020. The number of COVID-19 deaths and the COVID-19 mortality rate per million were calculated for hospitals, nursing homes and other places of death, according to diagnostic status (confirmed/possible infection). To evaluate historical mortality, monthly mortality rates were calculated from January 1900 to June 2020. Results Nine thousand five hundred ninety-one COVID-19 deaths and 39,076 deaths from all-causes were recorded, with a correlation of 94% (Spearman’s rho, p < 0,01). During the period with statistically significant excess mortality (March 20th to April 28th; total excess mortality 64.7%), 7917 excess deaths were observed among the 20,159 deaths from all-causes. In the same period, 7576 COVID-19 deaths were notified, indicating that 96% of the excess mortality were likely attributable to COVID-19. The inclusion of deaths in nursing homes doubled the COVID-19 mortality rate, while adding deaths in possible cases increased it by 27%. Deaths in laboratory-confirmed cases accounted for 69% of total COVID-19-related deaths and 43% of in-hospital deaths. Although the number of deaths was historically high, the monthly mortality rate was lower in April 2020 compared to the major fatal events of the last century. Conclusions Trends in all-cause mortality during the first wave of the epidemic was a key indicator to validate the Belgium’s high COVID-19 mortality figures. A COVID-19 mortality surveillance limited to deaths from hospitalised and selected laboratory-confirmed cases would have underestimated the magnitude of the epidemic. Excess mortality, daily and monthly number of deaths in Belgium were historically high classifying undeniably the first wave of the COVID-19 epidemic as a fatal event.

scholarly journals Evaluation of County-Level Heterogeneity in Excess Mortality in Colorado from March to September 2020

2021 ◽  
Author(s):  
Jay Chandra ◽  
Marie Charpignon ◽  
Mathew C Samuel ◽  
Anushka Bhaskar ◽  
Saketh Sundar ◽  
...  
Keyword(s):  
Public Health ◽  
Mortality Rate ◽  
Excess Mortality ◽  
Ethnic Disparities ◽  
The United States ◽  
The State ◽  
Mortality Data ◽  
County Level ◽  
All Cause Mortality ◽  
Excess Deaths

Importance: Tracking the direct and indirect impact of the coronavirus disease 2019 (COVID-19) pandemic on all-cause mortality in the United States has been hindered by the lack of testing and by reporting delays. Evaluating excess mortality, or the number of deaths above what is expected in a given time period, provides critical insights into the true burden of the COVID-19 pandemic caused by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Stratifying mortality data by demographics such as age, sex, race, ethnicity, and geography helps quantify how subgroups of the population have been differentially affected. Similarly, stratifying mortality data by cause of death reveals the public health effects of the pandemic in terms of other acute and chronic diseases. Objective: To provide stratified estimates of excess mortality in Colorado from March to September 2020. Design, Setting, and Population: This study evaluated the number of excess deaths both directly due to SARS-CoV-2 infection and from all other causes between March and September 2020 at the county level in Colorado. Data were obtained from the Vital Statistics Program at the Colorado Department of Public Health and Environment. These estimates of excess mortality were derived by comparing population- adjusted mortality rates in 2020 with rates in the same months from 2015 to 2019. Results: We found evidence of excess mortality in Colorado between March and September 2020. Two peaks in excess deaths from all causes were recorded in the state, one mid-April and the other at the end of June. Since the first documented SARS-CoV-2 infection on March 5th, we estimated that the excess mortality rate in Colorado was two times higher than the officially reported COVID-19 mortality rate. State-level cumulative excess mortality from all causes reached 71 excess deaths per 100k residents (~4000 excess deaths in the state); in contrast, 35 deaths per 100k directly due to SARS-CoV-2 were recorded in the same period (~1980 deaths. Excess mortality occurred in 52 of 64 counties, accounting for 99% of the state's population. Most excess deaths recorded from March to September 2020 were associated with acute events (estimated at 44 excess deaths per 100k residents and at 9 after excluding deaths directly due to SARS-CoV-2) rather than with chronic conditions (~21 excess deaths per 100k). Among Coloradans aged 14-44, 1.4 times more deaths occurred in those months than during the same period in the five previous years. Hispanic White males died of COVID-19 at the highest rate during this time (~90 deaths from COVID-19 per 100k residents); however, Non-Hispanic Black/African American males were the most affected in terms of overall excess mortality (~204 excess deaths per 100k). Beyond inequalities in COVID-19 mortality per se, these findings signal considerable regional and racial-ethnic disparities in excess all-cause mortality that need to be addressed for a just recovery and in future public health crises.

scholarly journals The geometry of mortality change: Convex hulls for demographic analysis

2019 ◽  
Vol 7 (1) ◽  
pp. 27-70
Author(s):  
Audrey F. Lai ◽  
Andrew Noymer ◽  
Tsuio Tai
Keyword(s):  
Sex Differences ◽  
Population Studies ◽  
Demographic Data ◽  
Adult Mortality ◽  
Convex Hulls ◽  
Mortality Data ◽  
Outlier Identification ◽  
Cohort Differences ◽  
Potential Applicability ◽  
The Relationship

We introduce convex hulls as a data visualization and analytic tool for demography. Convex hulls are widely used in computer science, and have been applied in fields such as ecology, but are heretofore underutilized in population studies. We briefly discuss convex hulls, then we show how they may profitably be applied to demography. We do this through three examples, drawn from the relationship between child and adult mortality (5q0 and 45q15 in life table notation). The three examples are: (i) sex differences in mortality; (ii) period and cohort differences and (iii) outlier identification. Convex hulls can be useful in robust compilation of demographic databases. Moreover, the gap/lag framework for sex differences or period/cohort differences is more complex when mortality data are arrayed by two components as opposed to a unidimensional measure such as life expectancy. Our examples show how, in certain cases, convex hulls can identify patterns in demographic data more readily than other techniques. The potential applicability of convex hulls in population studies goes beyond mortality.

scholarly journals Association of Cognitive Impairment and Elderly Mortality: Differences between two cohorts ascertained 6-years apart in China

2020 ◽  
Author(s):  
Jun Duan ◽  
Yue-Bin Lv ◽  
Xiang Gao ◽  
Jin-Hui Zhou ◽  
Virginia Byers Kraus ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mortality Risk ◽  
The Elderly ◽  
Educational Background ◽  
Mortality Data ◽  
Educational Levels ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Relationship Of ◽  
The Relationship

Abstract Background: Cognitive impairment is a major contributor to mortality among the elderly. However, the relationship between cognitive impairment evaluating by educational levels and mortality and the trend between cognitive impairment and mortality with time are unclear. We aim to evaluate the differences in associations of cognitive impairment, taking the stratification by educational levels into account, with all-cause mortality and explore the relationship of cognitive impairment with mortality in different age and sex groups in two cohorts ascertained 6 years apart in China. Methods: A total of 13906 and 13873 Chinese elderly aged 65 years and older were included in the 2002-2008 and 2008-2014 cohorts from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Mortality data was ascertained from interviews with family members or relatives of participants. Cognitive function, evaluated by the Mini-Mental State Examination (MMSE), were defined by different cut-offs taking educational background into account. Cox models were used to explore the relationship of cognitive impairment with mortality. Results: For the 2002-2008 and 2008-2014 cohorts, 55277 and 53267 person-years were followed up, and the mean (SD) age were 86.5 (11.6) and 87.2 (11.3) years, respectively. Compared to normal cognition, cognitive impairment was independently associated with higher mortality risk after controlling for potential confounders, with hazard ratios (HRs) of 1.32 (95% confidence interval [CI], 1.25-1.39) in 2002-2008 cohort and 1.26 (95% CI, 1.19-1.32) in 2008-2014 cohort, stratified by educational levels. The trend of cognitive impairment with all-cause mortality risk decreased from 2002-2008 to 2008-2014 cohort, while no significant interaction of cognitive impairment with cohort for all-cause mortality was observed. The associations of cognitive impairment and mortality were decreased with age in the two cohorts. Conclusions: Cognitive impairment evaluated by different cut-offs were associated with increased risk of mortality, especially among those aged 65-79 years in the two cohorts; this advocates that periodic screening for cognitive impairment among the elderly is warranted.

scholarly journals Association of Cognitive Impairment and Elderly Mortality: Differences between two cohorts ascertained 6-years apart in China

2020 ◽  
Author(s):  
Jun Duan ◽  
Yue-Bin Lv ◽  
Xiang Gao ◽  
Jin-Hui Zhou ◽  
Virginia Byers Kraus ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mortality Risk ◽  
The Elderly ◽  
Educational Background ◽  
Mortality Data ◽  
Educational Levels ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Relationship Of ◽  
The Relationship

Abstract Background: Cognitive impairment is a major contributor to mortality among the elderly. However, the relationship between cognitive impairment evaluating by educational levels and mortality and the trend between cognitive impairment and mortality with time are unclear. We aim to evaluate the differences in associations of cognitive impairment, taking the stratification by educational levels into account, with all-cause mortality and explore the relationship of cognitive impairment with mortality in different age and sex groups in two cohorts ascertained 6 years apart in China. Methods: A total of 13906 and 13873 Chinese elderly aged 65 years and older were included in the 2002-2008 and 2008-2014 cohorts from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Mortality data was ascertained from interviews with family members or relatives of participants. Cognitive function, evaluated by the Mini-Mental State Examination (MMSE), were defined by different cut-offs taking educational background into account. Cox models were used to explore the relationship of cognitive impairment with mortality. Results: For the 2002-2008 and 2008-2014 cohorts, 55277 and 53267 person-years were followed up, and the mean (SD) age were 86.5 (11.6) and 87.2 (11.3) years, respectively. Compared to normal cognition, cognitive impairment was independently associated with higher mortality risk after controlling for potential confounders, with hazard ratios (HRs) of 1.32 (95% confidence interval [CI], 1.25-1.39) in 2002-2008 cohort and 1.26 (95% CI, 1.19-1.32) in 2008-2014 cohort, stratified by educational levels. The trend of cognitive impairment with all-cause mortality risk decreased from 2002-2008 to 2008-2014 cohort, while no significant interaction of cognitive impairment with cohort for all-cause mortality was observed. The associations of cognitive impairment and mortality were decreased with age in the two cohorts. Conclusions: Cognitive impairment evaluated by different cut-offs were associated with increased risk of mortality, especially among those aged 65-79 years in the two cohorts; this advocates that periodic screening for cognitive impairment among the elderly is warranted.

Time-changes in the Mortality Rate: An Experimental Formula

1952 ◽  
Vol 78 (2) ◽  
pp. 171-204 ◽  
Author(s):  
L. G. K. Starke
Keyword(s):  
Mortality Rate ◽  
Statistical Tests ◽  
Adult Mortality ◽  
Mortality Data ◽  
Philosophical Theory ◽  
Standard Type ◽  
Mortality Experience ◽  
Time Changes

Although this paper deals with the application of mathematical formulae to mortality data, it is not concerned with ‘graduation’ if that word is held to imply the fitting of a particular curve to a particular experience with the object of satisfying statistical tests. Nor is the paper concerned with the development of any philosophical theory of mortality. The experiments which it describes were undertaken in the hope of finding a standard type of curve which would give a good over-all representation of adult mortality in general. If such a curve could be found, an examination of the variations in its parameters might contribute something to an understanding, not of the nature of mortality itself, but of the differences—more particularly the secular differences—between one mortality experience and another.

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