scholarly journals Why we should monitor disparities in old-age mortality with the modal age at death

2021 ◽  
Author(s):  
Viorela Diaconu ◽  
Alyson A van Raalte ◽  
Pekka Martikainen
Keyword(s):  
Life Expectancy ◽  
Old Age ◽  
Socioeconomic Disparities ◽  
Population Exposure ◽  
Age At Death ◽  
Occupational Class ◽  
Aging Research ◽  
Class Differences ◽  
Selection Dynamics ◽  
Similar Survival

BackgroundIndicators based a fixed ``old’’ age threshold have been widely used for assessing socioeconomic disparities in mortality at older ages. Interpretation of long-term trends and determinants of these indicators is challenging because mortality above a fixed age that in the past would have reflected old age deaths is today mixing premature and old-age mortality. We propose the modal (i.e. most frequent) age at death, $M$, an indicator increasingly recognized in aging research, but which has been infrequently used for monitoring mortality disparities at older ages. MethodsWe use mortality and population exposure data by occupational class over the 1971-2017 period from Finnish register data. The modal age and life expectancy indicators are estimated from mortality rates smoothed with penalized B-splines.ResultsOver the 1971-2017 period, occupational class disparities in life expectancy at 65 and 75 widened while disparities in $M$ remained relatively stable. The proportion of the group surviving to the modal age was constant across time and occupational class. In contrast, the proportion surviving to age 65 and 75 has roughly doubled since 1971 and showed strong occupational class differences. ConclusionsIncreasing socioeconomic disparities in mortality based on fixed old age thresholds may be a feature of changing selection dynamics in a context of overall declining mortality. Unlike life expectancy at a selected fixed old age, $M$ compares individuals with similar survival chances over time and across occupational classes. This property makes trends and differentials in $M$ easier to interpret in countries where old-age survival has improved significantly.

scholarly journals Dietary macronutrient content, age-specific mortality and lifespan

2019 ◽  
Vol 286 (1902) ◽  
pp. 20190393 ◽  
Author(s):  
Alistair M. Senior ◽  
Samantha M. Solon-Biet ◽  
Victoria C. Cogger ◽  
David G. Le Couteur ◽  
Shinichi Nakagawa ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Old Age ◽  
Dietary Protein ◽  
Middle Age ◽  
Early Adulthood ◽  
Later Life ◽  
Age At Death ◽  
Specific Mortality ◽  
Median Lifespan ◽  
High Concentrations

Protein and calorie restrictions extend median lifespan in many organisms. However, studies suggest that among-individual variation in the age at death is also affected. Ultimately, both of these outcomes must be caused by effects of nutrition on underlying patterns of age-specific mortality (ASM). Using model life tables , we tested for effects of dietary macronutrients on ASM in mice ( Mus musculus ). High concentrations of protein and fat relative to carbohydrates were associated with low life expectancy and high variation in the age at death, a result caused predominantly by high mortality prior to middle age. A lifelong diet comprising the ratio of macronutrients self-selected by mouse (in early adulthood) was associated with low mortality up until middle age, but higher late-life mortality. This pattern results in reasonably high life expectancy, but very low variation in the age at death. Our analyses also indicate that it may be possible to minimize ASM across life by altering the ratio of dietary protein to carbohydrate in the approach to old age. Mortality in early and middle life was minimized at around one-part protein to two-parts carbohydrate, whereas in later life slightly greater than equal parts protein to carbohydrate reduced mortality.

Life Expectancy in Individuals With Type 2 Diabetes: Implications for Annuities

2009 ◽  
Vol 30 (3) ◽  
pp. 409-414 ◽  
Author(s):  
Hermione C. Price ◽  
Philip M. Clarke ◽  
Alastair M. Gray ◽  
Rury R. Holman
Keyword(s):  
Type 2 Diabetes ◽  
Life Expectancy ◽  
Cholesterol Level ◽  
Total Cholesterol Level ◽  
Insurance Companies ◽  
Age At Death ◽  
Life Annuity ◽  
Uk Government ◽  
The Uk

Background. Insurance companies often offer people with diabetes ‘‘enhanced impaired life annuity’’ at preferential rates, in view of their reduced life expectancy. Objective. To assess the appropriateness of ‘‘enhanced impaired life annuity’’ rates for individuals with type 2 diabetes. Patients. There were 4026 subjects with established type 2 diabetes (but not known cardiovascular or other life-threatening diseases) enrolled into the UK Lipids in Diabetes Study. Measurements. Estimated individual life expectancy using the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model. Results. Subjects were a mean (SD) age of 60.7 (8.6) years, had a blood pressure of 141/83 (17/10) mm Hg, total cholesterol level of 4.5 (0.75) mmol/L, HDL cholesterol level of 1.2 (0.29) mmol/L, with median (interquartile range [IQR]) known diabetes duration of 6 (3—11) years, and HbA1c of 8.0% (7.2—9.0). Sixty-five percent were male, 91% white, 4% Afro-Caribbean, 5% Indian-Asian, and 15% current smokers. The UKPDS Outcomes Model median (IQR) estimated age at death was 76.6 (73.8—79.5) years compared with 81.6 (79.4—83.2) years, estimated using the UK Government Actuary’s Department data for a general population of the same age and gender structure. The median (IQR) difference was 4.3 (2.8—6.1) years, a remaining life expectancy reduction of almost one quarter. The highest value annuity identified, which commences payments immediately for a 60-year-old man with insulin-treated type 2 diabetes investing 100,000, did not reflect this difference, offering 7.4K per year compared with 7.0K per year if not diabetic. Conclusions. The UK Government Actuary’s Department data overestimate likely age at death in individuals with type 2 diabetes, and at present, ‘‘enhanced impaired life annuity’’ rates do not provide equity for people with type 2 diabetes. Using a diabetes-specific model to estimate life expectancy could provide valuable information to the annuity industry and permit more equitable annuity rates for those with type 2 diabetes.

scholarly journals Growing Income-Based Inequalities in Old-Age Life Expectancy in Sweden, 2006–2015

Demography ◽  
2021 ◽  
Author(s):  
Stefan Fors ◽  
Jonas W. Wastesson ◽  
Lucas Morin
Keyword(s):  
Income Inequality ◽  
Life Expectancy ◽  
Life Span ◽  
Old Age ◽  
Remaining Life ◽  
Neighborhood Deprivation ◽  
Income Gap ◽  
Remaining Life Expectancy ◽  
Mortality Improvement ◽  
Income Quartile

Abstract Sweden is known for high life expectancy and economic egalitarianism, yet in recent decades it has lost ground in both respects. This study tracked income inequality in old-age life expectancy and life span variation in Sweden between 2006 and 2015, and examined whether patterns varied across levels of neighborhood deprivation. Income inequality in remaining life expectancy at ages 65, 75, and 85 increased. The gap in life expectancy at age 65 grew by more than a year between the lowest and the highest income quartiles, for both men (from 3.4 years in 2006 to 4.5 years in 2015) and women (from 2.3 to 3.4 years). This widening income gap in old-age life expectancy was driven by different rates of mortality improvement: individuals with higher incomes increased their life expectancy at a faster rate than did those with lower incomes. Women with the lowest incomes experienced no improvement in old-age life expectancy. Furthermore, life span variation increased in the lowest income quartile, while it decreased slightly among those in the highest quartile. Income was found to be a stronger determinant of old-age life expectancy than neighborhood deprivation.

scholarly journals Dynamics of modal age at death in 1959−2014 in Russia

2019 ◽  
Vol 3 (4) ◽  
pp. 86-96
Author(s):  
Mikhail A. Maksimov
Keyword(s):  
Standard Deviation ◽  
Life Expectancy ◽  
Developed Countries ◽  
Life Tables ◽  
Age At Death ◽  
The Past ◽  
The 1950S ◽  
The Developed Countries ◽  
One Year

Abstract The aim of this paper is to determine the trends of the main indicators of life expectancy in Russia in the 1950s to 2000s. For this purpose, life tables for Russia (former — RSFSR) from 1959 to 2014 for one-year age intervals were analyzed. The main indicators under review are the modal age at death and the standard deviation of life expectancy from the modal value for all ages and the mode. As a result, it is concluded that in Russia the modal age at death and the indicator of life expectancy have stagnated over the past 60 years, and definite trends can be traced only in short periods of time, namely after 2009 when all basic life expectancy indicators were steadily increasing. Life expectancy is far behind those of the developed countries by about half a century.

The Best Exotic Marigold Hotel: international retirement migration on film

2016 ◽  
Vol 37 (10) ◽  
pp. 1975-1986 ◽  
Author(s):  
CLAUDIA BELL
Keyword(s):  
Life Expectancy ◽  
Developing Country ◽  
Old Age ◽  
Home Country ◽  
Life Stage ◽  
Developed Countries ◽  
Retirement Migration ◽  
Travel Experience ◽  
International Retirement Migration ◽  
John Madden

ABSTRACTThe two movies aboutThe Best Exotic Marigold Hotel(2012 and 2015) were directed by John Madden. Starring a cast of famous British older actors, the narratives are set in a faded hotel in India. These are individuals who have relocated because their retirement dreams cannot be realised in their home country. They reflect the growing phenomenon of international retirement migration (IRM): the quickly growing upsurge of financially independent individuals seeking an affordable old age. In India they can claim a position of relative comfort and privilege. For a generation that grew up in a consumerist culture, upward mobility in the senior life stage has become a purchasable commodity through exodus to a developing country. This generation of retirees is generally in better health compared with prior seniors, with a longer life expectancy. Many have a background of travel experience, and an ethos that places their own pleasures in life as pivotal. While global numbers are unavailable, it is estimated that there are millions of retirees relocating to less-developed countries for an affordable retirement. At retirement locations such as the Marigold Hotel, the discrepancies that continue between nations, and local poverty, enable this practice. The events in these movies might be read as a recapitulation of imperialism expressed through retirement migration.

scholarly journals Occupational class differences in pancreatic cancer survival: A population‐based cancer registry‐based study in Japan

2019 ◽  
Author(s):  
Masayoshi Zaitsu ◽  
Yongjoo Kim ◽  
Hye‐Eun Lee ◽  
Takumi Takeuchi ◽  
Yasuki Kobayashi ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Registry ◽  
Cancer Survival ◽  
Population Based ◽  
Occupational Class ◽  
Class Differences

scholarly journals Trends in air pollutants and health impacts in three Swedish cities over the past three decades

2018 ◽  
Author(s):  
Henrik Olstrup ◽  
Bertil Forsberg ◽  
Hans Orru ◽  
Mårten Spanne ◽  
Hung Nguyen ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Health Effects ◽  
Road Traffic ◽  
Dispersion Model ◽  
Developed Countries ◽  
Population Exposure ◽  
Model Calculations ◽  
Central Monitoring ◽  
Increasing Trend ◽  
Monitoring Stations

Abstract. Air pollution concentrations have been decreasing in many cities in the developed countries. We have estimated time trends and health effects associated with exposure to NOx, NO2, O3, and PM10 in the Swedish cities of Stockholm, Gothenburg, and Malmo from the 1990's to 2015. Trend analyses of concentrations have been performed by using the Mann-Kendall test and the Theil-Sen method. Measured concentrations are from central monitoring stations representing urban background levels, and they are assumed to indicate changes in long-term exposure to the population. However, corrections for population exposure have been performed for NOx, O3, and PM10 in Stockholm, and for NOx in Gothenburg. For NOx and PM10, the concentrations at the central monitoring stations are shown to overestimate exposure when compared to dispersion model calculations of spatially resolved population-weighted exposure concentrations, while the reverse applies to O3. The trends are very different for the pollutants that are studied; NOx and NO2 have been decreasing in all cities, O3 exhibits an increasing trend in all cities, and for PM10, there is a slowly decreasing trend in Stockholm, a slowly increasing trend in Gothenburg, and no significant trend in Malmo. When the trends are divided into weekdays and weekends, the decreasing trends associated with NOx and NO2 are more prominent during weekdays compared to weekends, indicating that local emission reductions from traffic to a large part have contributed to these declining trends. Health effects in terms of changes in life expectancy are calculated based on the trends in exposure to NOx, NO2, O3, and PM10, and the relative risks associated with exposure to these pollutants. The decreased levels of NOx are estimated to increase the life expectancy by up to 11 months for Stockholm and 12 months for Gothenburg. This corresponds to up to one fifth of the total increase in life expectancy (54–70 months) in the cities during the period 1990–2015. In contrast to NOx and NO2, the changing trends associated with O3 and PM10 have relatively little impact on the change in life expectancy. NOx and NO2 are highly associated with vehicle exhaust emissions, indicating that decreasing road-traffic emissions have had significant impact on the public health in these cities.

scholarly journals Controlling for Structural Changes in the Workforce Influenced Occupational Class Differences in Disability Retirement Trends

2019 ◽  
Vol 16 (9) ◽  
pp. 1523 ◽  
Author(s):  
Svetlana Solovieva ◽  
Taina Leinonen ◽  
Kirsti Husgafvel-Pursiainen ◽  
Antti Kauhanen ◽  
Pekka Vanhala ◽  
...  
Keyword(s):  
Structural Changes ◽  
Musculoskeletal Diseases ◽  
Occupational Class ◽  
Disability Retirement ◽  
Class Differences ◽  
Economic Stagnation ◽  
Study Population ◽  
Upper Level ◽  
Matched Study ◽  
Specific Disability

We explored occupational class differences in disability retirement trends accounting for structural changes in the workforce induced by the recent economic crisis and the following economic stagnation. Using nationwide register data on the general Finnish population aged 30–59 years, we examined trends in disability retirement due to all causes, musculoskeletal diseases, and mental disorders in 2007, 2010, and 2013. Applying propensity score (PS) matching to control for bias induced by structural changes in the workforce over time, we obtained 885,807 matched triplets. In the original study population, all-cause and cause-specific disability retirement declined between 2007 and 2013 for most occupational classes. In the matched study population, the disability retirement among skilled and unskilled manual workers sharply increased in 2010 and then declined in 2013. PS matching considerably attenuated the decline in disability retirement, particularly between the years 2007 and 2010. In general, the differences in disability retirement between both skilled and unskilled manual workers and upper-level non-manual employees widened during the period of economic stagnation. In occupational epidemiology, structural changes in the workforce should be accounted for when analysing trends in ill-health. Controlling for these changes revealed widening occupational class differences in disability retirement during the period of economic stagnation.

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