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Tidière M, Colchero F, Staerk J, Adkesson MJ, Andersen DH, Bland L, Böye M, Brando S, Clegg I, Cubaynes S, Cutting A, De Man D, Derocher AE, Dorsey C, Elgar W, Gaglione E, Anderson Hansen K, Jungheim A, Kok J, Laule G, Goya AL, Miller L, Monreal-Pawlowsky T, Mucha K, Owen MA, Petersen SD, Pilfold N, Richardson D, Richardson ES, Sabo D, Sato N, Shellabarger W, Skovlund CR, Tomisawa K, Trautwein SE, Van Bonn W, Van Elk C, Von Fersen L, Wahlberg M, Zhang P, Zhang X, Conde DA. Survival improvements of marine mammals in zoological institutions mirror historical advances in human longevity. Proc Biol Sci 2023; 290:20231895. [PMID: 37848064 PMCID: PMC10581765 DOI: 10.1098/rspb.2023.1895] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/21/2023] [Indexed: 10/19/2023] Open
Abstract
An intense public debate has fuelled governmental bans on marine mammals held in zoological institutions. The debate rests on the assumption that survival in zoological institutions has been and remains lower than in the wild, albeit the scientific evidence in support of this notion is equivocal. Here, we used statistical methods previously applied to assess historical improvements in human lifespan and data on 8864 individuals of four marine mammal species (harbour seal, Phoca vitulina; California sea lion, Zalophus californianus; polar bear, Ursus maritimus; common bottlenose dolphin, Tursiops truncatus) held in zoos from 1829 to 2020. We found that life expectancy increased up to 3.40 times, and first-year mortality declined up to 31%, during the last century in zoos. Moreover, the life expectancy of animals in zoos is currently 1.65-3.55 times longer than their wild counterparts. Like humans, these improvements have occurred concurrently with advances in management practices, crucial for population welfare. Science-based decisions will help effective legislative changes and ensure better implementation of animal care.
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Affiliation(s)
- Morgane Tidière
- Interdisciplinary Centre on Population Dynamics (CPop), University of Southern Denmark, Odense, Denmark
- Department of Biology, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
- Conservation and Science Department, Species360, 7900 International Drive, Suite 300, Minneapolis, MN 55425, USA
| | - Fernando Colchero
- Interdisciplinary Centre on Population Dynamics (CPop), University of Southern Denmark, Odense, Denmark
- Department of Mathematics and Computer Science, University of Southern Denmark, Odense, Denmark
- Department of Primate Behavior and Evolution, Max Planck Institute for Evolutionary Anthropology, Deutscher Pl. 6, 04103 Leipzig, Germany
| | - Johanna Staerk
- Interdisciplinary Centre on Population Dynamics (CPop), University of Southern Denmark, Odense, Denmark
- Department of Biology, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
- Conservation and Science Department, Species360, 7900 International Drive, Suite 300, Minneapolis, MN 55425, USA
| | | | - Ditte H. Andersen
- Department of Biology, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
| | - Lucie Bland
- Conservation and Science Department, Species360, 7900 International Drive, Suite 300, Minneapolis, MN 55425, USA
- Eureka Publishing, Thornbury, Australia
| | - Martin Böye
- Centre de Recherche et d'Etude pour l'Animal Sauvage, Planète Sauvage, 44710 Port Saint Pere, France
| | - Sabrina Brando
- AnimalConcepts, PO Box 378, 03725 Teulada, Alicante, Spain
| | - Isabella Clegg
- Animal Welfare Expertise, The Knoll, Woodlands, Combe Martin, EX34 0ATLittleton Manor, Winchester SO22 6QU, UK
| | - Sarah Cubaynes
- CEFE, Univ Montpellier, CNRS, EPHE-PSL University, IRD, Montpellier, France
| | - Amy Cutting
- Polar Bear International, PO Box 3008, Bozeman, MT, USA
| | - Danny De Man
- European Association of Zoos and Aquaria (EAZA), Plantage Middelaan 45, 1018-DC Amsterdam, The Netherlands
| | - Andrew E. Derocher
- Department of Biological Sciences, University of Alberta; Edmonton, Alberta, Canada T6G 2E9
| | - Candice Dorsey
- Association of Zoos and Aquariums, 8403 Colesville Road Ste 710, Silver Spring, MD 20910, USA
| | - William Elgar
- Zoo Miami, 12400 SW 152 Street, Miami, FL 33177, USA
| | - Eric Gaglione
- Georgia Aquarium, 225 Baker Street, Atlanta, GA 30313, USA
| | - Kirstin Anderson Hansen
- Department of Biology, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
- Marine Biological Research Center, University of Southern Denmark, Hindsholmvej 11, 5300 Kerteminde, Denmark
| | - Allison Jungheim
- Como Park Zoo and Conservatory, 1225 Estabrook Dr., Saint Paul, MN 55103, USA
| | - José Kok
- Ouwehands Zoo, Grebbeweg 111, 3911 AV Rhenen, The Netherlands
| | - Gail Laule
- Mandai Wildlife Group, 80 Mandai Lake Road, Singapore 729826
| | | | - Lance Miller
- Chicago Zoological Society, Brookfield Zoo, Brookfield, IL, USA
| | | | - Katelyn Mucha
- Conservation and Science Department, Species360, 7900 International Drive, Suite 300, Minneapolis, MN 55425, USA
| | - Megan A. Owen
- San Diego Zoo Wildlife Alliance, 15600 San Pasqual Valley Rd., Escondido, CA, USA
| | | | - Nicholas Pilfold
- San Diego Zoo Wildlife Alliance, 15600 San Pasqual Valley Rd., Escondido, CA, USA
| | - Douglas Richardson
- Zoological Consultancy Ltd, Columba Cottage, Mill Rd, Kingussie PH21 1LF, UK
- EAZA Polar Bear EEP, Amsterdam, Netherlands
| | - Evan S. Richardson
- Environment and Climate Change Canada, Unit 150–234 Donald Street, Winnipeg, Manitoba R3C 1M8, Canada
| | - Devon Sabo
- Columbus Zoo and Aquarium, 4850 W. Powell Road, PO Box 400, Powell, OH 43065-0400, USA
| | - Nobutaka Sato
- Asahiyama Zoological Park, Kuranuma, Higasiasahikawacho, Asahikawa city, Japan
| | | | - Cecilie R. Skovlund
- Conservation, Copenhagen Zoo, Roskildevej 38, 2000 Frederiksberg, Denmark
- Section of Animal Welfare and Disease Control, Department of Veterinary and Animal Sciences, University of Copenhagen, Grønnegårdsvej 8, 1870 Frederiksberg, Denmark
| | - Kanako Tomisawa
- Omuta City Zoo, 163 Showa-machi, Omuta, Fukuoka 836-0871, Japan
| | - Sandra E. Trautwein
- Conservation and Science Department, Species360, 7900 International Drive, Suite 300, Minneapolis, MN 55425, USA
| | - William Van Bonn
- A. Watson Armour III, Center for Animal Health and Welfare, Animal Care and Science Division, John G. Shedd Aquarium, Chicago, IL 60605, USA
| | - Cornelis Van Elk
- Independent practitioner, Arendsweg 98, Enschede 7544RM, The Netherlands
| | | | - Magnus Wahlberg
- Department of Biology, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
- Marine Biological Research Center, University of Southern Denmark, Hindsholmvej 11, 5300 Kerteminde, Denmark
| | - Peijun Zhang
- Mammal and Marine Bioacoustics Laboratory Institute of Deep-sea Science and Engineering, Chinese Academy of Sciences, Sanya 572000, People's Republic of China
| | - Xianfeng Zhang
- Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, People's Republic of China
| | - Dalia A. Conde
- Interdisciplinary Centre on Population Dynamics (CPop), University of Southern Denmark, Odense, Denmark
- Department of Biology, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
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2
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Spijker JJA, Rentería E. Shifts in Chronic Disease Patterns Among Spanish Older Adults With Multimorbidity Between 2006 and 2017. Int J Public Health 2023; 68:1606259. [PMID: 37920847 PMCID: PMC10618995 DOI: 10.3389/ijph.2023.1606259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/28/2023] [Indexed: 11/04/2023] Open
Abstract
Objectives: To investigate changes in multimorbidity patterns among Spanish older adults. Methods: Data come from the Spanish National Health Survey (ENSE) for individuals aged 60-89 years (2006: n = 9,758; 2017: n = 8,535). Prevalence rates and relative risks of 20 chronic conditions are estimated for the multimorbidity (3+ chronic conditions) sample, along with observed-to-expected prevalence of three-way disease combinations. Principal component and cluster analyses identify multimorbidity patterns and track temporal changes. Results: Overall, multimorbidity remained stable [2006: 59.6% (95% CI: 58.7%-60.6%); 2017: 60.3% (CI: 59.3%-61.3%)], except at older ages. Women exhibited higher multimorbidity prevalence, but sex differences declined by five percentage points. Low-high education differences widened by three percentage points. In 2017 most individuals living with multimorbidity experienced hypertension (63.4%), osteoarthrosis (62.4%) and chronic back pain (55.9%). These chronic conditions also dominate the most common triadic combinations. Multimorbid men also saw increases in cholesterol and diabetes. Conclusion: Multimorbidity trends and the most common combination of diseases can help plan healthcare for an ageing population. Sex and socioeconomic differences pose additional public health challenges as women and deprived populations tend to have more health complexities.
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Clegg ME, Methven L, Lanham-New SA, Green MA, Duggal NA, Hetherington MM. The Food4Years Ageing Network: Improving foods and diets as a strategy for supporting quality of life, independence and healthspan in older adults. NUTR BULL 2023; 48:124-133. [PMID: 36718711 PMCID: PMC10946951 DOI: 10.1111/nbu.12599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 11/20/2022] [Accepted: 11/28/2022] [Indexed: 02/01/2023]
Abstract
By 2050, it is predicted that one in four people in the United Kingdom will be aged 65 years and over. Increases in lifespan are not always translated into years spent in good health. Incidence rates for chronic diseases are increasing, with treatments allowing people to live longer with their disease. There is good evidence to support changes to lifestyle to maintain or improve body composition, cognitive health, musculoskeletal health, immune function and vascular health in older adults. Much research has been done in this area, which has produced significant support for foods and nutrients that contribute to improved healthspan. Yet two major barriers remain: firstly, older adult consumers are not meeting current UK recommendations for macro- and micronutrients that could benefit health and quality of life and secondly, the UK-specific recommendations may not be sufficient to support the ageing population, particularly for nutrients with key physiological roles. More work is needed to improve intakes of specific foods, diets and nutrients by older adults, through a variety of mechanisms including (i) development of specific food products; (ii) improved clarity of information and (iii) appropriate marketing, and policy changes to enable incentives. The Food4Years Ageing Network aims to build a wide-reaching and multidisciplinary community that is committed to the development, integration and communication of healthy, affordable foods and specific diets for all older adults across the UK food landscape. The Network will identify evidence-based strategies for improving food intake and nutrition in older adults, paving the way to "living well while living longer."
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Affiliation(s)
- Miriam E Clegg
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Lisa Methven
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Susan A Lanham-New
- Nutritional Sciences Department, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Surrey, UK
| | - Mark A Green
- Department of Geography and Planning, University of Liverpool, Liverpool, UK
| | - Niharika A Duggal
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
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Workforce participation, health and wealth inequality among older Australians between 2001 and 2015. Arch Public Health 2022; 80:104. [PMID: 35361261 PMCID: PMC8969371 DOI: 10.1186/s13690-022-00852-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 03/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background Australians born in 2012 can expect to live about 33 years longer than those born 100 years earlier. However, only seven of these additional years are spent in the workforce. Longer life expectancy has driven policies to extend working life and increase retirement age; the current Australian policy, which has increased the eligibility for the pension from 65 to 67 by 2023, assumes that an improvement in longevity corresponds with an improvement in healthy life expectancy. However, there is mixed evidence of health trends in Australia over the past two decades. Although some health outcomes are improving among older age groups, many are either stable or deteriorating. This raises a question of how health trends intersect with policy for older Australians aged from 50 to 70. This paper considers the interplay between older workers’ health and workforce participation rates over the past 15 years when extended workforce participation has been actively encouraged. Methods We compared health and economic outcomes of the older people in following years with the base year (start of the study period), adjusting for some key socio-economic characteristics such as age, sex, ethnicity, education and equivalized household income by applying the Random effects estimator with maximum likelihood estimation technique. Results We find that regardless of increasing longevity, the health of older adults aged between 50 and 70 has slightly deteriorated. In addition, health gaps between those who were working into their older age and those who were not have widened over the 15-year period. Finally, we find that widening health gaps linked to workforce participation are also accompanied by rising economic inequality in incomes, financial assets and superannuation. With the exception of a small group of healthy and very wealthy retirees, the majority of the older Australians who were not working had low incomes, assets, superannuation, and poor health. Conclusions The widening economic and health gap within older population over time indicates a clear and urgent need to add policy actions on income and health, to those that seek to increase workforce participation among older adults. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00852-z.
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Leitão C, Mignano A, Estrela M, Fardilha M, Figueiras A, Roque F, Herdeiro MT. The Effect of Nutrition on Aging-A Systematic Review Focusing on Aging-Related Biomarkers. Nutrients 2022; 14:nu14030554. [PMID: 35276919 PMCID: PMC8838212 DOI: 10.3390/nu14030554] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 02/08/2023] Open
Abstract
Despite the increasing life expectancy, an individual’s later years tends to be accompanied by a decrease in the quality of life. Though biological changes that occur through the natural process of aging cannot be controlled, the risk factors associated with lifestyle can. Thus, the main goal of this systematic review was to evaluate how nutrition can modulate aging. For this purpose, thirty-six studies were selected on (i) the efficiency of nutrition’s effect on aging, (ii) the evaluation of biomarkers that promote healthy aging, and (iii) how to increase longevity through nutrition, and their quality was assessed. The results showed that choosing low carbohydrate diets or diets rich in vegetables, fruits, nuts, cereals, fish, and unsaturated fats, containing antioxidants, potassium, and omega-3 decreased cardiovascular diseases and obesity risk, protected the brain from aging, reduced the risk of telomere shortening, and promoted an overall healthier life. With this study, the conclusion is that since the biological processes of aging cannot be controlled, changing one’s nutritional patterns is crucial to prevent the emergence and development of diseases, boost longevity, and, mostly, to enhance one’s quality of life and promote healthy aging.
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Affiliation(s)
- Catarina Leitão
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal; (A.M.); (M.E.); (M.F.)
- Correspondence: (C.L.); (F.R.); (M.T.H.); Tel.: +351-915-468-330 (C.L.); +351-965-577-778 (F.R.); +351-917-739-799 (M.T.H.)
| | - Anna Mignano
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal; (A.M.); (M.E.); (M.F.)
| | - Marta Estrela
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal; (A.M.); (M.E.); (M.F.)
| | - Margarida Fardilha
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal; (A.M.); (M.E.); (M.F.)
| | - Adolfo Figueiras
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28001 Madrid, Spain;
- Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Fátima Roque
- Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), 6300-559 Guarda, Portugal
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal
- Correspondence: (C.L.); (F.R.); (M.T.H.); Tel.: +351-915-468-330 (C.L.); +351-965-577-778 (F.R.); +351-917-739-799 (M.T.H.)
| | - Maria Teresa Herdeiro
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal; (A.M.); (M.E.); (M.F.)
- Correspondence: (C.L.); (F.R.); (M.T.H.); Tel.: +351-915-468-330 (C.L.); +351-965-577-778 (F.R.); +351-917-739-799 (M.T.H.)
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Permanyer I, Trias-Llimós S, Spijker JJA. Best-practice healthy life expectancy vs. life expectancy: Catching up or lagging behind? Proc Natl Acad Sci U S A 2021; 118:e2115273118. [PMID: 34772816 PMCID: PMC8609542 DOI: 10.1073/pnas.2115273118] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 12/26/2022] Open
Affiliation(s)
- Iñaki Permanyer
- Centre d'Estudis Demogràfics, Centres de Recerca de Catalunya, Universitat Autònoma de Barcelona, Bellaterra 08193, Spain;
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona 08010, Spain
| | - Sergi Trias-Llimós
- Centre d'Estudis Demogràfics, Centres de Recerca de Catalunya, Universitat Autònoma de Barcelona, Bellaterra 08193, Spain
| | - Jeroen J A Spijker
- Centre d'Estudis Demogràfics, Centres de Recerca de Catalunya, Universitat Autònoma de Barcelona, Bellaterra 08193, Spain
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Wanyonyi K, Couch C, John J, Louca C. e-Oral health interventions for older patients in an outreach primary dental care centre: A pilot trial nested acceptability study. Gerodontology 2021; 39:241-249. [PMID: 34018237 DOI: 10.1111/ger.12562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/21/2021] [Accepted: 04/28/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the acceptability and perceived helpfulness of an e-Oral Health intervention in form of text messages versus standard dental leaflets provided after a dental visit to patients aged 65 years and over. BACKGROUND Oral health care needs for older people are increasing. Remote interventions using e-Health can ensure oral care is provided despite physical hindrances or situations where dental appointments are limited such as has happened more widely during the COVID-19 pandemic. MATERIALS AND METHODS Mixed-method nested study within a pilot trial. Dental patients (n = 150) at an outreach primary dental care centre, ≥ 65 years old, were recruited and randomly allocated to e-Oral health text messages or leaflet intervention arms. Post-intervention (6 months), participants responded to open and closed-ended two-way survey phone texts. Survey questions investigated: (a) whether they would recommend the intervention, (b) intervention helpfulness and (c) OPEN feedback. Average helpfulness scores (Scale:1= Very Helpful to 5= Not Helpful at All) were compared for each arm using Independent Sample t-test. Percentage of participants providing positive recommendations in each arm were compared using chi-squared tests. Qualitative findings were analysed using thematic analysis. RESULTS N = 68 (45%) responded. Mean helpfulness scores in text group M = 2.2, SD=1.1) and leaflet group M = 2.3, SD=1.9, P = .29. Amongst the text arm respondents, 89% compared with 68.2% in leaflet arm; P = .005 would recommend the intervention. Four qualitative themes were outlined: intervention approach, content, behavioural impact and recommendations. CONCLUSION e-Oral Health text interventions are acceptable and helpful to older people, but these messages need to be tailored.
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Affiliation(s)
- Kristina Wanyonyi
- Queen Mary, Institute of Dentistry, Centre for Dental Public Health and Primary Care, Barts and The London School of Medicine and Dentistry, University of London, London, UK.,Formerly University of Portsmouth Dental Academy, Portsmouth, UK
| | | | - Jeyanthi John
- Public Health England South East (Wessex), London, UK
| | - Chris Louca
- University of Portsmouth Dental Academy, Portsmouth, UK
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Zueras P, Rentería E. Trends in disease-free life expectancy at age 65 in Spain: Diverging patterns by sex, region and disease. PLoS One 2020; 15:e0240923. [PMID: 33175856 PMCID: PMC7657566 DOI: 10.1371/journal.pone.0240923] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/05/2020] [Indexed: 11/28/2022] Open
Abstract
Life expectancy in Spain is among the highest in the world. Nevertheless, we do not know if improvements in health conditions at older ages have followed postponements of death. Previous studies in Spain show a stable trend in years lived in ill health in the past. In this paper we investigate changes between 2006, 2012 and 2017 in life expectancy with and without disease at age 65 in Spain and, for the first time, in Spanish regions, which have autonomous powers of health planning, public health and healthcare. Results show that, at the country level, disease-free life expectancy reduced between 2006 and 2017 in Spain. This was explained by an expansion of most diseases except for some cardiovascular and respiratory chronic conditions. However, at the regional level the evolution was different, especially regarding each disease and sex. First, regional differences reduced between 2006 and 2012 but largely widened in 2017, suggesting that not all regions had the same ability to recover after the 2008 financial crisis that caused government cuts to health services. Second, regional analysis also highlighted diverging trends by sex. While men experienced expansion of morbidity in most regions, women experienced a compression in about half of them, ending up with women showing higher disease-free life expectancies than men in 9 out of the 17 regions considered. This study, then, calls attention to the importance of focusing the analysis of health surveillance to more disaggregated levels, more in accordance with the level of health management, as regional trends showed heterogeneity in the prevalence of diseases and different progresses in the relationship between sexes.
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Affiliation(s)
- Pilar Zueras
- Centre d'Estudis Demogràfics, Bellaterra, Barcelona, Spain
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9
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The rise of metastatic bone disease in Ireland. Clin Exp Metastasis 2020; 37:693-702. [PMID: 33099723 DOI: 10.1007/s10585-020-10059-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/14/2020] [Indexed: 12/24/2022]
Abstract
To describe the expected rise of metastatic bone disease in Ireland, the relative primary types, and the locations of spread within the skeleton. This was a population-based epidemiological study using cancer registry data. We included patients with known metastatic cancer to bone, within 1 year of the primary diagnosis, during the years 1994 to 2012 inclusive. Our main outcome measures were age-specific, gender-specific and age-standardised incidence rates of bone metastasis, primary types and metastatic location within the skeleton. There were 14,495 recognised cases of bone metastasis in Ireland, 1994-2012 inclusive. Cases consistently rose over the time period, with 108% case increase and 51% age-standardised incidence rise. Annual percentage change increased across both genders and over all age groups. Most of this rise was not due to demographic population change. Breast, prostate and lung accounted for the majority of primary types. GI cancers were the fourth most common primary type. There were proportional increases in breast and lung, with proportional decreases in prostate. The spine was the major metastatic site. Bone metastasis is a significant and rising healthcare concern in Ireland. This rise is disproportionate to demographic changes. Breast, prostate and lung cancers account for the majority. GI cancers are implicated in an unexpectedly high number of cases. Spine is the most common location of bony metastasis, especially at presentation. Prudent healthcare planning is necessitated to prepare for the growing consequences of bone metastasis in cancer patients.
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10
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Liu Z, Zheng H, Wu Y, Wang S, Liu Y, Hu S. Self-Rated Healthy Life Expectancy Changes in Jiangxi Province of China by Gender and Urban-Rural Differences, 2013-2018. Front Public Health 2020; 8:596249. [PMID: 33569369 PMCID: PMC7868547 DOI: 10.3389/fpubh.2020.596249] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/14/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Globalization has brought about rapid economic and technological development, and life expectancy (LE) is constantly increasing. However, it is not clear whether an increase in LE will result in an increase in healthy life expectancy (HLE). This study evaluates trends in the self-rated healthy life expectancy (SRHLE) of residents aged 15 and older in Jiangxi Province of China from 2013 to 2018 and analyzes gender differences and urban-rural differences. This study provides a basis for the formulation of relevant public health policies. Methods: Based on two National Health Services Survey databases of Jiangxi in 2013 and 2018 as well as infant mortality rates and under-5 mortality rates from the Health Commission of Jiangxi, the Sullivan method was used to calculate SRHLE. The changes in SRHLE were decomposed into health and mortality effects using the decomposition method. Results: SRHLE decreased from 56.55 to 55.54 years and from 60.00 to 57.87 years for men and women aged 15 from 2013 to 2018, respectively. The SRHLE of women aged 15 was 3.45 and 2.34 years longer than that of men in 2013 and 2018, respectively. The SRHLE of urban men aged 15 was 2.9 and 4.46 years longer than that of rural men in 2013 and 2018, respectively, and that of urban women aged 15 was 3.28 and 5.57 years longer than that of rural women. Conclusions: The decreased SRHLE indicated that the self-rated health (SRH) status of residents in Jiangxi has worsened, and it provided evidence for the expansion of morbidity, mainly due to the increased prevalence of chronic diseases and the improvement in residents' health awareness. Policy efforts are necessary to control the increased morbidity of chronic diseases and reduce gender and urban-rural differences in the quantity and quality of years lived.
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Affiliation(s)
- Zhitao Liu
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, China
| | - Huilie Zheng
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, China
| | - Yuhang Wu
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, China
| | - Shengwei Wang
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, China
| | - Yong Liu
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, China
| | - Songbo Hu
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, China
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Balachandran A, James KS. A multi-dimensional measure of population ageing accounting for Quantum and Quality in life years: An application of selected countries in Europe and Asia. SSM Popul Health 2018; 7:100330. [PMID: 30581965 PMCID: PMC6287061 DOI: 10.1016/j.ssmph.2018.100330] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 11/02/2022] Open
Abstract
Population ageing measured through a fixed old-age threshold like 60+ or 65+ ignores the other important dimensions of ageing. There has been changes among the older persons in multiple dimensions that corresponds to quantity of life years lived as well as the quality of life. The existing multi-dimensional measures also consider the characteristics within a fixed old-age threshold framework which does not account for significant improvements in life expectancy over the years. We propose a new Multidimensional Old Age Threshold (MOAT) measure that accommodates different dimensions of quantity and quality of older persons. We achieve this through a modified framework of the Characteristic Approach. Our measure incorporates a forward-looking approach to measure ageing and specifies an old-age threshold for different countries after accounting for different dimensions of life expectancy, health and human capital. This method is more suitable for comparison across countries with distinct demographic and health achievements. The empirical application of our method using selected countries from Europe and Asia shows that the relative performance of countries differs in terms of MOAT in comparison to estimates based on existing measures, primarily due to the inclusion of the quality dimensions. Countries that have better performance in life expectancy, health and human capital have higher values of MOAT and a lower 'burden' of older persons in a cross-country perspective in comparison to the existing measures.
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Affiliation(s)
- Arun Balachandran
- Population Research Centre, University of Groningen, The Netherlands.,Institute for Social and Economic Change, Bengaluru, India
| | - K S James
- Centre for Study of Regional Development, Jawaharlal Nehru University, New Delhi, India
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Zeng Y, Nie C, Min J, Chen H, Liu X, Ye R, Chen Z, Bai C, Xie E, Yin Z, Lv Y, Lu J, Li J, Ni T, Bolund L, Land KC, Yashin A, O’Rand AM, Sun L, Yang Z, Tao W, Gurinovich A, Franceschi C, Xie J, Gu J, Hou Y, Liu X, Xu X, Robine JM, Deelen J, Sebastiani P, Slagboom E, Perls T, Hauser E, Gottschalk W, Tan Q, Christensen K, Shi X, Lutz M, Tian XL, Yang H, Vaupel J. Sex Differences in Genetic Associations With Longevity. JAMA Netw Open 2018; 1:e181670. [PMID: 30294719 PMCID: PMC6173523 DOI: 10.1001/jamanetworkopen.2018.1670] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 05/15/2018] [Indexed: 01/09/2023] Open
Abstract
IMPORTANCE Sex differences in genetic associations with human longevity remain largely unknown; investigations on this topic are important for individualized health care. OBJECTIVE To explore sex differences in genetic associations with longevity. DESIGN SETTING AND PARTICIPANTS This population-based case-control study used sex-specific genome-wide association study and polygenic risk score (PRS) analyses to examine sex differences in genetic associations with longevity. Five hundred sixty-four male and 1614 female participants older than 100 years were compared with a control group of 773 male and 1526 female individuals aged 40 to 64 years. All were Chinese Longitudinal Healthy Longevity Study participants with Han ethnicity who were recruited in 1998 and 2008 to 2014. MAIN OUTCOMES AND MEASURES Sex-specific loci and pathways associated with longevity and PRS measures of joint effects of sex-specific loci. RESULTS Eleven male-specific and 11 female-specific longevity loci (P < 10-5) and 35 male-specific and 25 female-specific longevity loci (10-5 ≤ P < 10-4) were identified. Each of these loci's associations with longevity were replicated in north and south regions of China in one sex but were not significant in the other sex (P = .13-.97), and loci-sex interaction effects were significant (P < .05). The associations of loci rs60210535 of the LINC00871 gene with longevity were replicated in Chinese women (P = 9.0 × 10-5) and US women (P = 4.6 × 10-5) but not significant in Chinese and US men. The associations of the loci rs2622624 of the ABCG2 gene were replicated in Chinese women (P = 6.8 × 10-5) and European women (P = .003) but not significant in both Chinese and European men. Eleven male-specific pathways (inflammation and immunity genes) and 34 female-specific pathways (tryptophan metabolism and PGC-1α induced) were significantly associated with longevity (P < .005; false discovery rate < 0.05). The PRS analyses demonstrated that sex-specific associations with longevity of the 4 exclusive groups of 11 male-specific and 11 female-specific loci (P < 10-5) and 35 male-specific and 25 female-specific loci (10-5 ≤P < 10-4) were jointly replicated across north and south discovery and target samples. Analyses using the combined data set of north and south showed that these 4 groups of sex-specific loci were jointly and significantly associated with longevity in one sex (P = 2.9 × 10-70 to 1.3 × 10-39) but not jointly significant in the other sex (P = .11 to .70), while interaction effects between PRS and sex were significant (P = 4.8 × 10-50 to 1.2 × 10-16). CONCLUSION AND RELEVANCE The sex differences in genetic associations with longevity are remarkable, but have been overlooked by previously published genome-wide association studies on longevity. This study contributes to filling this research gap and provides a scientific basis for further investigating effects of sex-specific genetic variants and their interactions with environment on healthy aging, which may substantially contribute to more effective and targeted individualized health care for male and female elderly individuals.
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Affiliation(s)
- Yi Zeng
- Center for the Study of Aging and Human Development, Medical School of Duke University, Durham, North Carolina
- Center for Healthy Aging and Development Studies, National School of Development, Raissun Institute for Advanced Studies, Peking University, Beijing, China
| | - Chao Nie
- BGI Education Center, University of Chinese Academy of Sciences, Shenzhen, China
- BGI–Shenzhen, Shenzhen, China
| | - Junxia Min
- The First Affiliated Hospital, Institute of Translational Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Huashuai Chen
- Center for the Study of Aging and Human Development, Medical School of Duke University, Durham, North Carolina
- Business School of Xiangtan University, Xiangtan, China
| | | | - Rui Ye
- BGI–Shenzhen, Shenzhen, China
| | | | - Chen Bai
- Center for Healthy Aging and Development Studies, National School of Development, Raissun Institute for Advanced Studies, Peking University, Beijing, China
| | - Enjun Xie
- The First Affiliated Hospital, Institute of Translational Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhaoxue Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuebin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiehua Lu
- Department of Sociology, Peking University, Beijing, China
| | - Jianxin Li
- Department of Sociology, Peking University, Beijing, China
| | - Ting Ni
- School of Life Sciences, Fudan University, Shanghai, China
| | - Lars Bolund
- BGI–Shenzhen, Shenzhen, China
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Kenneth C. Land
- Duke Population Research Institute, Duke University, Durham, North Carolina
| | - Anatoliy Yashin
- Duke Population Research Institute, Duke University, Durham, North Carolina
| | - Angela M. O’Rand
- Duke Population Research Institute, Duke University, Durham, North Carolina
| | - Liang Sun
- The MOH Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Ze Yang
- The MOH Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Wei Tao
- School of Life Sciences, Peking University, Beijing, China
| | | | | | - Jichun Xie
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - Jun Gu
- School of Life Sciences, Peking University, Beijing, China
| | | | | | - Xun Xu
- BGI–Shenzhen, Shenzhen, China
| | - Jean-Marie Robine
- French National Institute on Health and Medical Research and Ecole Pratique des Hautes Etudes, University of Montpellier, Montpellier, France
| | - Joris Deelen
- Max Planck Institute for Biology of Ageing, Cologne, Germany
| | | | - Eline Slagboom
- Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Elizabeth Hauser
- Molecular Physiology Institute, Medical Center, Duke University, Durham, North Carolina
| | - William Gottschalk
- Department of Neurology, Medical Center, Duke University, Durham, North Carolina
| | - Qihua Tan
- University of Southern Denmark, Odense, Denmark
| | | | - Xiaoming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mike Lutz
- Department of Neurology, Medical Center, Duke University, Durham, North Carolina
| | - Xiao-Li Tian
- Human Aging Research Institute and School of Life Science, Nanchang University, Jiangxi, China
| | - Huanming Yang
- BGI–Shenzhen, Shenzhen, China
- James D. Watson Institute of Genome Sciences, Hangzhou, China
| | - James Vaupel
- Max Planck Institute for Demographic Research, Rostock, Germany
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13
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Calder PC, Carding SR, Christopher G, Kuh D, Langley-Evans SC, McNulty H. A holistic approach to healthy ageing: how can people live longer, healthier lives? J Hum Nutr Diet 2018; 31:439-450. [PMID: 29862589 DOI: 10.1111/jhn.12566] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Although lifespan is increasing, there is no evidence to suggest that older people are experiencing better health in their later years than previous generations. Nutrition, at all stages of life, plays an important role in determining health and wellbeing. METHODS A roundtable meeting of UK experts on nutrition and ageing considered key aspects of the diet-ageing relationship and developed a consensus position on the main priorities for research and public health actions that are required to help people live healthier lives as they age. RESULTS The group consensus highlighted the requirement for a life course approach, recognising the multifactorial nature of the impact of ageing. Environmental and lifestyle influences at any life stage are modified by genetic factors and early development. The response to the environment at each stage of life can determine the impact of lifestyle later on. There are no key factors that act in isolation to determine patterns of ageing and it is a combination of environmental and social factors that drives healthy or unhealthy ageing. Too little is known about how contemporary dietary patterns and sedentary lifestyles will impact upon healthy ageing in future generations and this is a priority for future research. CONCLUSIONS There is good evidence to support change to lifestyle (i.e. diet, nutrition and physical) activity in relation to maintaining or improving body composition, cognitive health and emotional intelligence, immune function and vascular health. Lifestyle change at any stage of life may extend healthy lifespan, although the impact of early changes appears to be greatest.
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Affiliation(s)
- P C Calder
- Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - S R Carding
- Quadram Institute Bioscience and Norwich Medical School, University of East Anglia, Norwich, UK
| | - G Christopher
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - D Kuh
- Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK
| | - S C Langley-Evans
- School of Biosciences, University of Nottingham, Sutton Bonnington, UK
| | - H McNulty
- Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, UK
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Gutiérrez-Vega M, Esparza-Del Villar OA, Carrillo-Saucedo IC, Montañez-Alvarado P. The Possible Protective Effect of Marital Status in Quality of Life Among Elders in a U.S.-Mexico Border City. Community Ment Health J 2018; 54:480-484. [PMID: 28887605 PMCID: PMC5910460 DOI: 10.1007/s10597-017-0166-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 09/05/2017] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to determine how marital status may have an impact on quality of life in a group of older adults living in a U.S.-Mexico border city. Two-hundred and seventy-six older adults completed the Spanish version of the World Health Organization Quality of Life Assessment, composed of four domains: physical health, psychological health, social relationships, and environment. Participants answered a measure of sociodemographic variables. In the psychological health component of quality of life, single and married older adults had the highest scores as compared to widowed and divorced. Similarly, married older adults had the highest quality of life in social relationships. Marital status may play an important role when analyzing quality of life among older adults, this study suggests that being married may offer a protective mechanism against depressive symptoms and therefore against mental illnesses during late adulthood.
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Affiliation(s)
- Marisela Gutiérrez-Vega
- Universidad Autónoma de Ciudad Juárez, Av. Plutarco Elías Calles 1210, Juárez, 32310, Chihuahua, México.
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15
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Abstract
AbstractThere is conflicting evidence for the effect of BMI on mortality at older ages, and little information on its effect on healthy life expectancy (HLE). Longitudinal data were from the 1921–1926 cohort of the Australian Longitudinal Study on Women’s Health (n 11 119), over 18 years of follow-up. Self-rated health status was measured at each survey, and BMI was measured at baseline. Multi-state models were fitted to estimate the effect of BMI on total life expectancy (TLE) and HLE. Compared with women of normal weight, overweight women at the age of 75 years had similar TLE but fewer years healthy (−0·79; 95 % CI −1·21, −0·37) and more years unhealthy (0·99; 95 % CI 0·56, 1·42). Obese women at the age of 75 years lived fewer years in total than normal-weight women (−1·09; 95 % CI −1·77, −0·41), and had more unhealthy years (1·46; 95 % CI 0·97, 1·95 years). Underweight women had the lowest TLE and the fewest years of healthy life. Women should aim to enter old age at a normal weight and in good health, as the slight benefit on mortality of being overweight is offset by spending fewer years healthy. All outcomes were better for those who began in good health. The relationship between weight and HLE has important implications for nutrition for older people, particularly maintenance of lean body mass and prevention of obesity. The benefit of weight loss in obese older women remains unclear, but we support the recommendation that weight-loss advice be individualised, as any benefits may not outweigh the risks in healthy obese older adults.
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16
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Wouterse B, Huisman M, Meijboom BR, Deeg DJH, Polder JJ. The effect of trends in health and longevity on health services use by older adults. BMC Health Serv Res 2015; 15:574. [PMID: 26704342 PMCID: PMC4690430 DOI: 10.1186/s12913-015-1239-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Indexed: 11/23/2022] Open
Abstract
Background The effect of population aging on future health services use depends on the relationship between longevity gains and health. Whether further gains in life expectancy will be paired by improvements in health is uncertain. We therefore analyze the effect of population ageing on health services use under different health scenarios. We focus on the possibly diverging trends between different dimensions of health and their effect on health services use. Methods Using longitudinal data on health and health services use, a latent Markov model has been estimated that includes different dimensions of health. We use this model to perform a simulation study and analyze the health dynamics that drive the effect of population aging. We simulate three health scenarios on the relationship between longevity and health (expansion of morbidity, compression of morbidity, and the dynamic equilibrium scenario). We use the scenarios to predict costs of health services use in the Netherlands between 2010 and 2050. Results Hospital use is predicted to decline after 2040, whereas long-term care will continue to rise up to 2050. Considerable differences in expenditure growth rates between scenarios with the same life expectancy but different trends in health are found. Compression of morbidity generally leads to the lowest growth. The effect of additional life expectancy gains within the same health scenario is relatively small for hospital care, but considerable for long-term care. Conclusions By comparing different health scenarios resulting in the same life expectancy, we show that health improvements do contain costs when they decrease morbidity but not mortality. This suggests that investing in healthy aging can contribute to containing health expenditure growth.
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Affiliation(s)
- Bram Wouterse
- Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands. .,Center for Public Health Forecasting, National Institute for Public Health and the Environment, Bilthoven, >The Netherlands. .,CPB Netherlands Bureau for Economic Policy Analysis, P.O. Box 80510, The Hague, 2508 GM, >The Netherlands.
| | - Martijn Huisman
- EMGO + Institute on Health and Care Research, Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, >The Netherlands. .,Department of Sociology, VU University, Amsterdam, >The Netherlands.
| | - Bert R Meijboom
- Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
| | - Dorly J H Deeg
- EMGO + Institute on Health and Care Research, Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, >The Netherlands. .,Department of Psychiatry, VU University Medical Center, Amsterdam, >The Netherlands.
| | - Johan J Polder
- Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands. .,Center for Public Health Forecasting, National Institute for Public Health and the Environment, Bilthoven, >The Netherlands.
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17
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Badley EM, Canizares M, Perruccio AV, Hogg-Johnson S, Gignac MAM. Benefits gained, benefits lost: comparing baby boomers to other generations in a longitudinal cohort study of self-rated health. Milbank Q 2015; 93:40-72. [PMID: 25752350 PMCID: PMC4364431 DOI: 10.1111/1468-0009.12105] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
UNLABELLED POLICY POINTS: Despite beliefs that baby boomers are healthier than previous generations, we found no evidence that the health of baby boomers is substantially different from that of the previous or succeeding cohorts. The effects of increased education, higher income, and lower smoking rates on improving self-rated health were nearly counterbalanced by the adverse effect of increasing body mass index (BMI). Assumptions that baby boomers will require less health care as they age because of better education, more prosperity, and less propensity to smoke may not be realized because of increases in obesity. CONTEXT Baby boomers are commonly believed to be healthier than the previous generation. Using self-rated health (SRH) as an indicator of health status, this study examines the effects of age, period, and birth cohort on the trajectory of health across 4 generations: World War II (born between 1935 and 1944), older baby boomers (born between 1945 and 1954), younger baby boomers (born between 1955 and 1964), and Generation X (born between 1965 and 1974). METHODS We analyzed Canada's longitudinal National Population Health Survey 1994-2010 (n = 8,570 at baseline), using multilevel growth models to estimate the age trajectory of SRH by cohort, accounting for period and incorporating the influence of changes in education, household income, smoking status, and body mass index (BMI) on SRH over time. FINDINGS SRH worsened with increasing age in all cohorts. Cohort differences in SRH were modest (p = 0.034), but there was a significant period effect (p = 0.002). We found marked cohort effects for increasing education, income, and BMI, and decreasing smoking from the youngest to the oldest cohorts, which were much reduced (education and smoking) or removed (income and BMI) once period was taken into account. At the population level, multivariable analysis showed the benefits of increasing education and income and declines in smoking on the trajectory of improving SRH were almost counterbalanced by the effects of increasing BMI (obesity). CONCLUSIONS We found no evidence to support the expectation that baby boomers will age more or less healthily than previous cohorts did. We also found that increasing BMI has likely undermined improvements in health that might have otherwise occurred, with possible implications for the need for health care. Period effects had a more profound effect than birth cohort effects. This suggests that interventions to improve health, such as reducing obesity, can be targeted to the entire, or a major portion of the, population and need not single out particular birth cohorts.
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Affiliation(s)
- Elizabeth M Badley
- Toronto Western Research Institute, University Health Network; Dalla Lana School of Public Health, University of Toronto
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18
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Woodward A, Blakely T. Could we all live to 100? Should we? Aust N Z J Public Health 2015; 39:3-4. [PMID: 25648728 DOI: 10.1111/1753-6405.12357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Karcharnubarn R, Rees P, Gould M. Healthy life expectancy changes in Thailand, 2002-2007. Health Place 2013; 24:1-10. [PMID: 23999577 DOI: 10.1016/j.healthplace.2013.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 07/19/2013] [Accepted: 08/01/2013] [Indexed: 11/16/2022]
Abstract
We investigate links between increasing longevity and health status in Thailand. Using data from 2002 and 2007 national surveys of the elderly, healthy life expectancies at older ages were estimated. Change depended on health indicator, gender and age. Self-reported health and self-care disability showed expansion of morbidity. Mobility disability change indicated compression but a wording change means this may be an artefact. We compare these findings with the 1990 and 2010 results of the Global Burden of Disease study. Using HLE based on disease prevalence, the GBD found that Thailand experienced small longevity gains and morbidity compression. Our findings suggest these results should be treated with caution, as, since 2000, Thailand has introduced universal health care.
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Affiliation(s)
- Rukchanok Karcharnubarn
- College of Population Studies, Chulalongkorn University, Visid Prachuabmoh Building, Bangkok 10330, Thailand.
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Abstract
The ageing of European populations presents health, long-term care, and welfare systems with new challenges. Although reports of ageing as a fundamental threat to the welfare state seem exaggerated, societies have to embrace various policy options to improve the robustness of health, long-term care, and welfare systems in Europe and to help people to stay healthy and active in old age. These policy options include prevention and health promotion, better self-care, increased coordination of care, improved management of hospital admissions and discharges, improved systems of long-term care, and new work and pension arrangements. Ageing of the health workforce is another challenge, and policies will need to be pursued that meet the particular needs of older workers (ie, those aged 50 years or older) while recruiting young practitioners.
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Affiliation(s)
- Bernd Rechel
- European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK.
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Salomon JA, Wang H, Freeman MK, Vos T, Flaxman AD, Lopez AD, Murray CJL. Healthy life expectancy for 187 countries, 1990-2010: a systematic analysis for the Global Burden Disease Study 2010. Lancet 2012; 380:2144-62. [PMID: 23245606 DOI: 10.1016/s0140-6736(12)61690-0] [Citation(s) in RCA: 567] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Healthy life expectancy (HALE) summarises mortality and non-fatal outcomes in a single measure of average population health. It has been used to compare health between countries, or to measure changes over time. These comparisons can inform policy questions that depend on how morbidity changes as mortality decreases. We characterise current HALE and changes over the past two decades in 187 countries. METHODS Using inputs from the Global Burden of Disease Study (GBD) 2010, we assessed HALE for 1990 and 2010. We calculated HALE with life table methods, incorporating estimates of average health over each age interval. Inputs from GBD 2010 included age-specific information for mortality rates and prevalence of 1160 sequelae, and disability weights associated with 220 distinct health states relating to these sequelae. We computed estimates of average overall health for each age group, adjusting for comorbidity with a Monte Carlo simulation method to capture how multiple morbidities can combine in an individual. We incorporated these estimates in the life table by the Sullivan method to produce HALE estimates for each population defined by sex, country, and year. We estimated the contributions of changes in child mortality, adult mortality, and disability to overall change in population health between 1990 and 2010. FINDINGS In 2010, global male HALE at birth was 58·3 years (uncertainty interval 56·7-59·8) and global female HALE at birth was 61·8 years (60·1-63·4). HALE increased more slowly than did life expectancy over the past 20 years, with each 1-year increase in life expectancy at birth associated with a 0·8-year increase in HALE. Across countries in 2010, male HALE at birth ranged from 27·9 years (17·3-36·5) in Haiti, to 68·8 years (67·0-70·4) in Japan. Female HALE at birth ranged from 37·1 years (26·9-43·7) in Haiti, to 71·7 years (69·7-73·4) in Japan. Between 1990 and 2010, male HALE increased by 5 years or more in 42 countries compared with 37 countries for female HALE, while male HALE decreased in 21 countries and 11 for female HALE. Between countries and over time, life expectancy was strongly and positively related to number of years lost to disability. This relation was consistent between sexes, in cross-sectional and longitudinal analysis, and when assessed at birth, or at age 50 years. Changes in disability had small effects on changes in HALE compared with changes in mortality. INTERPRETATION HALE differs substantially between countries. As life expectancy has increased, the number of healthy years lost to disability has also increased in most countries, consistent with the expansion of morbidity hypothesis, which has implications for health planning and health-care expenditure. Compared with substantial progress in reduction of mortality over the past two decades, relatively little progress has been made in reduction of the overall effect of non-fatal disease and injury on population health. HALE is an attractive indicator for monitoring health post-2015. FUNDING The Bill & Melinda Gates Foundation.
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Affiliation(s)
- Joshua A Salomon
- Harvard School of Public Health, Harvard University, Boston, MA 02115, USA.
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Abstract
The implications of the imminent surge in population ageing for the work of health care services in high-income countries remain unclear. It is widely expected, however, that the prevention and management of chronic disease will increasingly dominate their workload, and that this is likely to require a major shift in the way that care is delivered. This paper argues that the central contribution of health care services to a healthy ageing strategy is to drive improvements in the prevention and management of chronic disease, and it explores some of the implications of this view in the light of evidence mainly from the UK.
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Abstract
Decisions around retirement and continued labor market participation are of great significance for those who make them, as well as policy makers, researchers, welfare states, and pension programs. The literature acknowledges the multifaceted nature of these choices and particularly the interaction of key variables—job satisfaction, financial status, caring responsibilities, spouse’s plans, and health. This article explores this latter factor, challenging assumptions that it can be treated as an unproblematic independent variable. Analyzing qualitative data from interviews with 96 people approaching or in the midst of retirement, the subjective experience of health and its effect on decisions was strongly evident. The socialized context—as shaped at societal, organizational, household, and individual-life-historical levels—was crucial in understanding how similar symptoms of morbidity resulted in widely varying decisions/outcomes. Direct interpersonal experiences, shaped by social structures, were useful in explaining the prevalence of health pessimism, despite general increases in life expectancy.
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Abstract
Substantial growth of the population aged 90 years or over has focused interest on trends in the functioning and disability of the oldest old, but research findings are scarce and they vary. In the Vitality 90+ Study, we evaluated overall, gender-specific, and age-specific trends in disability among total cohorts of people aged 90 years or older in the city of Tampere, Finland, in the years 2001, 2003, and 2007. The size of the target population ranged from 1113 to 1146 and the participation rate from 79 to 86%. The participants were asked whether they were able to get in and out of bed, dress and undress, move about indoors, walk 400 m, and use stairs. Independence was defined as being able to perform an activity without help. The aggregate outcome measures included independence in all five activities, dependence in one to four activities, dependence in all five activities (severe dependence), and a disability score. In analyses taking into account the within subject associations which resulted due to those who participated in several years, and proxy respondents, no overall or gender-specific trend was found in any of the independence or dependence estimates. In each year, independence decreased clearly by increasing age. Our results imply stable disability levels in nonagenarians in a population with increasing life expectancy and improving survival until the age of 90. Longer-time series are needed to confirm the trends.
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26
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Robine JM, Cheung SLK, Saito Y, Jeune B, Parker MG, Herrmann FR. Centenarians Today: New Insights on Selection from the 5-COOP Study. Curr Gerontol Geriatr Res 2011; 2010:120354. [PMID: 21423541 PMCID: PMC3056212 DOI: 10.1155/2010/120354] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Accepted: 12/31/2010] [Indexed: 11/18/2022] Open
Abstract
The number of oldest old grew tremendously over the past few decades. However, recent studies have disclosed that the pace of increase strongly varies among countries. The present study aims to specify the level of mortality selection among the nonagenarians and centenarians living currently in five low mortality countries, Denmark, France, Japan, Switzerland, and Sweden, part of the 5-Country Oldest Old Project (5-COOP). All data come from the Human Mortality Database, except for the number of centenarians living in Japan. We disclosed three levels of mortality selection, a milder level in Japan, a stronger level in Denmark and Sweden and an intermediary level in France and Switzerland. These divergences offer an opportunity to study the existence of a trade-off between the level of mortality selection and the functional health status of the oldest old survivors which will be seized by the 5-COOP project.
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Affiliation(s)
- Jean-Marie Robine
- National Institute on Health and Medical Research, INSERM, 75654 Paris, France
| | - Siu Lan Karen Cheung
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Yasuhiko Saito
- Nihon University Advanced Research Institute for the Sciences and Humanities, Tokyo 102-8251, Japan
| | - Bernard Jeune
- Danish Aging Research Center, Institute of Public Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Marti G. Parker
- Aging Research Center, Karolinska Institute, Stockholm University, 113 30 Stockholm, Sweden
| | - François R. Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, 1226 Thônex Geneva, Switzerland
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Abstract
Although Hong Kong has one of the best life expectancy (LE) records in the world, second only to Japan for women, we know very little about the changes in the health status of the older adult population. Our article aims to provide a better understanding of trends in both chronic morbidity and disability for older men and women. The authors compute chronic morbidity-free and disability-free life expectancy and the proportion of both in relation to total LE using the Sullivan method to examine whether Hong Kong older adults are experiencing a compression of morbidity and disability and whether there is any gender difference in relation to mortality and morbidity. The results of this study show that Hong Kong women tend to outlive Hong Kong men but are also more likely to suffer from a ‘double disadvantage’, namely more years of life with more chronic morbidity and disability. There has also been a significant expansion of chronic morbidity, as chronic morbidity-free life expectancy (CMFLE) decreased substantially for both genders from 1996 to 2008. Although disability-free life expectancy (DFLE) increased during this period, it increased at a slower pace compared to LE. The proportion of life without chronic morbidity also declined remarkably during these 12 years. Among the advanced ages, the proportion of remaining life in good health without disability has decreased since 1996, indicating a relative expansion of disability.
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Affiliation(s)
- Karen Siu Lan Cheung
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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