scholarly journals Increasing global heterogeneity in the life expectancy of older populations

2019 ◽  
Author(s):  
William Joe ◽  
Lathan Liou ◽  
S V Subramanian

ABSTRACTWith overall global improvements in life expectancy, one important concern is whether there is cross-country convergence in life expectancy at various ages. Insights in convergence patterns can help realign research priorities help governments better structure health investments across various age groups. We reveal global patterns in life expectancy improvements and identify convergent clubs in life expectancy at various ages for 201 countries / areas between 1950 and 2015. In the case of life expectancy at younger ages, most countries are moving in the same direction, but we observe significant cross-country variation for older adults and the elderly. Further, we observe increasing variance in life expectancy for older adults and elderly across countries. Increasing global heterogeneity in survival experience of older adults and the elderly population thus has remained a neglected aspect in the discussions on global life expectancy improvements. Data, research and policy focus beyond life-expectancy at birth is therefore critical to accelerate survival gains among older adults and elderly, particularly from the developing world.

2021 ◽  
Vol 15 (4) ◽  
pp. e0009312
Author(s):  
Yi-Hua Pan ◽  
Mei-Ying Liao ◽  
Yu-Wen Chien ◽  
Tzong-Shiann Ho ◽  
Hui-Ying Ko ◽  
...  

A shift in dengue cases toward the adult population, accompanied by an increased risk of severe cases of dengue in the elderly, has created an important emerging issue in the past decade. To understand the level of past DENV infection among older adults after a large dengue outbreak occurred in southern Taiwan in 2015, we screened 1498 and 2603 serum samples from healthy residents aged ≥ 40 years in Kaohsiung City and Tainan City, respectively, to assess the seroprevalence of anti-DENV IgG in 2016. Seropositive samples were verified to exclude cross-reaction from Japanese encephalitis virus (JEV), using DENV/JEV-NS1 indirect IgG ELISA. We further identified viral serotypes and secondary DENV infections among positive samples in the two cities. The overall age-standardized seroprevalence of DENV-IgG among participants was 25.77% in Kaohsiung and 11.40% in Tainan, and the seroprevalence was significantly higher in older age groups of both cities. Although the percentages of secondary DENV infection in Kaohsiung and Tainan were very similar (43.09% and 44.76%, respectively), DENV-1 and DENV-2 spanned a wider age range in Kaohsiung, whereas DENV-2 was dominant in Tainan. As very few studies have obtained the serostatus of DENV infection in older adults and the elderly, this study highlights the need for further investigation into antibody status, as well as the safety and efficacy of dengue vaccination in these older populations.


2020 ◽  
pp. 9-25
Author(s):  
Wiktoria Wróblewska

Since the 1990s, life expectancy at birth in Poland has increased by over three months on average each year for both sexes. However, in recent years there has been a decrease in life expectancy, and the number of deaths increased by 6% for men and 8% for women between 2016 and 2018. The aim of this study is to identify the subpopulations most sensitive to the recent changes in mortality in Poland. The increase in deaths is described with regard to changes in age distribution of the population and age at death contributing to life expectancy changes in recent years is analysed. The findings serve as a basis for making references to theoretical knowledge and proposals for future research directions as well as recommendations for public statistics and social policy. The increase in the number of deaths is a new phenomenon that cannot be accounted for by the size differences between the cohorts born between the two world wars and during the Second World War or the ageing of the baby-boom generations. The greatest contributors to the decreasing life expectancy are deaths at older age. This and the fast growing population aged 85 years and more indicate a need to devote more research attention to analysing mortality in the oldest age groups. It is also emphasised that the elderly are potentially the most prone to various threats associated with an excessive number of deaths, including inadequate health care funding.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Antje Nuthmann ◽  
Immo Schütz ◽  
Wolfgang Einhäuser

AbstractWhether fixation selection in real-world scenes is guided by image salience or by objects has been a matter of scientific debate. To contrast the two views, we compared effects of location-based and object-based visual salience in young and older (65 + years) adults. Generalized linear mixed models were used to assess the unique contribution of salience to fixation selection in scenes. When analysing fixation guidance without recurrence to objects, visual salience predicted whether image patches were fixated or not. This effect was reduced for the elderly, replicating an earlier finding. When using objects as the unit of analysis, we found that highly salient objects were more frequently selected for fixation than objects with low visual salience. Interestingly, this effect was larger for older adults. We also analysed where viewers fixate within objects, once they are selected. A preferred viewing location close to the centre of the object was found for both age groups. The results support the view that objects are important units of saccadic selection. Reconciling the salience view with the object view, we suggest that visual salience contributes to prioritization among objects. Moreover, the data point towards an increasing relevance of object-bound information with increasing age.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
N Nante ◽  
L Kundisova ◽  
F Gori ◽  
A Martini ◽  
F Battisti ◽  
...  

Abstract Introduction Changing of life expectancy at birth (LE) over time reflects variations of mortality rates of a certain population. Italy is amongst the countries with the highest LE, Tuscany ranks fifth at the national level. The aim of the present work was to evaluate the impact of various causes of death in different age groups on the change in LE in the Tuscany region (Italy) during period 1987-2015. Material and methods Mortality data relative to residents that died during the period between 1987/1989 and 2013/2015 were provided by the Tuscan Regional Mortality Registry. The causes of death taken into consideration were cardiovascular (CVS), respiratory (RESP) and infective (INF) diseases and cancer (TUM). The decomposition of LE gain was realized with software Epidat, using the Pollard’s method. Results The overall LE gain during the period between two three-years periods was 6.7 years for males, with a major gain between 65-89, and 4.5 years for females, mainly improved between 75-89, <1 year for both sexes. The major gain (2.6 years) was attributable to the reduction of mortality for CVS, followed by TUM (1.76 in males and 0.83 in females) and RESP (0.4 in males; 0.1 in females). The major loss of years of LE was attributable to INF (-0.15 in females; -0.07 in males) and lung cancer in females (-0.13), for which the opposite result was observed for males (gain of 0.62 years of LE). Conclusions During the study period (1987-2015) the gain in LE was major for males. To the reduction of mortality for CVS have contributed to the tempestuous treatment of acute CVS events and secondary CVS prevention. For TUM the result is attributable to the adherence of population to oncologic screening programmes. The excess of mortality for INF that lead to the loss of LE can be attributed to the passage from ICD-9 to ICD-10 in 2003 (higher sensibility of ICD-10) and to the diffusion of multi-drug resistant bacteria, which lead to elevated mortality in these years. Key messages The gain in LE during the period the 1987-2015 was higher in males. The major contribution to gain in LE was due to a reduction of mortality for CVS diseases.


2020 ◽  
Author(s):  
Robin Hellerstedt ◽  
Arianna Moccia ◽  
Chloe M. Brunskill ◽  
Howard Bowman ◽  
Zara M. Bergström

AbstractERP-based forensic memory detection is based on the logic that guilty suspects will hold incriminating knowledge about crimes they have committed, and therefore should show parietal ERP positivities related to recognition when presented with reminders of their crimes. We predicted that such forensic memory detection might however be inaccurate in older adults, because of changes to recognition-related brain activity that occurs with aging. We measured both ERPs and EEG oscillations associated with episodic old/new recognition and forensic memory detection in 30 younger (age < 30) and 30 older (age > 65) adults. EEG oscillations were included as a complementary measure which is less sensitive to temporal variability and component overlap than ERPs. In line with predictions, recognition-related parietal ERP positivities were significantly reduced in the older compared to younger group in both tasks, despite highly similar behavioural performance. We also observed ageing-related reductions in oscillatory markers of recognition in the forensic memory detection test, while the oscillatory effects associated with episodic recognition were similar across age groups. This pattern of results suggests that while both forensic memory detection and episodic recognition are accompanied by ageing-induced reductions in parietal ERP positivities, these reductions may be caused by non-overlapping mechanisms across the two tasks. Our findings suggest that EEG-based forensic memory detection tests are invalid in older populations, limiting their practical applications.


Author(s):  
Saleh Habibi ◽  
Arefeh Babazadeh ◽  
Soheil Ebrahimpour ◽  
Parisa Sabbagh ◽  
Mehran Shokri

Abstract Morbidity and mortality are higher in older adults with community-acquired pneumonia (CAP) than in other age groups. Also, CAP in older adults has various clinical manifestations with other. A higher mortality rate in the elderly with CAP may contribute to a delay in management. Consequently, the purpose of this study was to investigate the clinical and laboratory manifestations of CAP in the elderly. This cross-sectional study was conducted on 221 elderly patients with CAP who were admitted to Ayatollah Rouhani Hospital, in Babol, northern of Iran, in 2017-2019. Patient outcomes included 170 cases that recovered from CAP, and 51 cases that died of complications. Patients were evaluated in terms of their clinical and laboratory manifestations. The most common symptoms of pneumonia were cough (79.6%), sputum (73.8%), weakness (72.9%), fever (56%), dyspnea (46.2%). The most frequent underlying disease was ischemic heart disease (43.9%). In our study, clinical and laboratory characteristics in older patients with CAP were evaluated and compared with other studies confirming past findings, but there were differences in some cases, such as vital signs, gastrointestinal symptoms, and disturbance of the level of consciousness. Therefore, it recommends carefully taking the patients’ initial histories and accurately recording their clinical and laboratory symptoms.


2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Jordi Perez-Panades ◽  
Paloma Botella-Rocamora ◽  
Miguel Angel Martinez-Beneito

Abstract Background Most epidemiological risk indicators strongly depend on the age composition of populations, which makes the direct comparison of raw (unstandardized) indicators misleading because of the different age structures of the spatial units of study. Age-standardized rates (ASR) are a common solution for overcoming this confusing effect. The main drawback of ASRs is that they depend on age-specific rates which, when working with small areas, are often based on very few, or no, observed cases for most age groups. A similar effect occurs with life expectancy at birth and many more epidemiological indicators, which makes standardized mortality ratios (SMR) the omnipresent risk indicator for small areas epidemiologic studies. Methods To deal with this issue, a multivariate smoothing model, the M-model, is proposed in order to fit the age-specific probabilities of death (PoDs) for each spatial unit, which assumes dependence between closer age groups and spatial units. This age–space dependence structure enables information to be transferred between neighboring consecutive age groups and neighboring areas, at the same time, providing more reliable age-specific PoDs estimates. Results Three case studies are presented to illustrate the wide range of applications that smoothed age specific PoDs have in practice . The first case study shows the application of the model to a geographical study of lung cancer mortality in women. This study illustrates the convenience of considering age–space interactions in geographical studies and to explore the different spatial risk patterns shown by the different age groups. Second, the model is also applied to the study of ischaemic heart disease mortality in women in two cities at the census tract level. Smoothed age-standardized rates are derived and compared for the census tracts of both cities, illustrating some advantages of this mortality indicator over traditional SMRs. In the latest case study, the model is applied to estimate smoothed life expectancy (LE), which is the most widely used synthetic indicator for characterizing overall mortality differences when (not so small) spatial units are considered. Conclusion Our age–space model is an appropriate and flexible proposal that provides more reliable estimates of the probabilities of death, which allow the calculation of enhanced epidemiological indicators (smoothed ASR, smoothed LE), thus providing alternatives to traditional SMR-based studies of small areas.


Author(s):  
Minsung Sohn ◽  
Xianhua Che ◽  
Sungwon Lim ◽  
Hee-Jung Park

The aim of this study was to measure the magnitude and distribution of a Korean’s lifetime dental expenses depending on age and sex, by constructing a hypothetical lifetime and life table of survival. Additionally, we estimated the difference in life expectancy between men and women and its impact on dental expenses. We used the 2015 Korea Health Panel Survey to calculate the total dental expenditure, including expenses paid directly by patients and those paid by insurers. We generated survival profiles to simulate dental expenses during a typical lifetime (from birth to age 95) using the abridged life table (five-year intervals for age groups) in 2015 from the South Korean Statistical Information Service. We independently calculated the remaining dental expenses for survivors of all ages. The results showed that an estimate of average lifetime dental expenditure was $31,851 per capita: $31,587 for men and $32,318 for women. Nearly 33% of the average per capita lifetime dental expenditure was attributable to the longer life expectancy of women, with no statistically significant difference in lifetime dental expenditure between men and women. Many survivors incurred 70% of their lifetime dental expenses before age 65. The results highlighted the need for policymakers to address spending on age-specific dental care owing to extended life expectancy, given the disproportionate share of healthcare resources supporting the elderly.


2018 ◽  
Vol 12 (1) ◽  
pp. 67-74
Author(s):  
Guillermo Sánchez ◽  
Diana Buitrago

Background: The clinical characteristics and physio-pathogenic mechanisms of asthma in patients older than 60 years appear to differ from the behavior described for other age groups. Therefore, the effectiveness of medications for elderly patients with asthma should not be extrapolated from studies conducted on teenagers or young adults. Objective: The study aimed to establish the clinical effect of montelukast 10 mg in elderly patients with mild and moderate asthma compared to its effect on young adults. Method: A prospective cohort study was conducted during 12 weeks of follow-up, which consecutively included the total population of adult patients attended by a group of 21 general practitioners, between July and December 2016. Young adults (18-59 years) and older adults were included (60 years or older) with mild or moderate asthma, which, according to the criteria of his treating physician, had been prescribed montelukast 10 mg/day. The variables of interest were: use of inhaled corticosteroids during the last month, use of inhaled beta-2 adrenergic agonists as a rescue in the last month, having attended the emergency service during the last month due to an asthma attack, presence of wheezing in the physical examination, the number of attacks in the last month and the number of days without symptoms in the last month. Results: A total of 126 patients entered the cohort and 104 completed the follow-up, of which 29% were older adults. On admission, 65.4% of patients (68/104) had used rescue inhaled beta2 in the last month and had been using schemes with corticosteroids. After 12 weeks of follow-up, 58.1% (43/74) of the young adults required treatment schedules with corticosteroids, while in the elderly, only 36.7% of the patients (11/30) required this treatment scheme (p-value: 0.047). Regarding the use of rescue inhaled beta-2 at 12 weeks, 55% of young adults reported using them, compared to 33.3% of older adults (p-value: 0.041). Conclusion: In this cohort of patients, treated with montelukast 10 mg/day for 12 weeks, there was a reduction of broncho-obstructive symptoms and exacerbations of the disease. In older adults compared to young adults, a greater reduction in the use of beta2 agonists rescue medications and in the concomitant use of inhaled corticosteroid schemes was documented.


2003 ◽  
Vol 88 (1) ◽  
pp. 185-191 ◽  
Author(s):  
Reinhold Vieth ◽  
Yasmin Ladak ◽  
Paul G. Walfish

Vitamin D requirements are thought to vary with age, but there is little comparative evidence for this. One goal in establishing a vitamin D requirement is to avoid secondary hyperparathyroidism. We studied 1741 euthyroid, thyroid clinic outpatients without evidence of calcium abnormalities, ranging in age from 19 to 97 yr, whose serum and urine had been analyzed for calcium, vitamin D, and parathyroid status. We found no effect of age on the 25-hydroxyvitamin D [25(OH)D] concentration associated with specific vitamin D intakes, and there was no relationship between 25(OH)D and 1,25hydroxyvitamin D [1,25(OH)2D]. In every age group, serum 1,25(OH)2D declined with increasing creatinine (P &lt; 0.001). What changed with age included creatinine, which correlated with 25(OH)D (r = 0.146, P &lt; 0.001) only in the youngest age group (19–50 yr) but not in the older age groups (P &gt; 0.1). Creatinine did not correlate with PTH in the youngest age group, but the relationship became significant as age increased (e.g. for the elderly, r = 0.365, P &lt; 0.001). Linear regression of log PTH vs. log 25(OH)D agreed with the natural shape of the relationship observed with scatterplot smoothing, and this showed no plateau in PTH as 25(OH)D increased. We compared PTH concentrations among age groups, based on 20 nmol/liter increments in 25(OH)D. Mean PTH in adults older than 70 yr was consistently higher than in adults younger than 50 yr (P &lt; 0.05 by ANOVA and Dunnett’s t test). PTH levels of the elderly who had 25(OH)D concentrations greater than 100 nmol/liter matched PTH of younger adults having 25(OH)D concentrations near 70 nmol/liter. This study shows that all age groups exhibit a high prevalence of 25(OH)D insufficiency and secondary hyperparathyroidism. Older adults are just as efficient in maintaining 25(OH)D, but they need more vitamin D to produce the higher 25(OH)D concentrations required to overcome the hyperparathyroidism associated with their diminishing renal function.


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