Observations on recent increase in mortality from asthma.

The mortality attributed to asthma has increased annually in England and Wales from 1960 to 1965. The increase is more pronounced at ages 5 to 34 years than at older ages and is most pronounced at ages 10 to 14 years. In this last age group the mortality increased nearly eight times in seven years, and in 1966 asthma accounted for 7% of all deaths. No comparable increase has been observed in any other country, but smaller increases at ages 10 to 19 years have been observed in Australasia, Japan, western Europe, and the United States. There is no evidence to suggest that there has been any change in diagnostic habits, certification of deaths, or methods of classification which could account for the increase in Great Britain, and it is concluded that the increase is real. General practitioners'' records provide no evidence of an increase in prevalence and it seems probable that there has been an increase in case fatality. No environmental hazards are known which could have increased the severity of the disease, and the possibility has to be considered that the increase may be due to new methods of treatment. Corticosteroids have been used increasingly since 1952, and in Great Britain the use of pressurized aerosols containing sympathomimetics has increased rapidly since 1960.     

A Model for Antagonistic Pleiotropic Gene Action for Mortality and Advanced Age

Association or linkage studies involving control and long-lived populations provide information on genes that influence longevity. However, the relationship between allele-specific differences in survival and the genetic structure of aging cohorts remains unclear. We model a heterogeneous cohort comprising several genotypes differing in age-specific mortality. In its most general form, without any specific assumption regarding the shape of mortality curves, the model permits derivation of a fundamental property underlying abrupt age-related changes in the composition of a cohort. The model is applied to sex-specific survival curves taken from period life tables, and Gompertz-Makeham mortality coefficients are calculated for the French population. Then, adjustments are performed under Gompertz-Makeham mortality functions for three genotypes composing a heterogeneous cohort, under the constraint of fitting the resultant mortality to the real French population mortality obtained from life tables. Multimodal curves and divergence after the 8th decade appear as recurrent features of the frequency trajectories. Finally, a fit to data previously obtained at the angiotensin-converting-enzyme locus is realized, explaining what had seemed to be paradoxical results-namely, that the frequency of a genotype known as a cardiovascular risk factor was increased in centenarians. Our results help explain the well-documented departure from Gompertz-Makeham mortality kinetics at older ages. The implications of our model are discussed in the context of known genetic effects on human longevity and age-related pathologies. Since antagonistic pleiotropy between early and late survival emerges as a general rule, extrapolating the effects measured for a gene in a particular age class to other ages could be misleading.     

Evidence of sex-linked effects on the inheritance of human longevity: a population-based study in the Valserine valley (French Jura), 18-20th centuries

A long-standing puzzle in gerontology is the sex dependence of human longevity and its inheritance. We have analysed the sex-linked pattern of inheritance of longevity from 643 nuclear families on the historical population register of a French valley. We have focused on mean conditional life expectancy at a minimum age of 50 years, thus, in the present study, longevity refers to late or post-reproductive survival. A comparison of parents' and offspring's longevity has shown the existence of a heritable component of late survival in this population. We have found that the heritable component was substantially larger for daughters compared to sons. Moreover, this result appeared to be specific to late survival, that is, when only post-reproductive mortality for parental and offspring generations is taken into account. The stronger resemblance of parents to their daughters was no longer observed when considering younger ages at death for the offspring. This observation explains the hitherto unaccountable diversity of data in previous studies.     

Septic Shock in Advanced Age: Transcriptome Analysis Reveals Altered Molecular Signatures in Neutrophil Granulocytes

Sepsis is one of the highest causes of mortality in hospitalized people and a common complication in both surgical and clinical patients admitted to hospital for non-infectious reasons. Sepsis is especially common in older people and its incidence is likely to increase substantially as a population ages. Despite its increased prevalence and mortality in older people, immune responses in the elderly during septic shock appear similar to that in younger patients. The purpose of this study was to conduct a genome-wide gene expression analysis of circulating neutrophils from old and young septic patients to better understand how aged individuals respond to severe infectious insult. We detected several genes whose expression could be used to differentiate immune responses of the elderly from those of young people, including genes related to oxidative phosphorylation, mitochondrial dysfunction and TGF-β signaling, among others. Our results identify major molecular pathways that are particularly affected in the elderly during sepsis, which might have a pivotal role in worsening clinical outcomes compared with young people with sepsis.     

Effects of fish age and parasite dose on the development of whirling disease in rainbow trout

We determined the ages at which juvenile rainbow trout Oncorhynchus mykiss became resistant to the effects of whirling disease following exposure to a range of parasite doses. Heretofore, the development and severity of whirling disease in salmonids was known to be generally dependent on the age or size of fish when first exposed to the triactinomyxon spores of Myxobolus cerebralis; larger, older individuals tended to be less diseased. However, no systematic determination had been made of the exact age at which fish become resistant to the development of the disease. We exposed rainbow trout at 9 ages (1 to 17 wk post-hatch) to 4 parasite dose levels (0, 100, 1000 and 10,000 triactinomyxons per fish). Disease severity was measured using mortality, clinical signs, microscopic pathology, and myxospore counts. Disease and mortality were substantially reduced when exposure to the parasite occurred for the first time at 9 wk post-hatch (756 degree-days at 12 degrees C) or older. High doses elicited more disease among the younger age groups, but the effect was dampened in groups exposed at about 9 to 11 wk post-hatch and absent thereafter. Rainbow trout reared in M. cerebralis-free waters for 9 wk post-hatch or longer, whether in the wild or in a hatchery situation, should experience greater survival and less disease than fish first exposed to the parasite at younger ages.     

A divergent pattern of the sex difference in life expectancy: Sweden and Japan, early 1970s-late 1990s

For most of the 20th century the sex gap in life expectancy in the industrialized countries has widened in favor of women. By the early 1980s a reversal in the long-term pattern of this differential had occurred in some countries, where it reached a maximum and thereafter followed a declining trend. Of particular interest to the present investigation is the anomalous experience of Japan, where unlike other high-income countries the female advantage in life expectancy has been expanding. We contrast the case of Japan with that of Sweden, where, like many other high-income nations, the sex differential in longevity has been narrowing in recent years. We observe that in Sweden, until the early 1980s, the sex gap in life expectancy (female-male) exceeded that of Japan; but this situation reversed in subsequent periods, when the Swedish differential narrowed and that of Japan widened. A decomposition analysis indicates that these divergent patterns since 1980 have resulted mainly from larger than expected reductions in male mortality in Sweden due to heart disease and from accidents and violence, lung cancer and "other" cancers. In Japan, death rates for men and women from heart disease--which is a leading cause of death--have tended to decline more or less at the same pace since the early 1980s; and with regard to lung cancer, and "other" neoplasms, male death rates in Japan have been rising while those of women have either declined or risen more slowly. Moreover, during the 1990s, male and female suicide rates rose in Japan, but the rates for men went up faster. Altogether, the net effect of these divergent mortality trends for men and women in Japan underlie much of the observed widening of its sex differential in longevity in recent years.     

Four Decades of Educational Inequalities in Hospitalization and Mortality among Older Swedes

Background

The inverse association between education and mortality has grown stronger the last decades in many countries. During the same period, gains in life expectancy have been concentrated to older ages; still, old-age mortality is seldom the focus of attention when analyzing trends in the education-mortality gradient. It is further unknown if increased educational inequalities in mortality are preceded by increased inequalities in morbidity of which hospitalization may be a proxy.

Methods

Using administrative population registers from 1971 and onwards, education-specific annual changes in the risk of death and hospital admission were estimated with complimentary log-log models. These risk changes were supplemented by estimations of the ages at which 25, 50, and 75% of the population had been hospitalized or died (after age 60).

Results

The mortality decline among older people increasingly benefitted the well-educated over the less well-educated. This inequality increase was larger for the younger old, and among men. Educational inequalities in the age of a first hospital admission generally followed the development of growing gaps, but at a slower pace than mortality and inequalities did not increase among the oldest individuals.

Conclusions

Education continues to be a significant predictor of health and longevity into old age. That the increase in educational inequalities is greater for mortality than for hospital admissions (our proxy of overall morbidity) may reflect that well-educated individuals gradually have obtained more possibilities or resources to survive a disease than less well-educated individuals have the last four decades.     

Elderly and humor: a review

Ageing can be associated with physical, cognitive and/or social loss. Most older people, however, cope well with this loss, perhaps by using humour. In this review the research findings concerning humour were collected. Twenty six relevant publications were found. The sense of humour does not seem to be greater in older than in younger adults. There are no indications that humour appreciation or production is associated with longevity. In older people there is a correlation between humour on the one hand and well-being and morale on the other. It has not been proven, however, that the use of humour by the elderly people has a favourable influence on their health. In health care for older people humour is sometimes used as a therapy. Scientific evidence of any positive effects of humour on mental health was not found. It is perhaps better for caretakers to show appreciation for the humour of older people than to make jokes about older people oneself.     

Intergenerational and Genealogical Approaches for the Study of Longevity in the Saguenay-Lac-St-Jean Population

The mechanisms of longevity have been the subject of investigations for a number of years. Although the role of genetic factors is generally acknowledged, important questions persist regarding the relative impact of environmental exposures, lifestyle characteristics, and genes. The BALSAC population register offers a unique opportunity to study longevity from an intergenerational and genealogical point of view. Individuals from the Saguenay-Lac-St-Jean population who died at age 90 or older between 1950 and 1974 were selected from this database (n?=?576), along with a control group of individuals born in the same period who died between 50 and 75 years of age. For these subjects and controls, spouses’ ages at death and parental ages at death and at their birth were investigated using regression analysis. Genealogical reconstructions were carried out for each individual, and various analyses were performed on both groups. Both fathers’ and mothers’ mean ages at death were significantly higher among the longer-lived cases than among controls whereas spouses’ ages at death and parental ages at birth had no effect. Regression analysis confirmed the positive effect of both fathers’ and mothers’ age at death. Mean kinship coefficients for the parents’ generations displayed significant differences, indicating that kinship was higher among subjects than controls (this effect was stronger among the oldest 10% of the subjects). Frequencies and genetic contributions of ancestors were very similar for the two groups, and none of these ancestors appeared more likely to have introduced genetic variants involved in longevity patterns in this French Canadian population.     

Cardiovascular disease mortality in Canada.

During the past two decades approximately one half of all deaths in Canada were due to cardiovascular diseases. Ischemic heart disease and cerebrovascular disease caused more than 60% and 20% of those deaths respectively. The mortality rates for ischemic heart disease in males increased slightly until 1965 and then dropped substantially, whereas the rates for females, which were declining at least since the early 1960s, accelerated in their decline. As a consequence, the rates for males remain almost twice as high as those for females. The reductions were initially observed in males 25 to 34 years old and in all age groups of females, but became apparent in a wider range of ages in the second period reviewed (1969 through 1977). The mortality of cerebrovascular disease has gradually diminished for both sexes since the 1950s, but the decline has been more pronounced among females, who originally had the higher rate. Marked geographic differences in mortality rates still exist in Canada despite the decline in death rates for both ischemic heart disease and cerebrovascular disease in all regions of the country. Surprising regional differences in times of onset of these declines have been demonstrated. For ischemic heart disease Ontario maintains the highest and the Prairies the lowest mortality rates. Quebec, despite a sustained decline, still ranks third, while the Pacific region shows the second-lowest rates in the country. The Atlantic region showed the lowest rates of decline in the period reviewed. The reduction in the mortality of ischemic heart disease in Canada (16.4% between 1969 and 1977) must be considered real for a variety of reasons. Direct evidence is not available to elucidate whether the reduction is the consequence of reduced incidence, increased survival or a combination of the two factors. The potential role of various factors that may have contributed to this decline is briefly discussed in this article.     

Aging, disability, and frailty: implications for universal design

Throughout the world all populations are seeing burgeoning numbers of "elders", defined as persons aged 65 year and older. In many countries, including Japan, the United States, Norway, Sweden and the United Kingdom, those aged over 65 are at or approaching 15% of the population. As their numbers have increased, so have their health care expenses, leading to extensive research on the health, well being, and life expectancy of these increasingly older elders. Today this group is further sub-divided: the young-old ages 65-74, the old-old ages 75-84, and the oldest-old ages 85+, for both health care and research purposes. However broad variation still characterizes even these groupings. Rates of frailty and disability increase with increasing age among these elders. For example, inabilities to complete at least one activity of daily living increased from about 5-7% at ages 65-69 years to about 28-36% at ages 85+ in 1987. Death rates continue to decline at all ages past 50 years and rates of disability seem to be doing the same. For the foreseeable future, we may expect increasing numbers of older, frail elders than in previous decades. Thus, people are not only living longer, they generally are healthier at advanced ages than were previous cohorts, thus "old age" disabilities of the 20th century will be put off to even older ages during the 21st century. As yet there is no clear way to assess senescent changes in humans, although activities of daily living, allostatic load, and frailty indices have all been suggested. One future need is greater development and use of universal and accessible design in all aspects of the built environment.     

Causes of death which contribute to the mortality crossover effect

Abstract

Death rates vary over the life cycle in a standard fashion, with mortality probabilities being highest at infant and older ages. Nevertheless, when age curves of mortality are compared for different populations, they sometimes can be seen to intersect so that one population has higher death rates at younger and middle ages and lower rates at older ages. Past research has shown that this phenomenon is not due to erroneous data and is probably a result of some type of selection in survival patterns. A sample of pairs of mortality curves, 31 of which cross over and 31 of which do not, for combinations of countries and dates are analyzed to discover which causes of death are associated with the crossover phenomenon at the older ages. Cardiovascular and “other and unknown” diseases appear to contribute strongly to the crossover effect. Further research should deal with other comparisons and explore the underlying social and environmental factors.     

Langer leven, langer werken?De rol van gepercipieerde levensverwachting in het uittredeproces

Virtually all Western countries are seeking to bring retirement ages more in line with increases in longevity. The central question in this paper is whether individuals choose a retirement age that fits their life expectancy. This would be ideal from a public policy perspective. The present study aims to test empirically whether retirement planning varies with expectations of survival among a sample of older employees in the Netherlands. Two questions are addressed: (1) What are older employees' expectations of their remaining lifetime, and what factors influence this subjective life expectancy? (2) Are individuals who perceive longer life horizons (high subjective life expectancy) more inclined to retire later than people who expect to live shorter? Using data from a panel study on retirement behaviour in the Netherlands (N=1621 older employees aged 50-60), regression and survival models are estimated to examine the effect of subjective life expectancy on retirement planning and behaviour. The results indicate that subjective life expectancy is a factor that is taken into account in retirement decision making, at least as far as retirement intentions are concerned. Older employees with longer time horizons have a preference for later retirement. When it comes to actual behaviour, however, time horizon does not appear to play a role. The results suggest that particularly employees with a high perceived life expectancy and an intention to work longer do not succeed in carrying their intentions into effect.     

The many states of aging: a meeting and some demographic aspects

With an expectation of life at birth of 27 years in the middle of the 18th century, 21% of males reached their 60th birthday with a remaining expectation of life of 12 years. Under the conditions of mortality of 1950, in France, 70 percent could celebrate their 60th birthday, and they had still 15 years (only) to live on the average. This last figure started increasing after 1950: the expectancy of life at age 60 is now over 20 years, and it will exceed 25 years around 2050 (for women, the mean will be 31 years). Longevity is an individual capacity. It is now increasing fast, and becomes more and more responsible for the ageing of the population (the rise in the proportion of older persons in the population). We now try to forecast the number of centenarians, and even of super-centenarians (aged 110 years and more), and speculate about the maximum life span. We are in fact entering an entirely new era, when three, four, even five generations can survive simultaneously. Are we prepared to it? The French Ministers for Research and for Social affairs set up a Committee of 15 members (chaired by Henri Leridon) to prepare a National Meeting of Researchers on Ageing, in order to review the situation of research in France on this issue and to make proposals for organising and orienting new studies. The life span of human species, as well as the one of individuals, is undoubtedly depending upon genetic factors. But interactions with environmental factors and with behaviour also play a major role. To be able to disentangle these complex associations, it will be necessary to combine the work of biologists, clinicians and social sciences specialists. The main conclusions of the June 2001 meeting are reported here, together with some orientations of demographic research on mortality at oldest ages and the limits of longevity.     

A long-term study of Short-tailed Shearwaters Puffinus tenuirostris on Fisher Island, Australia

All 100–200 Short-tailed Shearwaters Puffinus tenuirostris breeding on Fisher Island, in Bass Strait, Australia, have been individually marked and their breeding performance monitored in each year since 1947. This long study has revealed that mortality rates are greater in older shearwaters and that reproductive performance varies with age, breeding experience and mate familiarity in complex ways. A single study population proved inadequate, however, for estimating pre-breeding survival rates, recruitment rates, emigration and immigration.     

Helicobacter pylori and gastric cancer

Gastric cancer is a worldwide cancer especially frequent in Japan and South America. This cancer affects 10 to 70 people per 100,000 according to the countries. Since the end of the Second World War, the incidence of gastric cancer has been decreasing in France and accounts for less than 10 % of mortality. Helicobacter pylori infection, host genetic background, food regimen are known to be involved in this cancer. Helicobacter pylori should be eradicated in selected patients, such as patients' relatives with documented gastric cancer as well as patients having another gastrointestinal cancer.     

Aging, cancer, and cancer vaccines

ABSTRACT: World population has experienced continuous growth since 1400 A.D. Current projections show a continued increase - but a steady decline in the population growth rate - with the number expected to reach between 8 and 10.5 billion people within 40 years. The elderly population is rapidly rising: in 1950 there were 205 million people aged 60 or older, while in 2000 there were 606 million. By 2050, the global population aged 60 or over is projected to expand by more than three times, reaching nearly 2 billion people 1. Most cancers are age-related diseases: in the US, 50% of all malignancies occur in people aged 65-95. 60% of all cancers are expected to be diagnosed in elderly patients by 2020 2. Further, cancer-related mortality increases with age: 70% of all malignancy-related deaths are registered in people aged 65 years or older 3. Here we introduce the microscopic aspects of aging, the pro-inflammatory phenotype of the elderly, and the changes related to immunosenescence. Then we deal with cancer disease and its development, the difficulty of treatment administration in the geriatric population, and the importance of a comprehensive geriatric assessment. Finally, we aim to analyze the complex interactions of aging with cancer and cancer vaccinology, and the importance of this last approach as a complementary therapy to different levels of prevention and treatment. Cancer vaccines, in fact, should at present be recommended in association to a stronger cancer prevention and conventional therapies (surgery, chemotherapy, radiation therapy), both for curative and palliative intent, in order to reduce morbidity and mortality associated to cancer progression.     

Reproductive mortality.

The transfer from traditional to modern methods of contraception in recent decades has been accompanied by a transfer of deaths from complications of pregnancy to deaths from complications of the modern contraceptive methods. In 1975, for example, it is estimated that there were more deaths at ages 25-44 years in England and Wales from adverse effects of oral contraceptive use than from all complications of pregnancy, delivery, and the puerperium combined. Thus maternal mortality is no longer an adequate indicator of the deaths associated with reproduction in the community. An alternative measure, the reproductive mortality rate should be used, which includes deaths from complications of contraceptive use as well as those from complications of pregnancy or abortion. The reproductive mortality rate in England and Wales seems to have declined continuously since 1950 for women aged 25-34. But after 1960 it increased for women aged 35-44, because of the higher mortality associated with oral contraceptive use in this age group.     

Causes of death and mortality crossovers by race

Abstract

The phenomenon of “mortality crossovers,” the intersection of age curves of mortality at older ages, has been observed in comparisons of various populations for some time. Some researchers have argued that crossovers are an artifact of deficient reporting of age that is greater for some populations than others. Other researchers attribute crossovers to selective processes by age that vary by group. We use mortality data from the National Center for Health Statistics for the U.S. at ages 55 and over, supplemented by comparable data from matched records of the National Health Interview Survey and National Death Index, to reexamine causes of death linked to mortality crossovers for Whites and Blacks in the U.S. Findings portray a more elaborate set of influences of causes of death than has been discovered heretofore; however, the major finding is that the mortality crossover for Whites and Blacks in the U. S. is real and, although observed for several causes of death, operates principally through varying trajectories of heart disease mortality.