Dataset Information

The rise of mortality from mental and neurological diseases in Europe, 1979-2009: observational study.

ABSTRACT:

Background

We studied recent trends in mortality from seven mental and neurological conditions and their determinants in 41 European countries.

Methods

Age-standardized mortality rates were analysed using standard methods of descriptive epidemiology, and were related to cultural, economic and health care indicators using regression analysis.

Results

Rising mortality from mental and neurological conditions is seen in most European countries, and is mainly due to rising mortality from dementias. Mortality from psychoactive substance use and Parkinson's disease has also risen in several countries. Mortality from dementias has risen particularly strongly in Finland, Iceland, Malta, Netherlands, Spain, Sweden and the United Kingdom, and is positively associated with self-expression values, average income, health care expenditure and life expectancy, but only the first has an independent effect.

Conclusions

Although trends in mortality from dementias have probably been affected by changes in cause-of-death classification, the high level of mortality from these conditions in a number of vanguard countries suggests that it is now among the most frequent causes of death in high-income countries. Recognition of dementias as a cause of death, and/or refraining from life-saving treatment for patients with dementia, appear to be strongly dependent on cultural values.

SUBMITTER: Mackenbach JP

PROVIDER: S-EPMC4139616 | biostudies-literature | 2014 Aug

REPOSITORIES: biostudies-literature

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Publications

The rise of mortality from mental and neurological diseases in Europe, 1979-2009: observational study.

Mackenbach Johan P JP Karanikolos Marina M Looman Caspar W N CW

BMC public health 20140813

<h4>Background</h4>We studied recent trends in mortality from seven mental and neurological conditions and their determinants in 41 European countries.<h4>Methods</h4>Age-standardized mortality rates were analysed using standard methods of descriptive epidemiology, and were related to cultural, economic and health care indicators using regression analysis.<h4>Results</h4>Rising mortality from mental and neurological conditions is seen in most European countries, and is mainly due to rising morta ...[more]

PMID: 25118099

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Project description:BackgroundThe Correa's cascade, encompassing chronic non-atrophic gastritis, atrophic gastritis, intestinal metaplasia, and dysplasia, represents the well-recognized pathway for the development of non-cardia gastric cancer. Population-based studies on all-cause and cause-specific mortalities among patients with gastric lesions in Correa's cascade are scarce.MethodsWe compiled a cohort of 340 744 eligible patients who had undergone endoscopy with biopsy for non-malignant indications during the period 1979-2011, which was followed up until 2014. Standardized mortality ratios (SMRs) with 95% confidence intervals (CIs) provided estimation of the relative risk, using the general Swedish population as reference. Cox regression model was used to estimate hazard ratios (HRs) of death for internal comparison.ResultsA total of 306 117 patients were included in the final analysis, accumulating 3,049,009 person-years of follow-up. In total 106,625 deaths were observed during the study period. Compared to the general population, excess risks of overall mortality were noted in all subgroups, with SMRs ranging from 1.11 (95% CI 1.08-1.14) for the normal mucosa group to 1.54 (95% CI 1.46-1.62) for the dysplasia group. For cause-specific mortalities, mortality from gastric cancer gradually increased along Correa's cascade, with excess risk rising from 105% for patients with chronic gastritis to more than 600% for the dysplasia group. These results were confirmed in the comparison with the normal mucosa group. For non-cancer conditions, increased death risks were noted for various diseases compared to the general population, especially among patients with more severe gastric precancerous lesions. But the results were confirmed only for "infectious diseases and parasitic diseases", "respiratory system diseases", and "digestive system disease", when using the normal mucosa group as reference.ConclusionsIncreased mortality from gastric cancer suggests that early recognition and intervention of gastric precancerous lesions probably benefit the patients. Excess mortality due to non-cancer conditions should be interpreted with caution, and future studies are warranted.

Dataset Information

The rise of mortality from mental and neurological diseases in Europe, 1979-2009: observational study.

Background

Methods

Results

Conclusions

Publications

The rise of mortality from mental and neurological diseases in Europe, 1979-2009: observational study.

Similar Datasets

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