Dataset Information

Socioeconomic Status, Frailty, and All-Cause Mortality in Korean Older Adults: A 3-Year Population-Based Prospective Study.

ABSTRACT: Little is known regarding the effects of socioeconomic status (SES) and frailty on mortality in Korea.This study investigated the combined impact of low SES and frailty on all-cause mortality in Korean older adults.Study sample at baseline comprised 7,960 community-dwelling adults (56.8% women) aged 65 years and older. The Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of low SES and frailty for all-cause mortality.Overall, low SES plus frailty resulted in an increased risk of all-cause mortality (HR = 1.56, 95% CI = 1.09-2.23, P = 0.015) even after adjustments for all the measured covariates, as compared with high SES plus nonfrailty (HR = 1). Among older adults aged 65-75 years, the increased mortality risk of either low SES plus nonfrailty (HR = 1.37, 95% CI = 1.02-1.84, P = 0.038) or high SES plus frailty (HR = 2.09, 95% CI = 1.12-3.91, P = 0.021) remained significant even after adjustments for all the covariates, as compared with high SES plus nonfrailty (HR = 1).The current findings suggest that either low SES or frailty is significantly associated with increased all-cause mortality in Korean older adults.

SUBMITTER: Cho J

PROVIDER: S-EPMC5745684 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

Socioeconomic Status, Frailty, and All-Cause Mortality in Korean Older Adults: A 3-Year Population-Based Prospective Study.

Cho Jinkyung J Lee Inhwan I Park Soo Hyun SH Jin Youngyun Y Kim Donghyun D Kong Ji Young JY Kang Hyunsik H

BioMed research international 20171214

<h4>Background</h4>Little is known regarding the effects of socioeconomic status (SES) and frailty on mortality in Korea.<h4>Objective</h4>This study investigated the combined impact of low SES and frailty on all-cause mortality in Korean older adults.<h4>Methods</h4>Study sample at baseline comprised 7,960 community-dwelling adults (56.8% women) aged 65 years and older. The Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of low SES and ...[more]

PMID: 29387717

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Project description:BackgroundSleep duration and vegetable consumption are associated with mortality at old age (termed as sleep-mortality linkage and vegetable-mortality linkage, respectively). Yet, little is known about the interplay of sleep duration and vegetable consumption on mortality.MethodsA dataset of nationwide longitudinal survey with 13,441 participants aged 65 years or older recruited in 2008 and followed up till 2014 was used. Sleep duration was classified into five groups (≤5, 6, 7-8, 9, and ≥ 10 h/day). Vegetable consumption was classified as either high frequency (eating vegetables almost daily) or low frequency. We used parametric Weibull hazard regression models to estimate associations of sleep duration and frequency of vegetable consumption with mortality, adjusting for demographics, socioeconomic factors, family/social support, health practice, and health conditions.ResultsOver the six-year study period, when only demographics were present, participants sleeping ≤5, 6, 9, and ≥ 10 h/day had relative hazard (RH) of mortality 1.18 (p < 0.001), 1.14(p < 0.01), 1.06 (p > 0.1), and 1.30 (p < 0.001), respectively, compared to those sleeping 7-8 h/day. The HRs were attenuated to 1.08 (p < 0.05), 1.08 (p < 0.05), 1.09 (p < 0.1), 1.18(p < 0.001), respectively, when all other covariates were additionally adjusted for. High frequency of eating vegetables was associated with 22% lower risk of mortality (RH= 0.78, p < 0.001) compared to low frequency in the demographic model, and with 9% lower risk (RH = 0.91, p < 0.05) in the full model. Subpopulation and interaction analyses show that the sleeping-mortality linkage was stronger in female, urban, oldest-old (aged ≥80), and illiterate participants compared to their respective male, rural, young-old, and literate counterparts. High frequency of vegetable intakes could offset the higher mortality risk in participants with short-sleeping duration, but low frequency of eating vegetables could exacerbate mortality risk for participants with either short or long sleep duration; and except for few cases, these findings held in subpopulations.ConclusionsToo short and too long sleep durations were associated with higher mortality risk, and infrequent vegetable consumption could exacerbate the risk, although frequent vegetable intake could offset the risk for short sleep duration. The relationship between these two lifestyles and mortality was complex and varied among subpopulations.

Project description:BACKGROUND:Multimorbidity and frailty are relevant conditions among older adult population. There is growing evidence about their association with poor health outcomes like disability, worst quality of life, and death. Nonetheless, the independent associations of both conditions have been studied, and few evidence exists about an interaction between them. Our aims were to assess the association of frailty and multimorbidity with the disability, quality of life and all-cause mortality as well as to analyze a potential interaction between these conditions. METHODS:Analytical samples included 1410 respondents for disability and quality of life, and 1792 for mortality. We performed a longitudinal analysis with older Mexican adults aged 50, using data collected from the WHO's Study on global AGEing and Adult Health Waves 1 and 2. Disability was measured using the World Health Organization Disability Assessment Schedule (WHODAS 2.0), and quality of life using the WHOQOL (WHO Quality of Life) instrument. All-cause mortality was determined by reviewing death certificates. Associations of frailty and multimorbidity with disability, quality of life and mortality were estimated using linear regression and Cox proportional hazards models. RESULTS:Multimorbidity assessed through three patterns (cardiopulmonary, vascular-metabolic, and mental-musculoskeletal) was associated with the three outcomes in this study. Cardiopulmonary and mental-musculoskeletal patterns increased the WHODAS mean score (??=?5.05; p <?0.01 and ??=?5.10; p <?0.01, respectively) and decreased WHOQOL score (??=?-?1.81; p <?0.01 and ??=?-?2.99; p <?0.01, respectively). Vascular-metabolic was associated with mortality (HR?=?1.47; p =?0.04), disability (??=?3.27; p <?0.01) and quality of life (??=?-?1.30; p =?0.02). Frailty was associated with mortality (pre-frail: HR?=?1.48; p?=?0.02 and frail: HR?=?1.68; p =?0.03), disability (pre-frail: ??=?5.02; p <?0.01; frail: ??=?13.29; p <?0.01) and quality of life (pre-frail: ??=?-?2.23; p <?0.01; frail: ??=?-?4.38; p <?0.01). Interaction terms of frailty and multimorbidity were not statistically significant. CONCLUSIONS:Multimorbidity and frailty are important predictors of poor health outcomes. These results highlight the importance of carrying out health promotion and prevention actions as well as specific interventions aimed at older adults who suffer from multimorbidity and frailty, in such a way that deleterious effects on health can be avoided.

Project description:Bangladesh has achieved remarkable gains in health indicators during the last four decades despite low levels of economic development. However, the persistence of inequities remains disturbing. This success was also accompanied by health and demographic transitions, which in turn brings new challenges for a nation that has yet to come to terms with pre-transition health challenges. It is therefore important to understand the causes of death and their relationship with socioeconomic status (SES).The paper aims to assess the causes of death by SES based on surveillance data from a rural area of Bangladesh, in order to understand the situation and inform policy makers and programme leaders.We analysed population-based mortality data collected from the Chakaria Health and Demographic Surveillance System in Bangladesh. The causes of death were determined by using a Bayesian-based programme for interpreting verbal autopsy findings (InterVA-4). The data included 1,391 deaths in 217,167 person-years of observation between 2010 and 2012. The wealth index constructed using household assets was used to assess the SES, and disease burdens were compared among the wealth quintiles.Analysing cause of death (CoD) revealed that non-communicable diseases (NCDs) were the leading causes of deaths (37%), followed by communicable diseases (CDs) (22%), perinatal and neonatal conditions (11%), and injury and accidents (6%); the cause of remaining 24% of deaths could not be determined. Age-specific mortality showed premature birth, respiratory infections, and drowning were the dominant causes of death for childhood mortality (0-14 years), which was inversely associated with SES (p<0.04). For adult and the elderly (15 years and older), NCDs were the leading cause of death (51%), followed by CDs (23%). For adult and the elderly, NCDs concentrated among the population from higher SES groups (p<0.005), and CDs among the lower SES groups (p<0.001).Epidemiologic transition is taking place with a shift from the dominance of CDs to NCDs. SES inequity in mortality still persists--the poor suffer from CDs in all age groups, whereas those better off suffer more from NCDs than CDs. Policy makers thus need to consider the social distribution of diseases before developing any public health action targeted towards reducing mortality and the extent of disease burden in an equitable manner.

Dataset Information

Socioeconomic Status, Frailty, and All-Cause Mortality in Korean Older Adults: A 3-Year Population-Based Prospective Study.

Publications

Socioeconomic Status, Frailty, and All-Cause Mortality in Korean Older Adults: A 3-Year Population-Based Prospective Study.

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