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The effects of increasing longevity and changing incidence on lifetime risk differentials: A decomposition approach.

ABSTRACT: Increasing longevity can distort time trends in summary measures of health and mortality, such as the lifetime risk of getting diseased. If not observing a cohort, this lifetime risk is calculated with cross-sectional data on age-specific incidence and survival. In those instances, incidence and survival may work in opposite directions resulting in lifetime risk estimates where, reductions in incidence might be offset by a simultaneous longevity increase. The proposed method decomposes the difference between two lifetime risks into contributions of changing incidence and changing survival. The approach can be extended to measure the contributions of changes in disease related mortality and even case fatality. We illustrate the method with hypothetical examples as well as remaining lifetime risk at age 60 of experiencing a myocardial infarction, colorectal cancer and hip fractures for Swedish males. The empirical examples show that the influence of increasing longevity on the development of lifetime risk depends on the respective age profile of occurrence. In the cases of myocardial infarction and hip fracture, longevity increases of the general population counterbalanced or even exceeded the substantial gains in disease incidence, while for colorectal cancer, the lifetime risk was almost unaffected by the longevity improvement. This was because colorectal cancer has an on average earlier onset than myocardial infarction and hip fracture.

SUBMITTER: Ebeling M

PROVIDER: S-EPMC5909551 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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The effects of increasing longevity and changing incidence on lifetime risk differentials: A decomposition approach.

Ebeling Marcus M Modig Karin K Ahlbom Anders A Rau Roland R

PloS one 20180419 4

Increasing longevity can distort time trends in summary measures of health and mortality, such as the lifetime risk of getting diseased. If not observing a cohort, this lifetime risk is calculated with cross-sectional data on age-specific incidence and survival. In those instances, incidence and survival may work in opposite directions resulting in lifetime risk estimates where, reductions in incidence might be offset by a simultaneous longevity increase. The proposed method decomposes the diffe ...[more]

PMID: 29672532

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Project description:BACKGROUND: While Malaysia has had great success in controlling Plasmodium falciparum and Plasmodium vivax, notifications of Plasmodium malariae and the microscopically near-identical Plasmodium knowlesi increased substantially over the past decade. However, whether this represents microscopic misdiagnosis or increased recognition of P. knowlesi has remained uncertain. METHODS: To describe the changing epidemiology of malaria in Sabah, in particular the increasing incidence of P. knowlesi, a retrospective descriptive study was undertaken involving a review of Department of Health malaria notification data from 2012-2013, extending a previous review of these data from 1992-2011. In addition, malaria PCR and microscopy data from the State Public Health Laboratory were reviewed to estimate the accuracy of the microscopy-based notification data. RESULTS: Notifications of P. malariae/P. knowlesi increased from 703 in 2011 to 815 in 2012 and 996 in 2013. Notifications of P. vivax and P. falciparum decreased from 605 and 628, respectively, in 2011, to 297 and 263 in 2013. In 2013, P. malariae/P. knowlesi accounted for 62% of all malaria notifications compared to 35% in 2011. Among 1,082 P. malariae/P. knowlesi blood slides referred for PCR testing during 2011-2013, there were 924 (85%) P. knowlesi mono-infections, 30 (2.8%) P. falciparum, 43 (4.0%) P. vivax, seven (0.6%) P. malariae, six (0.6%) mixed infections, 31 (2.9%) positive only for Plasmodium genus, and 41 (3.8%) Plasmodium-negative. Plasmodium knowlesi mono-infection accounted for 32/156 (21%) and 33/87 (38%) blood slides diagnosed by microscopy as P. falciparum and P. vivax, respectively. Twenty-six malaria deaths were reported during 2010-2013, including 12 with 'P. malariae/P. knowlesi' (all adults), 12 with P. falciparum (seven adults), and two adults with P. vivax. CONCLUSIONS: Notifications of P. malariae/P. knowlesi in Sabah are increasing, with this trend likely reflecting a true increase in incidence of P. knowlesi and presenting a major threat to malaria control and elimination in Malaysia. With the decline of P. falciparum and P. vivax, control programmes need to incorporate measures to protect against P. knowlesi, with further research required to determine effective interventions.

Dataset Information

The effects of increasing longevity and changing incidence on lifetime risk differentials: A decomposition approach.

Publications

The effects of increasing longevity and changing incidence on lifetime risk differentials: A decomposition approach.

Similar Datasets

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