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Impact of delayed effects on human old-age mortality1.

ABSTRACT: BACKGROUND:There is growing empirical evidence supporting theories of developmental origins of health and disease (DOHaD). However, the implications of DOHaD conjectures for aggregate population patterns of human disease, disability, mortality and aging are poorly understood. OBJECTIVE:We empirically test two predictions derived from a formal model of aggregate population-level impacts of DOHaD. This model predicts that populations potentially influenced by delayed effects should experience singularities in their adult mortality patterns that can be empirically detected from aggregate data. METHODS:We test predictions using a large mortality database for populations in the Latin American and Caribbean region (LAC) spanning nearly one hundred years of mortality history. RESULTS:Results are consistent. within explicit bounds of uncertainty, with expected patterns. We find that younger cohorts in countries whose mortality decline starts more recently experience deceleration in survival gains at older ages, attenuation of the rate of aging at older ages and a decline in the association between early childhood and adult mortality. CONCLUSIONS:Results point to the importance of adverse early conditions for human longevity. Future research should shed light on the impact on morbidity, disability and healthy life expectancy. CONTRIBUTION:To our knowledge this is the first time that implications of DOHaD conjectures for populations' mortality patterns are formulated precisely and empirically tested with aggregate population data.

SUBMITTER: Verhulst A

PROVIDER: S-EPMC6709713 | biostudies-literature | 2019 Jan-Jun

REPOSITORIES: biostudies-literature

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Impact of delayed effects on human old-age mortality<sub>1</sub>.

Verhulst Andrea A Beltran-Sanchez Hiram H Palloni Alberto A

Demographic research 20190101

<h4>Background</h4>There is growing empirical evidence supporting theories of developmental origins of health and disease (DOHaD). However, the implications of DOHaD conjectures for aggregate population patterns of human disease, disability, mortality and aging are poorly understood.<h4>Objective</h4>We empirically test two predictions derived from a formal model of aggregate population-level impacts of DOHaD. This model predicts that populations potentially influenced by delayed effects should ...[more]

PMID: 31452626

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Project description:Objective:This study was performed to identify a reasonable cutoff age for defining older patients with colorectal cancer (CRC) and to examine whether old age was related with increased colorectal cancer-specific death (CSD) and poor colorectal cancer-specific survival (CSS). Methods:A total of 76,858 eligible patients from the surveillance, epidemiology, and end results (SEER) database were included in this study. The Cox proportional hazard regression model and the Chow test were used to determine a suitable cutoff age for defining the older group. Furthermore, a propensity score matching analysis was performed to adjust for heterogeneity between groups. A competing risk regression model was used to explore the impact of age on CSD and non-colorectal cancer-specific death (non-CSD). Kaplan-Meier survival curves were plotted to compare CSS between groups. Also, a Cox regression model was used to validate the results. External validation was performed on data from 1998 to 2003 retrieved from the SEER database. Results:Based on a cutoff age of 70 years, the examined cohort of patients was classified into a younger group (n = 51,915, <70 years of old) and an older group (n = 24,943, ?70 years of old). Compared with younger patients, older patients were more likely to have fewer lymph nodes sampled and were less likely to receive chemotherapy and radiotherapy. When adjusted for other covariates, age-dependent differences of 5-year CSD and 5-year non-CSD were significant in the younger and older groups (15.84% and 22.42%, P < 0.001; 5.21% and 14.21%, P < 0.001). Also an age of ?70 years remained associated with worse CSS comparing with younger group (subdistribution hazard ratio, 1.51 95% confidence interval (CI) [1.45-1.57], P < 0.001). The Cox regression model as a sensitivity analysis had a similar result. External validation also supported an age of 70 years as a suitable cutoff, and this older group was associated with having reduced CSS and increased CSD. Conclusions:A total of 70 is a suitable cutoff age to define those considered as having elderly CRC. Elderly CRC was associated with not only increased non-CSD but also with increased CSD. Further research is needed to provide evidence of whether cases of elderly CRC should receive stronger treatment if possible.

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Impact of delayed effects on human old-age mortality1.

Publications

Impact of delayed effects on human old-age mortality<sub>1</sub>.

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