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Estimating expected life-years and risk factor associations with mortality in Finland: cohort study.

ABSTRACT: OBJECTIVE:To develop a tool to inform individuals and general practitioners about benefits of lifestyle changes by providing estimates of the expected age of death (EAD) for different risk factor values, and for those who plan and decide on preventive activities and health services at population level, to calculate potential need for these. DESIGN:Prospective cohort study to estimate EAD using a model with 27 established risk factors, categorised into four groups: (1) sociodemographic background and medical history, (2) lifestyles, (3) life satisfaction, and (4) biological risk factors. We apply a Poisson regression model on the survival data split into 1-year intervals. PARTICIPANTS:Total of 38?549 participants aged 25-74 years at baseline of the National FINRISK Study between 1987 and 2007. PRIMARY OUTCOME MEASURES:Register-based comprehensive mortality data from 1987 to 2014 with an average follow-up time of 16 years and 4310 deaths. RESULTS:Almost all risk factors included in the model were statistically significantly associated with death. The largest influence on the EAD appeared to be a current heavy smoker versus a never smoker as the EAD for a 30-year-old man decreased from 86.8 years, which corresponds to the reference values of the risk factors, to 80.2 years. Diabetes decreased EAD by >6.6 years. Whole or full milk consumers had 3.4 years lower EAD compared with those consuming skimmed milk. Physically inactive men had 2.4 years lower EAD than those with high activity. Men who found their life almost unbearable due to stress had 2.8 years lower EAD. CONCLUSIONS:The biological risk factors and lifestyles, and the factors connected with life satisfaction were clearly associated with EAD. Our model for estimating a person's EAD can be used to motivate lifestyle changes.

SUBMITTER: Harkanen T

PROVIDER: S-EPMC7064132 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Estimating expected life-years and risk factor associations with mortality in Finland: cohort study.

Härkänen Tommi T Kuulasmaa Kari K Sares-Jäske Laura L Jousilahti Pekka P Peltonen Markku M Borodulin Katja K Knekt Paul P Koskinen Seppo S

BMJ open 20200308 3

<h4>Objective</h4>To develop a tool to inform individuals and general practitioners about benefits of lifestyle changes by providing estimates of the expected age of death (EAD) for different risk factor values, and for those who plan and decide on preventive activities and health services at population level, to calculate potential need for these.<h4>Design</h4>Prospective cohort study to estimate EAD using a model with 27 established risk factors, categorised into four groups: (1) sociodemogra ...[more]

PMID: 32152164

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Project description:BACKGROUND:Despite positive changes in the health of the population of Poland, compared to the EU average, the average life expectancy in 2011 was 5 years shorter for males and 2.2 years shorter for females. The immediate cause is the great number of premature deaths, which results in years of life lost in the population. The aim of the study was to identify the major causes of years of life lost in Poland. METHODS:The analysis was based on a database of the Central Statistical Office of Poland, containing information gathered from 375,501 death certificates of inhabitants of Poland who died in 2011. The SEYLLp (Standard Expected Years of Life Lost per living person) and the SEYLLd (SEYLL per death) measures were calculated to determine years of life lost. RESULTS:In 2011, the total number of years of life lost by in Polish residents due to premature mortality was 2,249,213 (1,415,672 for males and 833,541 for females). The greatest number of years of life lost in males were due to ischemic heart disease (7.8 per 1,000), lung cancer (6.0), suicides (6.6), cerebrovascular disease (4.6) and road traffic accidents (5.4). In females, the factors contributing to the greatest number of deaths were cerebrovascular disease (3.8 per 1,000), ischemic heart disease (3.7), heart failure (2.7), lung cancer (2.5) and breast cancer (2.3). Regarding the individual scores per person in both males and females, the greatest death factors were road traffic accidents (20.2 years in males and 17.1 in females), suicides (17.4 years in males and 15.4 in females) and liver cirrhosis (12.1 years in males and 11.3 in females). CONCLUSIONS:It would be most beneficial to further reduce the number of deaths due to cardiovascular diseases, because they contribute to the greatest number of years of life lost. Moreover, from the economic point of view, the most effective preventative activities are those which target causes which result in a large number of years of life lost at productive age for each death due to a particular reason, i.e. road traffic accidents, suicides and liver cirrhosis.

Project description:BackgroundTo complement available information on mortality in a population Standard Expected Years of Life Lost (SEYLL), an indicator of premature mortality, is increasingly used to calculate the mortality-associated disease burden. SEYLL consider the age at death and therefore allow a more accurate view on mortality patterns as compared to routinely used measures (e.g. death counts). This study provides a comprehensive assessment of disease and injury SEYLL for Hong Kong in 2010.MethodsTo estimate the SEYLL, life-expectancy at birth was set according to the 2004 Global Burden of Disease study at 82.5 and 80 years for females and males, respectively. Cause of death data for 2010 were corrected for misclassification of cardiovascular and cancer causes. In addition to the baseline estimates, scenario analyses were performed using alternative assumptions on life-expectancy (Hong Kong standard life-expectancy), time-discounting and age-weighting. To estimate a trend of premature mortality a time-series analysis from 2001 to 2010 was conducted.ResultsIn 2010 524,706.5 years were lost due to premature death in Hong Kong with 58.3% of the SEYLL attributable to male deaths. The three overall leading single causes of SEYLL were "trachea, bronchus and lung cancers", "ischaemic heart disease" and "lower respiratory infections" together accounting for about 29% of the overall SEYLL. Further, self-inflicted injuries (5.6%; ranked 5) and liver cancer (4.9%; ranked 7) were identified as important causes not adequately captured by classical mortality measures. Scenario analyses highlighted that by using a 3% time-discount rate and non-uniform age-weights the SEYLL dropped by 51.6%. Using Hong Kong's standard life-expectancy values resulted in an overall increase of SEYLL by 10.8% as compared to the baseline SEYLL. Time-series analysis indicates an overall increase of SEYLL by 6.4%. In particular, group I (communicable, maternal, perinatal and nutritional) conditions showed highest increases with SEYLL-rates per 100,000 in 2010 being 1.4 times higher than 2001.ConclusionsThe study stresses the mortality impact of diseases and injuries that occur in earlier stages of life and thus presents the SEYLL measure as a more sensitive indicator compared to classical mortality indicators. SEYLL provide useful additional information and supplement available death statistics.

Dataset Information

Estimating expected life-years and risk factor associations with mortality in Finland: cohort study.

Publications

Estimating expected life-years and risk factor associations with mortality in Finland: cohort study.

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