Dataset Information

The rise and fall of women's advantage: a comparison of national trends in life expectancy at age 65 years.

ABSTRACT: The female advantage in life expectancy (LE) is found worldwide, despite differences in living conditions, the status of women and other factors. However, this advantage has decreased in recent years in low-mortality countries. Few researchers have looked at the gender gap in LE in old age (age 65) in a longer historical perspective. Have women always had an advantage in LE at old age and do different countries share the same trends? Life expectancy data for 17 countries were assessed from Human Mortality Database from 1751 to 2007. Since most of the changes in LE taking place today are driven by reductions of old age mortality the gender difference in LE was calculated at age 65. Most low-mortality countries show the same historical trend, a rise and fall of women's advantage in LE at age 65. Three phases that all but two countries passed through were discerned. After a long phase with a female advantage in LE at 65 of <1 year, the gender gap increased significantly during the twentieth century. The increase occurred in all countries but at different time points. Some countries such as England and France had an early rise in female advantage (1900-1919), while it occurred 50 years later in Sweden, Norway and in the Netherlands. The rise was followed by a more simultaneous fall in female advantage in the studied countries towards the end of the century, with exceptions of Japan and Spain. The different timing regarding the increase of women's advantage indicates that country-specific factors may have driven the rise in female advantage, while factors shared by all countries may underlie the simultaneous fall. More comprehensive, multi-disciplinary study of the evolution of the gender gap in old age could provide new hypotheses concerning the determinants of gendered differences in mortality.

SUBMITTER: Thorslund M

PROVIDER: S-EPMC3851807 | biostudies-other | 2013

REPOSITORIES: biostudies-other

ACCESS DATA

Similar Datasets

Project description:BackgroundAs society ages, promoting the health of the extra years of life is of paramount importance for health, social care and pension provision. Increases in life expectancy in the UK and elsewhere have slowed in recent years, but the reasons for this are unclear. No formal comparison of trends in healthy life years between the UK and the other countries of the EU28 in recent times has been published. These countries are geographically proximate, and share many social, cultural and demographic properties, making them interesting and useful comparators, especially as the UK prepared to leave the European Union in 2020.MethodsWe calculated sex-specific healthy life years (HLY), unhealthy life years (ULY), mild and severe ULY at birth and age 65 using life tables and age-specific prevalence of activity limitation amongst the EU28 between 2008 and 2016 from EuroHex. Trends in life expectancy, HLY, ULY and proportion of life spent healthy (HLY%) were compared. We then decomposed HLY temporal changes into relative effects of changes in healthy life and mortality, by age group.FindingsLife expectancy at birth, and age 65, in the UK were increasing rapidly in 2008 but slowed around 2011. Germany, Portugal and France showed evidence of a similar slowing. HLY at birth in the UK decreased, whereas it increased in most EU28 countries. The UK experienced a period of absolute expansion of unhealthy life in both sexes. The reduction in HLY at birth in the UK was mainly attributable to increases in unhealthy life in younger age groups.InterpretationThe UK's performance relative to the other countries of the EU28 was poor after 2011, combining static life expectancy and reductions in healthy life years. These trends suggest that the UK government's Ageing Society Grand Challenge (to increase the healthy life expectancy by five years by 2035) will be difficult to attain.FundingNational Institute for Health Research (NIHR) Policy Research Programme conducted through the NIHR Older People and Frailty Policy Research Unit, PR-PRU-1217-21502. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Project description:To conduct post-hoc analysis of National CT Colonography Trial data and compare the sensitivity and specificity of computed tomographic (CT) colonography in participants younger than 65 years with those in participants aged 65 years and older.Of 2600 asymptomatic participants recruited at 15 centers for the trial, 497 were 65 years of age or older. Approval of this HIPAA-compliant study was obtained from the institutional review board of each site, and informed consent was obtained from each subject. Radiologists certified in CT colonography reported lesions 5 mm in diameter or larger. Screening detection of large (≥10-mm) histologically confirmed colorectal neoplasia was the primary end point; screening detection of smaller (6-9-mm) colorectal neoplasia was a secondary end point. The differences in sensitivity and specificity of CT colonography in the two age cohorts (age < 65 years and age ≥ 65 years) were estimated with bootstrap confidence intervals (CIs).Complete data were available for 477 participants 65 years of age or older (among 2531 evaluable participants). Prevalence of adenomas 1 cm or larger for the older participants versus the younger participants was 6.9% (33 of 477) versus 3.7% (76 of 2054) (P < .004). For large neoplasms, mean estimates for CT colonography sensitivity and specificity among the older cohort were 0.82 (95% CI: 0.644, 0.944) and 0.83 (95% CI: 0.779, 0.883), respectively. For large neoplasms in the younger group, CT colonography sensitivity and specificity were 0.92 (95% CI: 0.837, 0.967) and 0.86 (95% CI: 0.816, 0.899), respectively. Per-polyp sensitivity for large neoplasms for the older and younger populations was 0.75 (95% CI: 0.578, 0.869) and 0.84 (95% CI: 0.717, 0.924), respectively. For the older and younger groups, per-participant sensitivity was 0.72 (95% CI: 0.565, 0.854) and 0.81 (95% CI: 0.745, 0.882) for detecting adenomas 6 mm in diameter or larger.For most measures of diagnostic performance and in most subsets, the difference between senior-aged participants and those younger than 65 years was not statistically significant.

Project description:Importance:Falls are common among older adults, particularly those with previous falls and cognitive impairment and in the postdischarge period. Hospitals have financial incentives to reduce both inpatient falls and hospital readmissions, yet little is known about whether fall-related injuries (FRIs) are common diagnoses for 30-day hospital readmissions. Objective:To compare fall-related readmissions with other leading rehospitalization diagnoses, including for patients at greatest risk of readmission. Design, Setting, and Participants:Retrospective cohort study of the Hospital Cost and Utilization Project's Nationwide Readmissions Database of nationally representative US hospital discharges among Medicare beneficiaries aged 65 years and older from January 1, 2013, to November 30, 2014. The prevalence and ranking of FRIs compared with other diagnostic factors for 30-day unplanned hospital-wide readmissions were determined, overall and for 2 acute geriatric cohorts, classified by fall injury or cognitive impairment diagnoses observed at the index admission. Analyses were also stratified by patient discharge disposition (home, home health care, skilled nursing facility). Analyses were conducted from February 1, 2018, to February 26, 2018. Main Outcomes and Measures:Unplanned hospital-wide readmission within 30 days of discharge. Results:From the database, 8?382?074 eligible index admissions were identified, including 746?397 (8.9%) in the FRI cohort and 1?367?759 (16.3%) in the cognitive impairment cohort. Among the entire 8 382 074-discharge cohort, mean (SD) age was 77.7 (7.8) years and 4?736?281 (56.5%) were female. Overall, 1?205?962 (14.4%) of index admissions resulted in readmission, with readmission rates of 12.9% for those with a previous fall and 16.0% for patients with cognitive impairment. Overall, FRIs ranked as the third-leading readmission diagnosis, accounting for 60?954 (5.1%) of all readmission diagnoses. Within the novel acute geriatric cohorts, FRIs were the second-leading diagnosis for readmission both for patients with an FRI at index admission (10.3% of all readmission diagnoses) and those with cognitive impairment (7.0% of all readmission diagnoses). For those with an FRI at index admission and discharged home or to home health care, FRIs were the leading readmission diagnosis. Conclusions and Relevance:This study found that posthospital FRIs were a leading readmission diagnosis, particularly for patients originally admitted with a FRI or cognitive impairment. Targeting at-risk hospitalized older adults, particularly those discharged to home or home health care, is an underexplored, cost-effective mechanism with potential to reduce readmissions and improve patient care.

Dataset Information

The rise and fall of women's advantage: a comparison of national trends in life expectancy at age 65 years.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets