Author/Authors :
KD Lindsted، نويسنده , , NS Daher، نويسنده ,
Abstract :
PURPOSE: To evaluate age-specific life expectancy free from Cardiovascular Heart Disease (CHD) and the death rate from heart disease from 1960 to 1988 for males and females in the Adventist Mortality Study (AMS) (n = 27517) and the Adventist Health Study (AHS) (n = 34192) combined. The data are used to model life expectancy free from subsequent CHD using the Lee-Carter model. Differences in life expectancy free from CHD are explored among subgroups with different life styles. The life styles considered included physical inactivity, diet, smoking status, and educational level. Subjects with a healthy lifestyle showed a higher life expectancy.
METHODS: We used the abridged life table to calculate life expectancy free from CHD for persons ages 30–49 years old and those in each ten-year age interval up to age 90 from 1960 to 1988. We used the Lee-Carter method to model life expectancy free from CHD in the future. We also used the Multivariate Multiple Decrement Life Table Analysis Program (MMDLP) to calculate life expectancies after adjusting for confounders. The model is basically non-parametric except for a proportional hazard assumption, and the time variable is attained age. We also modeled life expectancies using linear regression. Life expectancy in subjects with CHD was also explored.
RESULTS: For all age groups, the life expectancy free from CHD increased linearly from 1960 to 1988. For males, life expectancy was 15.77 years for subjects 60–69 years in 1960 versus 19.73 in 1988. For males 80-89 years of age, life expectancy was 6.04 years in 1960 versus 6.31 in the year 1988. The death rate from CHD decreased from 0.03288 in 1960 to 0.01491 in 1988 for males 60–69 years of age and from 0.14483 in 1960 to 0.132 in 1988 for males 80–89 years of age. For females 60–69 years of age, the life expectancy free from CHD increased from 16.79 in 1960 to 27.03 in the year 1988. For females 80–89 years of age, it increased from 5.46 in 1960 to 11.3 in 1988. For females 60–69 years old, the death rate from CHD decreased from 0.025 in 1960 to 0.00688 in 1988, and for females 80–89 years of age, the rate decreased from 0.16667 in 1960 to 0.05471 in 1988.
CONCLUSION: Even in the oldest old (90+ for males and females), there is an increase in life expectancy free from CHD and decrease in death rate from 1960 to 1988. The negative intercept on the regression lines may indicate that the life expectancy free from CHD did not always increased linearly prior to 1960.