Abstract
Though the general trend in the United States has been toward increasing life expectancy both at birth and at age 65, the temporal rate of change in life expectancy since 1900 has been variable and often restricted to specific population groups. There have been periods during which the age- and gender-specific risks of particular causes of death have either increased or decreased. These periods partly reflect the persistent effects of population health factors on specific birth cohorts. It is important to understand the ebbs and flows of cause-specific mortality rates because general life expectancy trends are the product of interactions of multiple dynamic period and cohort factors. Consequently, we first review factors potentially affecting cohort health back to 1880 and explore how that history might affect the current and future cohort mortality risks of major chronic diseases. We then examine how those factors affect the age-specific linkage of disability and mortality in three sets of birth cohorts assessed using the 1982, 1984, and 1989 National Long Term Care Surveys and Medicare mortality data collected from 1982 to 1991. We find large changes in both mortality and disability in those cohorts. providing insights into what changes might have occurred and into what future changes might be expected.
Young Cohort, Multiple Risk Factor Intervention Trial, Cohort Difference, Social Security Administration, Male Cohort
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References
Antiplatelet Trialists’ Collaboration
(1994
). Collaborative Overview of Randomized Trials of Antiplatelet Therapy-I: Prevention of Death, Myocardial Infarction, and Stroke by Prolonged Antiplatelet Therapy in Various Categories of Patients
. British Medical Journal
, 308
, 81
–106
.Antonovsky, A. (
1968
). Social Class and the Major Cardiovascular Diseases
. Journal of Chronic Diseases
, 21
, 65
–106
. 10.1016/0021-9681(68)90098-2Bishop, M.C. (
1994
). Treatment of Advanced Prostate Cancer
. The Lancet
, 343
, 110
–11
. 10.1016/S0140-6736(94)90837-0Bourgeois-Pichat, J. 1978. “Future Outlook for Mortality Declines in the World.” Population Bulletin of the United Nations Number II.
Buja, L.M., & Willerson, J.T. (
1994
). Role of Inflammation in Coronary Plaque Disruption
. Circulation
, 89
(1
), 503
–505
.Cooper, G.R., Myers, G.L., Smith, S.J., & Schlant, R.C. (
1992
). Blood Lipid Measurements: Variations and Practical Utility
. Journal of the American Medical Association
, 267
(12
), 1652
–60
. 10.1001/jama.267.12.1652Correa, P. (
1975
). A Model for Gastric Cancer Epidemiology
. The Lancet
, 2
, 58
–60
. 10.1016/S0140-6736(75)90498-5Davis, C.E., Ritkind, B.M., Brenner, H., & Gordon, DJ. (
1990
). A Single Cholesterol Measurement Underestimates the Risk of Coronary Heart Disease: An Empirical Example from the Lipid Research Clinics Morality Followup Study
. Journal of American Medical Journal
, 264
, 3044
–46
.Elayda, M.A.A., Hall, R.I., Reul, R.M., Alonzo, D.M., Gillette, N., Reul, G.J., & Cooley, D.A. (
1993
). Aortic Valve Replacement in Patients 80 Years and Older: Operative Risks and Long-Term Results
. Circulation
, 88
(Part 2
), 11
–16
.Farnsworth, T.A., & Heseltine, D. (
1993
). Treatment of Elderly Hypertensives: Some Questions Remain Unanswered
. Age and Ageing
, 22
, 1
–4
. 10.1093/ageing/22.1.1Fogel, R.W. (
1994
). Economic Growth, Population Theory, and Physiology: The Bearing of Long-term Processes on the Making of Economic Policy
. American Economic Review
, 84
(3
), 369
–95
.Forman, D. (
1991
). Helicobacter Pylori Infection: A Novel Risk Factor in the Etiology of Gastric Cancer
. Journal of the National Cancer Institute
, 83
(23
), 1702
–1703
. 10.1093/jnci/83.23.1702Frankel, S., Elwood, P., Sweetnam, P., Yarnell, J., & Smith, G.D. (
1996
). Birthweight, Body-Mass Index in Middle Age, and Incident Coronary Heart Disease
. The Lancet
, 348
, 1478
–80
. 10.1016/S0140-6736(96)03482-4Gordon, D.J., Pobstfield, J.L., Garrison, R.J., Neaton, J.D., Castelli, W.P., Knoke, J.D., Jacobs, D.R., Bangdiwala, S., & Troyler, H.A. (
1989
). High-Density Lipoprotein Cholesterol and Cardiovascular Disease: Four Prospective American Studies
. Circulation
, 79
, 8
–15
.Hansson, L.E., Nyren, O., Hsing, A.W., Bergstrom, R., Josefsson, S., Chow, W.H., Fraumeni, J.F., & Adami, H.O. (
1996
). The Risk of Stomach Cancer in Patients with Gastric or Duodenal Ulcer Disease
. New England Journal of Medicine
, 335
(4
), 242
–80
. 10.1056/NEJM199607253350404Hosking, M.P., Warner, M.A., Lodbell, C.M., Offord, K.P., & Melton, L.J. (
1989
). Outcomes of Surgery in Patients 90 Years of Age and Older
. Journal of the American Medical Association
, 261
, 1909
–15
. 10.1001/jama.261.13.1909Iso, H., Jacobs, D.R., Wentworth, D., Neaton, J.D., & Cohen, J.D. (
1989
). Serum Cholesterol Levels and Six-Year Mortality from Stroke in 350,977 Men Screened for the Multiple Risk Factor Intervention Trial
. New England Journal of Medicine
, 320
(14
), 904
–10
. 10.1056/NEJM198904063201405Jacobs, D., Blackburn, H., Higgins, M., Reed, D., Iso, H., McMillan, G., Neaton, J., Nelson, J., Potter, J., Ritkind, B., Rossouw, J., Shekelle, Rand, & Yusuf, S. (
1992
). Report of the conference on low blood cholesterol: Mortality association
. Circulation
, 86
(3
), 1046
–1060
.Joossens, J.V. (
1968
). La Relation Entre I’Epidemiologie des Accidents Cerebro-Vasculaires et du Cancer de I’Estomac. L ’evolution Medicale
, 12
, 381
–85
.Joossens, J.V., & Geboers, J. (
1983
). Epidemiology of gastric cancer: A Clue to Etiology
. In Sherlock, P., Morson, B.C., & Barbari, L. (Eds.), Precancerous Lesions of the Gastrointestinal Tract
(pp. 97
–113
). New York
: Raven Press
.Joossens, JV, M.J. Hill, P. Elliott, R. Stamler, J. Stamler, E. Lesaffre, A. Dyer, R. Nichols, and H. Kesteloot, (European Cancer Prevention (ECP) and the INTERSALT Cooperative Research Group). “Dietary Salt, Nitrate, and Stomach Cancer Mortality in 24 Countries.” International Journal of Epidemiology 25(3):494-504.
Kalon, K.L., Anderson, K.M., Kannel, W.B., Grossman, W., & Levy, D. (
1993
). Survival After the Onset of Congestive Heart Failure in Framingham Heart Study Subjects
. Circulation
, 88
(1
), 107
–15
.Kaplan, E.L. (
1993
). Global Assessment of Rheumatic Fever and Rheumatic Heart Disease at the Close of the Century. Influences and Dynamics of Populations and Pathogens: A Failure to Realize Prevention?
. Circulation
, 88
(4
), 1964
–72
.Kaplan, G.A., & Keil, J.E. (
1993
). Socioeconomic Factors and Cardiovascular Disease: A Review of the Literature
. Circulation
, 88
(4
), 1973
–98
.Kelijman, M. (
1991
). Age-Related Alterations of the Growth Hormone/ Insulin-Like-Growth-Factor I Axis
. Journal of the American Geriatrics Society
, 39
, 295
–307
.Kitagawa, E., & Hauser, P. (
1973
). Differential Mortality in the United States: A Study in Socio-Economic Epidemiology
. Boston
: Harvard University Press
.Ko, W., Gold, J.P., Lazzaro, R., Zelano, J.A., Lang, S., Isom, O.W., & Kreiger, K.H. (
1992
). Survival Analysis of Octogenarian Patients with Coronary Artery Disease Managed by Elective Coronary Artery Bypass Surgery Versus Conventional Medical Treatment
. Circulation
, 86
(Suppl. II
), 191
–97
.Kullback, S., & Leibler, R.A. (
1951
). On Information and Sufficiency
. Annals of Mathematical Satistics
, 22
, 79
–86
. 10.1214/aoms/1177729694Law, M.R., Thompson, S.G., & Wald, N.J. (
1994
). Assessing Possible Hazards of Reducing Serum Cholesterol
. British Medical Journal
, 308
, 373
–79
.Levine, G.N., Keaney, J.F., & Vita, J.A. (
1995
). Cholesterol Reduction in Cardiovascular Disease
. New England Journal of Medicine
, 332
(8
), 512
–21
. 10.1056/NEJM199502233320807Linnanmiiki, E., Leinonen, M., Mattila, K., Nieminen, M.S., Valtonen, V., & Saikku, P. (
1993
). Chlamydia Pneumoniae-s-Specific Circulating Immune Complexes in Patients with Chronic Coronary Heart Disease
. Circulation
, 87
(4
), 1130
–34
.Maggioni, A.P., Maseri, A., Fresco, C., Franzosi, M.G., Mauri, F., Santoro, E., & Tognoni, G. (
1993
). Age Related Increase in Mortality Among Patients with First Myocardial Infarctions Treated with Thrombolysis
. New England Journal of Medicine
, 329
(20
), 1442
–48
. 10.1056/NEJM199311113292002Manton, K.G., Corder, L.S., & Stallard, E. (
1993
). Estimates of Change in Chronic Disability and Institutional Incidence and Prevalence Rates in the U.S. Elderly Population from the 1982, 1984, and 1989 National Long Term Care Survey
. Journal of Gerontology: Social Sciences
, 47
(4
), S153
–66
.Manton, K.G., Cornelius, E.S., & Woodbury, M.A. (
1995
). Nursing Home Residents: A Multivariate Analysis of Their Medical, Behavioral, Psycho-Social and Service Use Characteristics
. Journal of Gerontology: Biological Sciences and Medical Sciences
, 50
(5
), M242
–51
.Manton, K.G., & Stallard, E. (
1988
). Chronic Disease Modeling: Measurement and Evaluation of the Risks of Chronic Disease Processes
. London
: Charles Griffin Ltd
.Manton, K.G., & Stallard, E. (
1992
). Demographics (1950–1987) of Breast Cancer in Birth Cohorts of Older Women
. Journal of Gerontology
, 47
, 32
–42
.Manton, K.G., & Stallard, E. (
1995
). Program Payment and Utilization Trends for Medicare Beneficiaries with Disabilities
. In Wiener, J.M., Clauser, S.B., & Kennell, D.L. (Eds.), Persons with Disabilities; Issues in Health Care Financing and Service Delivery
. Washington, DC
: Brookings Institution
.Manton, K.G., & Stallard, E. (
1996
). Change in Health, Mortality, and Disability and the Impact on Long Term Care
. Journal of Aging and Social Policy
, 7
(3/4
), 25
–52
. 10.1300/J031v07n03_03Manton, K.G. and E. Stallard. 1996b. “Longevity in the U.S.: Age and Sex Specific Evidence on Life Span Limits from Mortality Patterns: 19621990.” Unpublished manuscript. Center for Demographic Studies, Duke University.
Manton K.G., E. Stallard, and L.S. Corder. 1997. “Education Specific Estimates of Life Expectancy and Age Specific Disability in the U.S. Elderly Population: 1982 to 1991.” Journal of Aging and Health.
Manton, K.G., Stallard, E., & Singer, B.H. (
1992
). Projecting the Future Size and Health Status of the U.S. Elderly Population
. International Journal of Forecasting
, 8
, 433
–58
. 10.1016/0169-2070(92)90057-GManton, K.G., Stallard, E., & Singer, B.H. (
1994
). Methods for Projecting the Future Size and Health Status of the U.S. Elderly Population
. In Wise, D. (Ed.), Studies of the Economics of Aging
(pp. 41
–77
). Chicago
: University of Chicago Press for National Bureau of Economic Research
.Manton, K.G., Stallard, E., & Tolley, H.D. (
1991
). Limits to Human Life Expectancy: Evidence, Prospects, and Implications
. Population and Development Review
, 17
(4
), 603
–38
. 10.2307/1973599Manton, K.G., Stallard, E., & Vaupel, J.W. (
1986
). Alternative Models for the Heterogeneity of Mortality Risks Among The Aged
. Journal ofthe American Statistical Association
, 81
, 635
–44
. 10.2307/2288991Manton, K.G., Stallard, E., Woodbury, M.A., & Dowd, J.E. (
1994
). Time- Varying Covariates in Models of Human Mortality and Aging: Multidimensional Generalization of the Gornpertz
. Journal of Gerontology: Biological Sciences
, 49
, 169
–90
.Manton K.G., M.A. Woodbury, E. Stallard, and L.S. Corder. 1992. “The Use of Grade of Membership Techniques to Estimate Regression Relationships.” Pp. 321–81 in Sociological Methodology.
Manton, K.G., Woodbury, M.A., & Tolley, H.D. (
1994
). Statistical Applications Using Fuzzy Sets
. New York
: John Wiley & Sons
.Martyn, C.N., Barker, D.J.P., & Osmond, C. (
1996
). Mothers’ Pelvic Size, Fetal Growth, and Death from Stroke Andcoronary Heart Disease in Men in the U.K.
. The Lancet
, 348
, 1264
–68
. 10.1016/S0140-6736(96)04257-2McCully, K.S. (
1983
). Homocysteine Theory of Arteriosclerosis: Development and Current Status
. Atherosclerosis Review
, 2
, 157
–246
.Melnick, J.L., & Schattner, A. (
1992
). Viruses and Atherosclerosis
. Israel Journal of Medical Science
, 28
, 463
–65
.Moon, J., Bandy, B., & Davison, A.J. (
1992
). Hypothesis: Etiology of Atherosclerosis and Osteoporosis: Are Imbalances in the Calciferol Endocrine System Implicated
. Journal of the American College of Nutrition
, 11
(5
), 567
–83
.Moser, M. (
1991
). An Overview of the Meta-Analysis of the Hypertension Treatment Trials Commentary
. Archives of Internal Medicine
, 151
, 1277
–79
. 10.1001/archinte.151.7.1277Mozar, H.N., Bal, D.G., & Farag, S.A. (
1990
). The Natural History of Atherosclerosis: An Ecologic Perspective
. Atherosclerosis
, 82
, 157
–64
. 10.1016/0021-9150(90)90154-BMuhlbaier, L.H., Pryor, D.B., Rankin, S., Smith, L.R., Mark, D.B., Jones, R.H., Glower, D.D., Harrell, F.E., Lee, K.L., Califf, R.M., & Sabiston, D.C. (
1992
). Observational Comparison of EventFree Survival with Coronary Artery Disease: 20 Years of Follow-Up.
. Circulation
, 86
(5
), 198
–204
.Multiple Risk Factor Intervention Trial Research Group
(1990
). Mortality Rates After 10.5 Years for Participants in the Multiple Risk Factor Intervention Trial
. Journal of the American Medical Association
, 263
, 1795
–1801
. 10.1001/jama.263.13.1795Multiple Risk Factor Intervention Trial Research Group
(1990
). Mortality After 10.5 Years for Hypertensive Participants in the Multiple Risk Factor Intervention Trial
. Circulation
, 82
, 1616
–28
.Myers, G.C. (
1981
). Future Age Projections and Society
. In Gilmore, A.G. (Ed.), Aging: A Challenge to Science and Social Policy
(pp. 248
–60
). New York
: Oxford University Press
.The change in Mortality Trends in the United States
. (1964
). Washington, DC
: National Center for Health Statistics
.Health, United States, 1994
. (1995
). Hyatsville, MD
: Public Health Service
.Nightingale, T.E., & Gruber, J. (
1994
). Helicobacter and Human Cancer
. Journal of the National Cancer Institute
, 86
(20
), 1505
–1509
. 10.1093/jnci/86.20.1505Nihon University. “Population aging in Japan: Problems and policy issues in the 21st century.” In International Conference on an Aging Society: Strategies for the 21st Century Japan, edited by T. Kuroda. Japan: Nihon University Population Research Institute.
Omran, A.R. (
1971
). The Epidemiologic Transition: A Theory of the Epidemiology of Population Change
. Milbank Memorial Quarterly
, XLIX
(4
), 509
–38
. 10.2307/3349375Parsonnet, J. (
1995
). The Incidence of Helicobacter pylori Infection
. Alimentary Pharmacology and Therapeutics
, 9
(2
), 45
–41
.Prasad, K.N., & Edwards-Prasad, J. (
1992
). Vitamin E and Cancer Prevention: Recent Advances and Future Potentials
. Journal of the American College of Nutrition
, 11
(5
), 487
–500
.Salive, M.E., Guralnik, J., Glynn, R.J., Christen, W., Wallace, R.B., & Ostfeld, A.M. (
1994
). Association of Visual Impairment with Mobility and Physical Function
. Journal of the American Geriatrics Society
, 42
, 287
–92
.Shinton, R., & Sagar, G. (
1993
). Lifelong Exercise and Stroke
. British Medical Journal
, 307
, 231
–34
. 10.1136/bmj.307.6898.231Social Security Administration. 1992. Life Tables for the United States Social Security Area 1900-2080 Actuarial study 107. Social Security Administration (SSA Pub No. 11-11536), August.
Sonnenberg, A. (
1995
). Temporal Trends and Geographical Variations of Peptic Ulcer Disease
. Alimentary Pharmacology and Therapeutics
, 9
(2
), 3
–12
.Tango, T., & Kurashina, S. (
1987
). Age, Period and Cohort Analysis of Trends in Mortality from Major Diseases in Japan, 1955 to 1979: Peculiarity of the Cohort Born in the Early Showa Era
. Statistics in Medicine
, 6
, 709
–26
. 10.1002/sim.4780060608Taylor, A. (
1993
). Cataract: Relationships Between Nutrition and Oxidation
. Journal of the American College of Nutrition
, 12
(2
), 138
–46
.Tsugane, S., Tei, Y., Takahashi, T., Wtanabe, S., & Sugano, K. (
1994
). Salty Food Intake and Risk of Helicobacter pylori Infection
. Japanese Journal of Cancer Research
, 85
, 474
–78
.Virchow, R. (
1856
). Phlogose und Thrombose im Gefass-System
. Frankfurt
: Gesammelte Abhandlungen zur Wissenschaftlichen Medizin
.Woodbury, M. 1963. “Inapplicability of Bayes Theorem of Diagnosis.” Fifth International Conference of Medical Electronics. Liege, Belgium.
Woodbury, M.A., & Manton, K.G. (
1977
). A Random Walk Model of Human Mortality and Aging
. Theoretical Population Biology
, 11
, 37
–48
. 10.1016/0040-5809(77)90005-3Woodbury, M.A., & Manton, K.G. (
1983
). A theoretical model of the physiological dynamics of circulatory disease in human populations
. Human Biology
, 55
, 417
–41
.Woodbury, M.A., & Manton, K.G. (
1989
). Grade of Membership Analysis of Depression-Related Psychiatric Disorders
. Sociological Methods and Research
, 18
(1
), 126
–63
. 10.1177/0049124189018001005© Population Association of America 1997
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