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    Ageing and mortality. Results from the Zutphen-Study

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    Authors
    Hoogenveen RT
    Type
    Report
    Language
    en
    
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    Title
    Ageing and mortality. Results from the Zutphen-Study
    Translated Title
    Veroudering en sterfte. Resultaten op basis van de Zutphen-studie
    Publiekssamenvatting
    Het verband tussen concurrerende doodsoorzaken en de verandering van risicofactorniveau's over de tijd is onderzocht met behulp van gegevens van de Zutphen-Studie en het model van Manton&Stallard. Het Zutphen-cohort bestaat uit 878 mannen, aanvankelijk met leeftijd 40-59 jaar, die gevolgd zijn vanaf 1960. Het model van Manton&Stallard beschrijft de veranderingen van de verdeling van de risicofactorniveau's van een cohort als functie van selectieve sterfte en de risicofactorniveau-veranderingen binnen individuen. De gebruikte mortaliteits hazard functie lijkt op die van het Cox model. Voor vrijwel dezelfde combinaties van risicofactoren en doodsoorzaken werden significante modelparameters gevonden. Het gebruik van actuele in plaats van 'baseline' meetwaarden leidde tot kleinere effecten voor bloeddruk en cholesterol (te verklaren door medicijngebruik) en een groter effect voor BMI en longkanker (te verklaren door een omgekeerd verband). De meest opvallende en interessante resultaten werden gevonden met betrekking tot de risicofactor veranderingen. Wij vonden positieve veranderingen met de leeftijd (hoewel niet-significant voor cholesterol), in tegenstelling tot de uitkomsten van eenvoudige regressie analyses. Meer specifieke resultaten werden gevonden met betrekking tot de risicofactor specifieke deterministische en toevalsveranderingen. De resultaten van de analyses worden gebruikt bij de verdere ontwikkeling van het chronische ziekten model.<br>
    The link between competing death risks and the change of risk factor levels over time has been analysed using data from the Zutphen-Study and the model of Manton&Stallard. The Zutphen-cohort consists of 878 men, initially with te ages of 40-59 years, that have been followed since 1960. The model of Manton&Stallard describes the change of the distribution of the risk factor levels of a cohort over time taking into account mortality and the change of levesl within individuals. The hazard function used is similar to the one used in the Cox proportional hazards model. For almost the same combinations of risk factors and causes of death significant effects have been found as in Cox analyses. However, using current instead of baseline risk factor measurement values result in smaller effects probably due to medication (for total cholesterol and systolic bloodpressure) or in larger effects probably due to a reverse causal relation (for BMI and lung cancer). The most interesting and striking rsults were found with respect to the risk factor changes over age. We found positive age-trends for all risk factors (although non-significant for cholesterol), whereas the results of simple regression analyses were not that clear. More specific results relate to the interactions with respect to the deterministic and random changes. The results of the analyses will be used for the further development of the chronic diseases modelling tools. That means, the refinement of the modelling of the changes of the risk factors mentioned above over age, and the relation (interaction) between thes changes<br>
    Publisher
    Rijksinstituut voor Volksgezondheid en Milieu RIVM
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