Survival after the Age of 80 in the United States, Sweden, France, England, and Japan

Mantón, Kenneth G.; Vaupel, James W.

doi:10.1056/nejm199511023331824

Cited by 260 publications

(128 citation statements)

References 29 publications

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“…For example, the quality of and access to health care for the elderly is likely to differ between the United States and Latin American and other foreign countries with concomitant differences in survival outcomes (Ross, Pagan and Polsky 2006). In fact, it has been suggested that mortality of the oldest old in the United States is lower than in Europe and Japan at least in part because of greater availability of medical care for the elderly in the United States (Manton & Vaupel 1995).…”

Section: Discussionmentioning

confidence: 99%

The Impact of Salmon Bias on the Hispanic Mortality Advantage: New Evidence from Social Security Data

Turra

Elo

2008

Popul Res Policy Rev

313

236

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A great deal of research has focused on factors that may contribute to the Hispanic mortality paradox in the United States. In this paper, we examine the role of the salmon bias hypothesis -the selective return of less-healthy Hispanics to their country of birth -on mortality at ages 65 and above. These analyses are based on data drawn from the Master Beneficiary Record and NUMIDENT data files of the Social Security Administration. These data provide the first direct evidence regarding the effect of salmon bias on the Hispanic mortality advantage. Although we confirm the existence of salmon bias, it is of too small a magnitude to be a primary explanation for the lower mortality of Hispanic than NH white primary social security beneficiaries. Longitudinal surveys that follow individuals in and out of the United States are needed to further explore the role of migration in the health and mortality of foreign-born US residents and factors that contribute to the Hispanic mortality paradox.

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Section: Discussionmentioning

confidence: 99%

The Impact of Salmon Bias on the Hispanic Mortality Advantage: New Evidence from Social Security Data

Turra

Elo

2008

Popul Res Policy Rev

313

236

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“…The notion of limited life expectancy should not hinder that effort because survival to the age of 80 years and beyond has been reported to have increased in many developed countries. 26 The remaining life expectancy of a white fe-male age 75 years is estimated to be 11.7 years. 27 Recent data have suggested that laparoscopic staging in elderly patients with gynecologic malignancies appears to be well tolerated.…”

Section: Discussionmentioning

confidence: 99%

Is endometrial carcinoma intrinsically more aggressive in elderly patients?

Alektiar

Venkatraman

Abu‐Rustum

et al. 2003

Cancer

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BACKGROUNDThe current study was conducted to determine the influence of old age (age ≥ 70 years) on outcome in a group of patients with endometrial carcinoma who were treated with simple hysterectomy followed by adjuvant radiation therapy (RT).METHODSBetween November 1987 and May 2000, 405 patients with International Federation of Gynecology and Obstetrics (FIGO) Stage IB‐II endometrial carcinoma were treated with postoperative RT. Intravaginal RT alone was given to 77% of patients (median dose, 21grays [Gy] given in 3 fractions). Additional postoperative external beam radiation therapy (EBRT) was given to 23% of patients (median dose, 45 Gy). Eighty‐four patients were age ≥ 70 years and 321 patients were age < 70 years. The two groups were well balanced with regard to race, comprehensive surgical staging, aggressive histology, lymphovascular invasion, lower uterine segment involvement, cervical involvement, and the use of postoperative EBRT. Significantly more patients in the age ≥ 70 years group had other comorbidities such as obesity, diabetes mellitus, or hypertension (P = 0.02) and were found to have deep (> 50%) myometrial invasion (P = 0.008).RESULTSWith a median follow‐up time of 48 months, the 5‐year locoregional control (LRC), disease‐free survival (DFS), and overall survival (OS) rates were 95%, 91%, and 90% respectively. On multivariate analysis, poor LRC was found to be correlated with age ≥ 70 years (P = 0.019) and lymphovascular invasion (P = 0.001). Poor DFS was found to be correlated with age ≥ 70 years (P = 0.03), lymphovascular invasion (P = 0.01), and aggressive histology (P = 0.001). Similarly, poor OS was found to correlate with age ≥ 70 years (P = 0.001), lymphovascular invasion (P = 0.01), aggressive histology (P = 0.01), and cervical involvement (P = 0.02). The same factors that were found to correlate with OS (age ≥ 70 years, lymphovascular involvement, aggressive histology, and cervical involvement) also appeared to correlate with disease‐specific survival (P = 0.03, P = 0.008, P = 0.001, and P = 0.04, respectively). The 5‐year actuarial rates of Radiation Therapy Oncology Group late complications that were ≥ Grade 3 (gastrointestinal tract, genitourinary tract, or vagina) were 3% in both groups.CONCLUSIONSEven when treated in a similar fashion, endometrial carcinoma patients age ≥ 70 years appear to fare worse than younger patients independent of other poor prognostic factors. The rate of complications from adjuvant RT, despite a higher rate of comorbidity in elderly patients, was found to be similar in both age groups. Endometrial carcinoma appears to be intrinsically more aggressive in older patients, thus mandating further improvement in their treatment strategies. Cancer 2003. © 2003 American Cancer Society.

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“…The 38), and with the proposition that higher United States expenditures on LTC better meet the needs of the very elderly than the lower LTC expenditures, and less complete LTC service availability, in Japan (39,40).…”

Section: Discussionmentioning

confidence: 99%

Chronic disability trends in elderly United States populations: 1982–1994

Mantón

Corder²,

Stallard³

1997

Proc. Natl. Acad. Sci. U.S.A.

Self Cite

579

301

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Statistically significant declines in chronic disability prevalence rates were observed in the elderly United States population between the 1982 and 1989 National Long Term Care Surveys (NLTCS). The 1994 NLTCS was used to investigate whether disability rate declines continued to 1994. The 1982The , 1984The , 1989, and 1994 NLTCS employ the same sample design and instrumentation so that trends in disability can be estimated with minimal sampling and measurement bias. Age (5-year categories from 65 to >95)-specific rates were calculated for the 1982 NLTCS and applied to United States Census Bureau estimates of the 1994 population to calculate chronic disability prevalence rates adjusted for aging in the United States population aged >65. The 1982 age standardized rates were compared with 1994 NLTCS estimates. The prevalence of disability estimated for 1994 (21.3%) was 3.6% lower than the 1982 age standardized rate (24.9%)-a highly significant reduction (t ‫؍‬ ؊8.5; P < < 0.0001). Of the 3.6 percentage point decline in prevalence, 1.7% occurred in the 5 years between 1989 and 1994-compared with the 1.9% decline in the 7 years between 1982 and 1989. Both declines are significant. Because of the shorter time period, the per year decline in disability prevalence from 1989 to 1994 was greater than that from 1982 to 1989. Given the higher acute and long-term care service needs of the disabled elderly population, Medicare, Medicaid, and private health expenditures may be dramatically lower than if declines had not occurred.

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Survival after the Age of 80 in the United States, Sweden, France, England, and Japan

Abstract: For people 80 years old or older, life expectancy is greater in the United States than it is in Sweden, France, England, and Japan. This finding suggests that elderly Americans are receiving better health care than the elderly citizens of other developed countries.

Cited by 260 publications

References 29 publications

The Impact of Salmon Bias on the Hispanic Mortality Advantage: New Evidence from Social Security Data

The Impact of Salmon Bias on the Hispanic Mortality Advantage: New Evidence from Social Security Data

Is endometrial carcinoma intrinsically more aggressive in elderly patients?

Chronic disability trends in elderly United States populations: 1982–1994

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