Mortality from Major Causes of Death and its Risk Factors in the Elderly. 26-year Follow-up Study in Hisayama.

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  • Iwamoto Hiromitsu
    Second Department of Internal Medicine, Faculty of Medicine, Kyushu University
  • Kiyohara Yutaka
    Second Department of Internal Medicine, Faculty of Medicine, Kyushu University
  • Kato Isao
    Second Department of Internal Medicine, Faculty of Medicine, Kyushu University
  • Ohmura Takao
    Second Department of Internal Medicine, Faculty of Medicine, Kyushu University
  • Nakayama Keizo
    Second Department of Internal Medicine, Faculty of Medicine, Kyushu University
  • Ohmori Susumu
    Second Department of Internal Medicine, Faculty of Medicine, Kyushu University
  • Nomiyama Kensuke
    Second Department of Internal Medicine, Faculty of Medicine, Kyushu University
  • Yoshitake Taketo
    Second Department of Internal Medicine, Faculty of Medicine, Kyushu University
  • Ueda Kazuo
    Second Department of Internal Medicine, Faculty of Medicine, Kyushu University
  • Fujishima Masatoshi
    Second Department of Internal Medicine, Faculty of Medicine, Kyushu University

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Other Title
  • 久山町における高齢者の生命予後とその危険因子　２６年間の追跡調査
  • ヒサヤママチ ニ オケル コウレイシャ ノ セイメイ ヨゴ ト ソノ キケン
  • 26-year Follow-up Study in Hisayama
  • 26年間の追跡調査

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Abstract

The authors studied mortality from major causes of death and risk factors in the elderly in a long-term prospective survey conducted in a Japanese suburban community, Hisayama. In the baseline survery in 1961, we scrutinized 1658 residents of the town aged 40 years or older accounting for 92% of the total population in this age range. Of those, 591 residents (245 men and 346 women) aged 60 years or older, who were free from major cardiovascular disease, were selected for the present study. They were followed-up for 26 years from 1961 to 1987. The average age was 67 years for men and 70 years for women, being significantly higher for women than for men. During the follow-up period, 529 subjects (89.5%) died, and 448 were autopsied (autopsy rate 84.7%). The all-cause mortality (per 1, 000 person-years) after adjustment for age was 89.9 for men and 56.7 for women, the former being significantly higher than the latter (p<0.01). The age-adjusted mortality from cerebrovascular disease was estimated to be 21.4 for men and 9.9 for women, i.e. 8.9 and 8.8 from heart disease, and 19.9 and 10.6 from neoplasm, and 18.1 and 12.2 from-pneumonia, respectively. There was significant sex difference in mortality from cerebrovascular disease, neoplasm and pneumonia (p<0.01) but not from heart disease (p>0.1). Multiple Cox's proportional hazards regression analysis showed systolic blood pressure and male sex to be significant risk factors for death by cerebrovascular disease. Systolic blood pressure was also a predictor for death by heart disease. Smoking and high body mass index were significant risk factors for death by neoplasm, while low body mass index was a risk factor for death from pneumonia. Age remained a significant risk factor for these endpoints. The present study revealed that there are differences according to sex for the major causes of death among the aged in a Japanese suburban community. Risk factors for cause-specific deaths were analyzed, and their significance in relation to the prognosis was discussed.

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