Evolution of the "fourth stage" of epidemiologic transition in people aged 80 years and over: population-based cohort study using electronic health records

Population Health Metrics
Nisha C Hazra, Martin C Gulliford

Abstract

In the "fourth stage" of epidemiological transition, the distribution of non-communicable diseases is expected to shift to more advanced ages, but age-specific changes beyond 80 years of age have not been reported. This study aimed to evaluate demographic and health transitions in a population aged 80 years and over in the United Kingdom from 1990 to 2014, using primary care electronic health records. Epidemiological analysis of chronic morbidities and age-related impairments included a cohort of 299,495 participants, with stratified sampling by five-year age group up to 100 years and over. Cause-specific proportional hazards models were used to estimate hazard ratios for incidence rates over time. Between 1990 and 2014, nonagenarians and centenarians increased as a proportion of the over-80 population, as did the male-to-female ratio among individuals aged 80 to 95 years. A lower risk of coronary heart disease (HR 0.54, 95% confidence interval [CI]: 0.50-0.58), stroke (0.83, 0.76-0.90) and chronic obstructive pulmonary disease (0.59, 0.54-0.64) was observed among 80-84 year-olds in 2010-2014 compared to 1995-1999. By contrast, the risk of type II diabetes (2.18, 1.96-2.42), cancer (1.52, 1.43-1.61), dementia (2.94, 2.70-3.21),...Continue Reading

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Citations

Jun 2, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Federico ConrottoGaetano Maria De Ferrari
Dec 27, 2017·Health Economics, Policy, and Law·Nisha C HazraCaroline Rudisill
Dec 16, 2020·Memory·Agnieszka J JaroslawskaJoni Holmes
Mar 26, 2021·Clinical Medicine : Journal of the Royal College of Physicians of London·Alexander J RobbinsZudin Puthucheary

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