A demographic analysis is proposed of mortality patterns in the U.S. elderly population for the 14-year period 1968 to 1981 utilizing race, age, and sex specific mortality data where all medical conditions reported on the death certificate, and not just the underlying cause of death, are analyzed. The purpose of this analysis is to explain recent increases in life expectancy at later ages by examining trends for major chronic diseases over the 14-year period and to determine sources of variation in those trends.
Five specific aims are addressed.
The first aim i s to use life table and categorical data strategies to assess both underlying cause and total mentions trends in chronic disease mortality.
The second aim i s to evaluate sex differentials in multiple cause mortality data for major chronic diseases and to determine if those sex differentials can be related to cohort differentials in cause specific mortality risks.
The third aim i s to examine differences in the complexity of cause of death patterns for the extreme elderly population (i.e., age 85+) and to compare the pattern of conditions reported at those ages, and their changes over time, with those for persons 75-84 (a portion of the """"""""old-old"""""""" population), persons 65-74 (post-retirement), and persons 55-64 (pre-retirement).
The fourth aim i s to determine if there is significant geographical variation in the cross-temporal multiple cause mortality patterns. If significant geographic variation exists, this suggests that changes in mortality patterns occur at different times in different areas (e.g., circulatory disease declines began in certain states significantly before the rest of the country) and that national mortality patterns are really an average of distinct patterns in discrete geographic regions. The fifth aim is to relate the cause specific mortality patterns to underlying health changes based on biologically motivated models of human aging processes and mortality. In the first four aims demographic mortality analyses and Poisson regression strategies will be employed. In the fifth aim, biologically motivated models will be proposed which will extensively employ insights from biomedical theory and auxiliary health data. An important component of this fifth aim is to evaluate the sensitivity of analytic results to various assumptions. The characterization of trends using multiple cause mortality data will improve understanding of mortality patterns and mechanisms in the elderly population, help understand changes in survival patterns in the population and permit changes in mortality and health in the elderly population to be better anticipated.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
2R01AG001159-09
Application #
3114170
Study Section
Social Sciences and Population Study Section (SSP)
Project Start
1980-04-01
Project End
1987-11-30
Budget Start
1984-12-01
Budget End
1985-11-30
Support Year
9
Fiscal Year
1985
Total Cost
Indirect Cost
Name
Duke University
Department
Type
Organized Research Units
DUNS #
071723621
City
Durham
State
NC
Country
United States
Zip Code
27705
Manton, Kenneth G; Gu, Xi-Liang; Lowrimore, Gene et al. (2009) NIH funding trajectories and their correlations with US health dynamics from 1950 to 2004. Proc Natl Acad Sci U S A 106:10981-6
Manton, Kenneth G; Gu, XiLiang; Lowrimore, Gene R (2008) Cohort changes in active life expectancy in the U.S. elderly population: experience from the 1982-2004 National Long-Term Care Survey. J Gerontol B Psychol Sci Soc Sci 63:S269-81
Manton, Kenneth G; Lowrimore, Gene R; Ullian, Arthur D et al. (2007) Labor force participation and human capital increases in an aging population and implications for U.S. research investment. Proc Natl Acad Sci U S A 104:10802-7
Manton, Kenneth G; Lamb, Vicki L; Gu, XiLiang (2007) Medicare cost effects of recent U.S. disability trends in the elderly: future implications. J Aging Health 19:359-81
Manton, Kenneth G; Gu, XiLiang; Lamb, Vicki L (2006) Change in chronic disability from 1982 to 2004/2005 as measured by long-term changes in function and health in the U.S. elderly population. Proc Natl Acad Sci U S A 103:18374-9
Manton, K G; Akushevich, I; Kulminski, A (2004) Demographic analysis and modeling of human populations exposed to ionizing radiation. Front Biosci 9:2144-52
Manton, Kenneth G; Volovik, Serge; Kulminski, Alexander (2004) ROS effects on neurodegeneration in Alzheimer's disease and related disorders: on environmental stresses of ionizing radiation. Curr Alzheimer Res 1:277-93
Zuev, S M; Yashin, A I; Manton, K G et al. (2000) Vitality index in survival modeling: how physiological aging influences mortality. J Gerontol A Biol Sci Med Sci 55:B10-9
Manton, K G; Stallard, E; Corder, L (1997) Education-specific estimates of life expectancy and age-specific disability in the U.S. elderly population: 1982 to 1991. J Aging Health 9:419-50
Manton, K G; Stallard, E (1996) Longevity in the united states: age and sex-specific evidence on life span limits from mortality patterns 1960-1990. J Gerontol A Biol Sci Med Sci 51:B362-75

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