of Work: The purpose of this agreement was to support the collection and analysis of data on cause of death and characteristics of the last year of life in the planning of the 1992 Pretest and 1993 Main Survey of the 1993 National Mortality Followback Survey (NMFS), conducted by NCHS, CDC. This survey supplements information from death certificates in the vital statistics file with information on characteristics of the decedent. The pretest examined approximately 800 deaths of individuals aged 15 years and over who died in 1992. The main survey examined approximately 22,951 deaths of individuals aged 15 years and over who died in 1993. This includes 884 deaths to centenarians. Activities during FY 2000 have been concentrated on data analysis. Two analyses involving EDB staff and Visiting Scientist Dr. David Melzer from the U.K. have been completed and submitted for publication. One analysis concerned premortem use of surgery by the decedents for replacement of hip and knee joints and other devices (such as screws, pins, etc.) related to lower limb mobility problems. The reported high usage may have contributed to a substantial decrease in mobility disability in late life. A second analysis concerned problem behaviors among older decedents and related behaviors to alcohol and drug use and depressive symptoms among the decedents. A preliminary analysis of the 1986 and 1993 NMFS data that explored trends in diagnosed dementia over the 7-year period between the two surveys has been confirmed by subsequent analysis, showing both an increase in the recognition of dementia mortality by physicians completing the death certificates and by informants responding for the decedents in the survey. However, the levels of morbidity as measured in terms of physical and cognitive functioning in the last year of life showed little increase over the seven-year period. Future analytic plans will look at trends in reported lifetime history of other conditions between the 1986 and 1993 NMFS, examination of lifestyle factors related to death at very old ages, hypotheses regarding decreased use of health services in the last years of life among the very old, and possible studies of compression of morbidity among the oldest old.
| Foley, Daniel J; Brock, Dwight B; Lanska, Douglas J (2003) Trends in dementia mortality from two National Mortality Followback Surveys. Neurology 60:709-11 |
| Bedford, S; Melzer, D; Guralnik, J (2001) Problem behavior in the last year of life: prevalence, risks, and care receipt in older Americans. J Am Geriatr Soc 49:590-5 |
