Are China’s oldest-old living longer with less disability? A longitudinal modeling analysis of birth cohorts born 10 years apart

Liu, Zuyun; Han, Ling; Feng, Qiushi; Dupre, Matthew E.; Gu, Danan; Allore, Heather G.; Gill, Thomas M.; Payne, Collin F.

doi:10.1186/s12916-019-1259-z

Cited by 40 publications

(33 citation statements)

References 79 publications

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“…Recently, two successive cohorts study from China also present consistent with the results of these developed countries [23,24]. Liu et al demonstrated that the life expectancy of the population ages 90-99 was 3.9-4.0 years [23].…”

Section: Discussionsupporting

confidence: 57%

“…The life expectancy for 90-year-olds (ranging 4 -5 years) is still reasonably short than that for an 80-year-old (ranging 8 -10 years) [10,11,21,22]. Recently, two successive cohorts study from China also present consistent with the results of these developed countries [23,24]. Liu et al demonstrated that the life expectancy of the population ages 90-99 was 3.9-4.0 years [23].…”

Section: Discussionmentioning

confidence: 85%

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Long-term survival of femoral neck fracture patients age over ninety: Arthroplasty compare with conservative treatment

Liu

Zhang

Zhao

2020

Preprint

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Background The aging of the China population is expected to lead to increasing of nonagenarian and centenarian.The mortality rates of nonagenarian hip fracture patients would return to an equivalent mortality risk to the normal population at five years after injury. It is imperative to evaluate the 5-year mortality for this small but very challenging subgroup patients in order to optimize patient management. The main purpose of the current retrospective study was to compare the five-year survival between arthroplasty treatment and conservative treatment of femoral neck fracture patients age over 90 years during the same 16 -year period.Methods From January 1998 to December 2014, all consecutive nonagenarian and centenarian patients with femoral neck fracture admitted to our hospital were included for evaluation. The primary outcome was defined as thirty-day mortality, 1-year, 3-year, and 5-year mortality after injury. Survival status analysis was performed by the Kaplan–Meier method for mortality. Using the log-rank test, the stratified analyses were performed to compare the difference of overall cumulative mortality and three-time points (1-year, 3-year, and 5-year) mortality after injury were performed to compare the difference of survival distributions.Results Over the 16-year study period, the arthroplasty group and the conservative treatment group included 33 and 53 patients, respectively. The long-term survival probability of the arthroplasty group is significantly higher than the conservative treatment group( p=0.002277). The survival time of the arthroplasty group is significantly higher than the conservative treatment group(Median(P75-P25)=53(59) versus Median(P75-P25)=22(52), p=0.001). The difference of five time points (1-year, 2-year, 3-year, 4-year, and 5-year) mortality between the conservative group and arthroplasty group is significant except for 30-day mortality.The stratified analyses of overall cumulative mortality and three-time points (1-year, 3-year, and 5-year) mortality after injury demonstrated that the arthroplasty group is significant higher than the conservative treatment group.Conclusions Our study demonstrate that, compared with conservative treatment, arthroplasty surgery is more likely to improve the long-term survival of femoral neck fracture patients over 90s. What can be expected is that nearly half of patients will survive more than five years after surgery.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 85%

Long-term survival of femoral neck fracture patients age over ninety: Arthroplasty compare with conservative treatment

Liu

Zhang

Zhao

2020

Preprint

View full text Add to dashboard Cite

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“…Recently, two successive cohort studies from China presented results consistent with the results from developed countries [22,23]. Liu et al demonstrated that the life expectancy of the population aged 90-99 years was 3.9-4.0 years [22].…”

Section: Discussionmentioning

confidence: 73%

“…The life expectancy for 90-year-olds (ranging from 4 to 5 years) in most high-income countries is still reasonably shorter than that for 80-year-olds (ranging from 8 to 10 years) [21]. Recently, two successive cohort studies from China presented results consistent with the results from developed countries [22,23]. Liu et al demonstrated that the life expectancy of the population aged 90-99 years was 3.9-4.0 years [22].…”

Section: Discussionmentioning

confidence: 75%

Long-term survival of femoral neck fracture patients aged over ninety years: Arthroplasty compared with nonoperative treatment

Liu

Zhang

Zhao

2020

BMC Musculoskelet Disord

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Background: The aging of the Chinese population is expected to lead to an increase in nonagenarians and centenarians. The mortality rate in nonagenarian hip fracture patients is equivalent to the mortality rate in the average population at 5 years after injury. It is imperative to evaluate 5-year mortality in this small but very challenging subgroup of patients to optimize patient management. The primary purpose of the current retrospective study was to compare five-year survival in patients aged over 90 years who received arthroplasty or nonoperative treatment for femoral neck fracture during a 16-year period. Methods: From January 1998 to December 2014, all consecutive nonagenarian and centenarian patients with femoral neck fracture admitted to our hospital were included in the evaluation. The primary outcome was defined as thirty-day, 1-year, 3-year, and 5-year mortality after injury. Survival analysis was performed with the Kaplan-Meier method. Using the log-rank test, stratified analyses were performed to compare differences in the overall cumulative mortality and mortality at three time points (1 year, 3 years, and 5 years) after injury and differences in survival distributions. Results: Over the 16-year study period, the arthroplasty group and the nonoperative treatment group included 33 and 53 patients, respectively. The long-term survival probability of the arthroplasty group was significantly higher than that of the nonoperative treatment group (p = 0.002). The survival time of the arthroplasty group was significantly higher than that of the nonoperative treatment group (median (P 75-P 25) = 53 (59) versus median (P 75-P 25) = 22 (52), p = 0.001). The mortality differences, except for 30-day mortality, at five time points (1, 2, 3, 4, and 5 years) between the nonoperative group and arthroplasty group were significant. The stratified analyses of overall cumulative mortality and mortality at three time points (1, 3, and 5 years) after injury demonstrated that the nonoperative treatment group had significantly higher cumulative mortality than the arthroplasty group. Conclusions: Our study demonstrates that arthroplasty is more likely to improve long-term survival in femoral neck fracture patients aged over 90 years than nonoperative treatment. It can be expected that nearly half of patients will survive more than 5 years after surgery.

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“…During the in-depth study, the Chinese Center for Disease Control and Prevention (CDC) local network medical doctors conducted physical examinations of the participants, and also collected biomarker datasets contain about 30 indicators on routine blood tests, urine tests and blood biochemical tests(41). More detailed descriptions have been previously published elsewhere(44)(45)(46).…”

mentioning

confidence: 99%

Plasma 25-hydroxyvitamin D level and risk of frailty among Chinese community-based oldest-old: evidence from CLHLS study

Xiao

Cui

et al. 2019

Preprint

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Background: Whether vitamin D deficiency may contribute to frailty remains inconclusive in Chinese older adults. The aim of this study was to examine the association between 25-hydroxyvitamin D [25(OH)D] level and risk of frailty among Chinese oldest-old in the communities.Methods: Secondary analysis of data compiled by the 2011 wave of the Chinese Longitudinal Healthy Longevity Survey (n=1324) was extracted. Frailty was assessed by the Study of Osteoporotic Fractures (SOF) index. Multivariate logistic regression with spine smoothing was performed to investigate the association between 25(OH)D level and risk of frailty after adjusting for sociodemographic variables, health characteristics and confounding biomarkers.Results: The mean age was 92.89 ± 7.92 years, and 844(63.7%) of participants were women. In all, 426 (33.2% , 95% confidence interval, CI: 29.66-34.69) frail participants were recorded. After adjustment for confounding covariates, the level of 25(OH)D is significantly related to frailty. By the spline smoothing and threshold effect analysis , a monotonically negative association between 25(OH)D and frailty was identified. Subgroup analyses revealed that the association did not differ by gender and age . Conclusions: Plasma 25(OH)D was inversely associated with the risk of frailty among Chinese oldestold. The findings indicate the practical significance of monitoring and managing plasma 25(OH)D level in the elders. BackgroundWith the dramatic population aging, growing attention has been given to the aging-related issues.Frailty is defined as a geriatric syndrome representing a reduced ability to re-build homeostasis in response to external stressors during daily life(1). Frailty in the elderly is well established to be related to long-term adverse health outcomes (such as falls, depression, disability, dependency, and mortality) which were not utterly explained by aging, function decline, or comorbidities (2-5).There are two main methods of diagnosing and assessing frailty in existing studies: the Frailty Index and Frailty Phenotype (6-9). The Frailty Index (FI) is based on the comprehensive geriatric assessment (CGA) of overall health decline by the accumulation of deficits in multiple domains(10).

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Are China’s oldest-old living longer with less disability? A longitudinal modeling analysis of birth cohorts born 10 years apart

Cited by 40 publications

References 79 publications

Long-term survival of femoral neck fracture patients age over ninety: Arthroplasty compare with conservative treatment

Long-term survival of femoral neck fracture patients age over ninety: Arthroplasty compare with conservative treatment

Long-term survival of femoral neck fracture patients aged over ninety years: Arthroplasty compared with nonoperative treatment

Plasma 25-hydroxyvitamin D level and risk of frailty among Chinese community-based oldest-old: evidence from CLHLS study

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