The Male-Female Health-Mortality Paradox

Lego, Vanessa di; Lazarevič, Patrick

doi:10.1007/978-3-030-22009-9_798

Cited by 7 publications

(5 citation statements)

References 50 publications

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“…This trend represents another possible explanation for the decline in the strength of the association between the frailty phenotype and mental disorders in individuals over 60 years of age observed in the current study. The observation that frailty was increased in females whereas all-cause mortality was elevated in males is consistent with the male-female health-mortality paradox that has been documented elsewhere [ 7 , 46 ]. Although biological, behavioural, and social factors have been hypothesised to explain this finding, the evidence for possible explanations (e.g.…”

Section: Discussionsupporting

confidence: 89%

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Frailty in individuals with depression, bipolar disorder and anxiety disorders: longitudinal analyses of all-cause mortality

Mutz

Choudhury

Zhao

et al. 2022

BMC Med

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Background Frailty is a medical syndrome that is strongly associated with mortality risk and an emerging global health burden. Mental disorders are associated with reduced life expectancy and elevated levels of frailty. In this study, we examined the mortality risk associated with frailty in individuals with a lifetime history of mental disorders compared to individuals without a history of mental disorders. Methods The UK Biobank study recruited > 500,000 adults, aged 37–73, between 2006 and 2010. We derived the two most common albeit distinctive measures of frailty, the frailty phenotype and the frailty index. Individuals with lifetime depression, bipolar disorder or anxiety disorders were identified from multiple data sources. The primary outcome was all-cause mortality. We have also examined differences in frailty, separately by sex and age. Results Analyses included up to 297,380 middle-aged and older adults with a median follow-up of 12.19 (interquartile range = 1.31) years, yielding 3,516,706 person-years of follow-up. We observed higher levels of frailty in individuals with mental disorders for both frailty measures. Standardised mean differences in the frailty index ranged from 0.66 (95% confidence interval [CI] 0.65–0.67) in individuals with anxiety disorders to 0.94 (95% CI 0.90–0.97) in individuals with bipolar disorder, compared to people without mental disorders. For key comparisons, individuals with a mental disorder had greater all-cause mortality hazards than the comparison group without mental disorders. The highest hazard ratio (3.65, 95% CI 2.40–5.54) was observed among individuals with bipolar disorder and frailty, relative to non-frail individuals without mental disorders. Conclusions Our findings highlight elevated levels of frailty across three common mental disorders. Frailty and mental disorders represent potentially modifiable targets for prevention and treatment to improve population health and life expectancy, especially where both conditions coexist.

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Section: Discussionsupporting

confidence: 89%

“…Although biological, behavioural, and social factors have been hypothesised to explain this finding, the evidence for possible explanations (e.g. increased health-care use by females) has generally not been conclusive [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Frailty in individuals with depression, bipolar disorder and anxiety disorders: longitudinal analyses of all-cause mortality

Mutz

Choudhury

Zhao

et al. 2022

BMC Med

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“…Consistent with previous studies [9][10][11][12], the Male-Female Health-Mortality Paradox [33] existed among older adults, meaning that older women had a longer total LE and frail LE, but a lower robust LE than older men. We also found inequalities in total LE and robust LE by socioeconomic status, which may be explained by social, behavioural, and biological factors throughout life [12,34].…”

Section: Discussionsupporting

confidence: 89%

Life expectancy among older adults with or without frailty in China: multistate modelling of a national longitudinal cohort study

Gao

Wang

et al. 2023

BMC Med

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Background Little is known about life expectancy (LE) with or without frailty. We aimed to estimate the total LE and duration of the state of frailty in China. Methods This study included older adults aged 65 years and older from the Chinese Longitudinal Healthy Longevity Study (CLHLS). Frailty status was classified into robust, pre-frailty and frailty based on a cumulative deficit model. Total and specific frailty state LEs at 65 years of age were estimated and stratified by demographic characteristics, behaviours, and psychosocial factors using continuous-time multistate modelling. Results The total LE of older adults aged 65 years in China was 14.74 years on average (95% CI: 14.52–14.94), of which 4.18 years (95% CI: 4.05–4.30) were robust, 7.46 years (95% CI: 7.31–7.61) pre-frail and 3.10 years (95% CI: 3.01–3.20) frail. Older adults with higher robust LE included men (4.71 years, 95% CI: 4.56–4.88), married older adults (4.41 years, 95% CI: 4.27–4.56), those engaging in physical activity (4.41 years, 95% CI: 4.23–4.59), those consuming fruits daily (4.48 years, 95% CI: 4.22–4.77) and those with high social participation (4.39 years, 95% CI: 4.26–4.53). Increased educational attainment were gradually associated with increased robust LE. Conclusions Frailty may lead to a reduced total LE and robust LE of older adults in China. In addition to finding inequalities in total and robust LEs by socioeconomic status, our findings also highlight that healthy behaviours and social participation may ease frailty-related reductions in total and robust LE. Our findings imply that national life-course strategies aimed at frailty screening and psychosocial and behavioural interventions could be important for health aging in China.

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“…Additionally, women may perceive disease differently from men, actively seeking follow-up and preventive care. Women also tend to have more support networks, which can positively impact their health outcomes [ 20 ]. However, the mortality rate of AKF in women aged over 65 years was found to be higher than that in men of the same age group.…”

Section: Discussionmentioning

confidence: 99%

Decadal Analysis of Age-Adjusted Mortality Rates for Acute and Chronic Kidney Disease in Brazil, 2000-2021

Hauwanga,

Alphonse,

Akram

et al. 2024

Cureus

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IntroductionRenal failure, comprising acute kidney injury (AKI) and chronic kidney disease (CKD), involves a decline or loss of kidney function. AKI is sudden and reversible, with a rapid decline in function over hours to days, while CKD involves persistent abnormalities lasting at least three months. Developing countries are seeing a rise in AKI cases, especially in critically ill patients. Globally, there's a growing occurrence and mortality rate linked to CKD. MethodsThe study used a retrospective cross-sectional design to analyze AKI and CKD mortality rates in Brazil from 2019 to 2022. Data on population and demographics, including sex and age, were obtained from the Brazilian Institute of Geography and Statistics. Mortality data for kidney diseases were sourced from the Brazilian Hospital Information System. The analysis utilized the Joinpoint Regression Program to calculate average annual percentage changes (AAPCs) and their respective 95% confidence intervals. Weighted Bayesian information criterion was used to determine the significance levels and identify the best-fitting combination of line segments and joinpoints. ResultsThe study findings revealed a significant rise in AKI mortality rates for both males and females, from 2008 to 2021 (APC = 3.16; CI: 2.29 to 5.93), with higher mortality rates recorded among males compared to women over the entire study period. Analyses according to age groups showed that males between the ages 40 to 49 experienced the most rapid increase in mortality during the 2019 -2021 period (APC = 35.41; CI: 16.72 to 46.57); meanwhile, the most rapid increase in mortality for females was observed from 2019 to 2021, and this was among those aged 30 to 39 (APC = 40.33; CI = 6.48 to 59.78). Furthermore, there was an observable upward trend in mortality related to CKD (APC = 0.70; CI: 0.41 to 1.01), with males consistently having higher mortality rates throughout the entire study period. The elderly population, both males and females, experienced the most rapid increase in CKD-related mortality, with AAPC values of 2.32 (CI: 1.82 to 2.89) for males and 1.62 (CI: 1.08 to 2.10) for females. ConclusionWe observed a consistent increase in mortality rates from acute kidney diseases for both males and females since 2008, with males experiencing higher mortality rates overall. The study highlighted the need for further research to understand the underlying factors contributing to these trends. Additionally, interventions targeting modifiable risk factors and improving access to healthcare could help reduce mortality related to renal failure.

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The Male-Female Health-Mortality Paradox

Cited by 7 publications

References 50 publications

Frailty in individuals with depression, bipolar disorder and anxiety disorders: longitudinal analyses of all-cause mortality

Frailty in individuals with depression, bipolar disorder and anxiety disorders: longitudinal analyses of all-cause mortality

Life expectancy among older adults with or without frailty in China: multistate modelling of a national longitudinal cohort study

Decadal Analysis of Age-Adjusted Mortality Rates for Acute and Chronic Kidney Disease in Brazil, 2000-2021

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