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Early Life Exposure to the 1918 Influenza Pandemic and Old-Age Mortality by Cause of Death

Identifieur interne : 000612 ( Pmc/Checkpoint ); précédent : 000611; suivant : 000613

Early Life Exposure to the 1918 Influenza Pandemic and Old-Age Mortality by Cause of Death

Auteurs : Mikko Myrskyl ; Neil K. Mehta ; Virginia W. Chang

Source :

RBID : PMC:3682600

Abstract

Objectives. We sought to analyze how early exposure to the 1918 influenza pandemic is associated with old-age mortality by cause of death.

Methods. We analyzed the National Health Interview Survey (n = 81 571; follow-up 1989–2006; 43 808 deaths) and used year and quarter of birth to assess timing of pandemic exposure. We used Cox proportional and Fine-Gray competing hazard models for all-cause and cause-specific mortality, respectively.

Results. Cohorts born during pandemic peaks had excess all-cause mortality attributed to increased noncancer mortality. We found evidence for a trade-off between noncancer and cancer causes: cohorts with high noncancer mortality had low cancer mortality, and vice versa.

Conclusions. Early disease exposure increases old-age mortality through noncancer causes, which include respiratory and cardiovascular diseases, and may trigger a trade-off in the risk of cancer and noncancer causes. Potential mechanisms include inflammation or apoptosis. The findings contribute to our understanding of the causes of death behind the early disease exposure–later mortality association. The cancer–noncancer trade-off is potentially important for understanding the mechanisms behind these associations.


Url:
DOI: 10.2105/AJPH.2012.301060
PubMed: 23678911
PubMed Central: 3682600


Affiliations:


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PMC:3682600

Le document en format XML

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<name sortKey="Mehta, Neil K" sort="Mehta, Neil K" uniqKey="Mehta N" first="Neil K." last="Mehta">Neil K. Mehta</name>
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<name sortKey="Chang, Virginia W" sort="Chang, Virginia W" uniqKey="Chang V" first="Virginia W." last="Chang">Virginia W. Chang</name>
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<title level="j">American Journal of Public Health</title>
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<italic>Objectives.</italic>
We sought to analyze how early exposure to the 1918 influenza pandemic is associated with old-age mortality by cause of death.</p>
<p>
<italic>Methods.</italic>
We analyzed the National Health Interview Survey (n = 81 571; follow-up 1989–2006; 43 808 deaths) and used year and quarter of birth to assess timing of pandemic exposure. We used Cox proportional and Fine-Gray competing hazard models for all-cause and cause-specific mortality, respectively.</p>
<p>
<italic>Results.</italic>
Cohorts born during pandemic peaks had excess all-cause mortality attributed to increased noncancer mortality. We found evidence for a trade-off between noncancer and cancer causes: cohorts with high noncancer mortality had low cancer mortality, and vice versa.</p>
<p>
<italic>Conclusions.</italic>
Early disease exposure increases old-age mortality through noncancer causes, which include respiratory and cardiovascular diseases, and may trigger a trade-off in the risk of cancer and noncancer causes. Potential mechanisms include inflammation or apoptosis. The findings contribute to our understanding of the causes of death behind the early disease exposure–later mortality association. The cancer–noncancer trade-off is potentially important for understanding the mechanisms behind these associations.</p>
</div>
</front>
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<pmc article-type="research-article">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
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<journal-id journal-id-type="nlm-ta">Am J Public Health</journal-id>
<journal-id journal-id-type="iso-abbrev">Am J Public Health</journal-id>
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<journal-title>American Journal of Public Health</journal-title>
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<article-id pub-id-type="doi">10.2105/AJPH.2012.301060</article-id>
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<subject>Aging</subject>
<subject>Cancer</subject>
<subject>Cardiovascular Disease</subject>
<subject>Epidemiology</subject>
<subject>Other Infections</subject>
<subject>Other Maternal And Infant Health</subject>
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<subject>Online Research and Practice</subject>
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<article-title>Early Life Exposure to the 1918 Influenza Pandemic and Old-Age Mortality by Cause of Death</article-title>
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<name>
<surname>Myrskylä</surname>
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<degrees>PhD</degrees>
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<name>
<surname>Mehta</surname>
<given-names>Neil K.</given-names>
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<degrees>PhD</degrees>
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<name>
<surname>Chang</surname>
<given-names>Virginia W.</given-names>
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<degrees>MD, PhD</degrees>
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<aff>Mikko Myrskylä is with Research Group Lifecourse Dynamics and Demographic Change, Max Planck Institute for Demographic Research, Rostock, Germany. Neil K. Mehta is with the Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA. Virginia W. Chang is with the Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY.</aff>
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<author-notes>
<corresp>Correspondence should be sent to Mikko Myrskylä, Max Planck Institute for Demographic Research, Konrad Zuse Str 1, 18057 Rostock, Germany (e-mail:
<email>myrskyla@demogr.mpg.de</email>
). Reprints can be ordered at
<ext-link ext-link-type="uri" xlink:href="http://www.ajph.org">http://www.ajph.org</ext-link>
by clicking the “Reprints” link.</corresp>
<fn>
<p>
<bold>Contributors</bold>
</p>
<p>M. Myrskylä and N. K. Mehta conceptualized and designed the study with input from V. W. Chang. M. Myrskylä and N. K. Mehta conducted the statistical analysis. All authors contributed to the interpretation of the findings and to the writing of the article.</p>
</fn>
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<pub-date pub-type="ppub">
<month>7</month>
<year>2013</year>
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<month>7</month>
<year>2013</year>
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<month>7</month>
<year>2013</year>
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<pmc-comment> PMC Release delay is 0 months and 0 days and was based on the . </pmc-comment>
<volume>103</volume>
<issue>7</issue>
<fpage>e83</fpage>
<lpage>e90</lpage>
<history>
<date date-type="accepted">
<day>5</day>
<month>9</month>
<year>2012</year>
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<permissions>
<copyright-statement>© American Public Health Association 2013</copyright-statement>
<copyright-year>2013</copyright-year>
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<abstract>
<p>
<italic>Objectives.</italic>
We sought to analyze how early exposure to the 1918 influenza pandemic is associated with old-age mortality by cause of death.</p>
<p>
<italic>Methods.</italic>
We analyzed the National Health Interview Survey (n = 81 571; follow-up 1989–2006; 43 808 deaths) and used year and quarter of birth to assess timing of pandemic exposure. We used Cox proportional and Fine-Gray competing hazard models for all-cause and cause-specific mortality, respectively.</p>
<p>
<italic>Results.</italic>
Cohorts born during pandemic peaks had excess all-cause mortality attributed to increased noncancer mortality. We found evidence for a trade-off between noncancer and cancer causes: cohorts with high noncancer mortality had low cancer mortality, and vice versa.</p>
<p>
<italic>Conclusions.</italic>
Early disease exposure increases old-age mortality through noncancer causes, which include respiratory and cardiovascular diseases, and may trigger a trade-off in the risk of cancer and noncancer causes. Potential mechanisms include inflammation or apoptosis. The findings contribute to our understanding of the causes of death behind the early disease exposure–later mortality association. The cancer–noncancer trade-off is potentially important for understanding the mechanisms behind these associations.</p>
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