The combined effect of cancer and cardiometabolic conditions on the mortality burden in older adults

Parminder Raina (Corresponding author), Anne Gilsing, Heinz Freisling, Edwin van den Heuvel, Nazmul Sohel, Mazda Jenab, Pietro Ferrari, Anne Tjønneland, Vassiliki Benetou, Susan Picavet, Sture Eriksson, Ben Schöttker, Hermann Brenner, Kai Uwe Saum, Laura Perna, Tom Wilsgaard, Antonia Trichopoulou, Paolo Boffetta, Lauren E. Griffith

Onderzoeksoutput: Bijdrage aan tijdschriftTijdschriftartikelAcademicpeer review

Uittreksel

BACKGROUND: The number of older people living with cancer and cardiometabolic conditions is increasing, but little is known about how specific combinations of these conditions impact mortality. METHODS: A total of 22,692 participants aged 65 years and older from four international cohorts were followed-up for mortality for an average of 10 years (8,596 deaths). Data were harmonized across cohorts and mutually exclusive groups of disease combinations were created for cancer, myocardial infarction (MI), stroke, and diabetes at baseline. Cox proportional hazards models for all-cause mortality were used to estimate the age- and sex-adjusted hazard ratio and rate advancement period (RAP) (in years). RESULTS: At baseline, 23.6% (n = 5,116) of participants reported having one condition and 4.2% (n = 955) had two or more conditions. Data from all studies combined showed that the RAP increased with each additional condition. Diabetes advanced the rate of dying by the most years (5.26 years; 95% confidence interval [CI], 4.53-6.00), but the effect of any single condition was smaller than the effect of disease combinations. Some combinations had a significantly greater impact on the period by which the rate of death was advanced than others with the same number of conditions, for example, 10.9 years (95% CI, 9.4-12.6) for MI and diabetes versus 6.4 years (95% CI, 4.3-8.5) for cancer and diabetes. CONCLUSIONS: Combinations of cancer and cardiometabolic conditions accelerate mortality rates in older adults differently. Although most studies investigating mortality associated with multimorbidity used disease counts, these provide little guidance for managing complex patients as they age.

TaalEngels
Pagina's366-372
Aantal pagina's7
TijdschriftThe Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Volume74
Nummer van het tijdschrift3
DOI's
StatusGepubliceerd - 15 feb 2019

Vingerafdruk

Mortality
Neoplasms
Confidence Intervals
Myocardial Infarction
Proportional Hazards Models
Comorbidity
Stroke

Trefwoorden

    Citeer dit

    Raina, Parminder ; Gilsing, Anne ; Freisling, Heinz ; van den Heuvel, Edwin ; Sohel, Nazmul ; Jenab, Mazda ; Ferrari, Pietro ; Tjønneland, Anne ; Benetou, Vassiliki ; Picavet, Susan ; Eriksson, Sture ; Schöttker, Ben ; Brenner, Hermann ; Saum, Kai Uwe ; Perna, Laura ; Wilsgaard, Tom ; Trichopoulou, Antonia ; Boffetta, Paolo ; Griffith, Lauren E./ The combined effect of cancer and cardiometabolic conditions on the mortality burden in older adults. In: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2019 ; Vol. 74, Nr. 3. blz. 366-372
    @article{655e97799e1647c0ad84ec439d8769cc,
    title = "The combined effect of cancer and cardiometabolic conditions on the mortality burden in older adults",
    abstract = "BACKGROUND: The number of older people living with cancer and cardiometabolic conditions is increasing, but little is known about how specific combinations of these conditions impact mortality. METHODS: A total of 22,692 participants aged 65 years and older from four international cohorts were followed-up for mortality for an average of 10 years (8,596 deaths). Data were harmonized across cohorts and mutually exclusive groups of disease combinations were created for cancer, myocardial infarction (MI), stroke, and diabetes at baseline. Cox proportional hazards models for all-cause mortality were used to estimate the age- and sex-adjusted hazard ratio and rate advancement period (RAP) (in years). RESULTS: At baseline, 23.6{\%} (n = 5,116) of participants reported having one condition and 4.2{\%} (n = 955) had two or more conditions. Data from all studies combined showed that the RAP increased with each additional condition. Diabetes advanced the rate of dying by the most years (5.26 years; 95{\%} confidence interval [CI], 4.53-6.00), but the effect of any single condition was smaller than the effect of disease combinations. Some combinations had a significantly greater impact on the period by which the rate of death was advanced than others with the same number of conditions, for example, 10.9 years (95{\%} CI, 9.4-12.6) for MI and diabetes versus 6.4 years (95{\%} CI, 4.3-8.5) for cancer and diabetes. CONCLUSIONS: Combinations of cancer and cardiometabolic conditions accelerate mortality rates in older adults differently. Although most studies investigating mortality associated with multimorbidity used disease counts, these provide little guidance for managing complex patients as they age.",
    keywords = "Aging, Epidemiology, Multimorbidity, Risk factor",
    author = "Parminder Raina and Anne Gilsing and Heinz Freisling and {van den Heuvel}, Edwin and Nazmul Sohel and Mazda Jenab and Pietro Ferrari and Anne Tj{\o}nneland and Vassiliki Benetou and Susan Picavet and Sture Eriksson and Ben Sch{\"o}ttker and Hermann Brenner and Saum, {Kai Uwe} and Laura Perna and Tom Wilsgaard and Antonia Trichopoulou and Paolo Boffetta and Griffith, {Lauren E.}",
    year = "2019",
    month = "2",
    day = "15",
    doi = "10.1093/gerona/gly053",
    language = "English",
    volume = "74",
    pages = "366--372",
    journal = "The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences",
    issn = "1079-5006",
    publisher = "Oxford University Press",
    number = "3",

    }

    Raina, P, Gilsing, A, Freisling, H, van den Heuvel, E, Sohel, N, Jenab, M, Ferrari, P, Tjønneland, A, Benetou, V, Picavet, S, Eriksson, S, Schöttker, B, Brenner, H, Saum, KU, Perna, L, Wilsgaard, T, Trichopoulou, A, Boffetta, P & Griffith, LE 2019, 'The combined effect of cancer and cardiometabolic conditions on the mortality burden in older adults' The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, vol. 74, nr. 3, blz. 366-372. DOI: 10.1093/gerona/gly053

    The combined effect of cancer and cardiometabolic conditions on the mortality burden in older adults. / Raina, Parminder (Corresponding author); Gilsing, Anne; Freisling, Heinz; van den Heuvel, Edwin; Sohel, Nazmul; Jenab, Mazda; Ferrari, Pietro; Tjønneland, Anne; Benetou, Vassiliki; Picavet, Susan; Eriksson, Sture; Schöttker, Ben; Brenner, Hermann; Saum, Kai Uwe; Perna, Laura; Wilsgaard, Tom; Trichopoulou, Antonia; Boffetta, Paolo; Griffith, Lauren E.

    In: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, Vol. 74, Nr. 3, 15.02.2019, blz. 366-372.

    Onderzoeksoutput: Bijdrage aan tijdschriftTijdschriftartikelAcademicpeer review

    TY - JOUR

    T1 - The combined effect of cancer and cardiometabolic conditions on the mortality burden in older adults

    AU - Raina,Parminder

    AU - Gilsing,Anne

    AU - Freisling,Heinz

    AU - van den Heuvel,Edwin

    AU - Sohel,Nazmul

    AU - Jenab,Mazda

    AU - Ferrari,Pietro

    AU - Tjønneland,Anne

    AU - Benetou,Vassiliki

    AU - Picavet,Susan

    AU - Eriksson,Sture

    AU - Schöttker,Ben

    AU - Brenner,Hermann

    AU - Saum,Kai Uwe

    AU - Perna,Laura

    AU - Wilsgaard,Tom

    AU - Trichopoulou,Antonia

    AU - Boffetta,Paolo

    AU - Griffith,Lauren E.

    PY - 2019/2/15

    Y1 - 2019/2/15

    N2 - BACKGROUND: The number of older people living with cancer and cardiometabolic conditions is increasing, but little is known about how specific combinations of these conditions impact mortality. METHODS: A total of 22,692 participants aged 65 years and older from four international cohorts were followed-up for mortality for an average of 10 years (8,596 deaths). Data were harmonized across cohorts and mutually exclusive groups of disease combinations were created for cancer, myocardial infarction (MI), stroke, and diabetes at baseline. Cox proportional hazards models for all-cause mortality were used to estimate the age- and sex-adjusted hazard ratio and rate advancement period (RAP) (in years). RESULTS: At baseline, 23.6% (n = 5,116) of participants reported having one condition and 4.2% (n = 955) had two or more conditions. Data from all studies combined showed that the RAP increased with each additional condition. Diabetes advanced the rate of dying by the most years (5.26 years; 95% confidence interval [CI], 4.53-6.00), but the effect of any single condition was smaller than the effect of disease combinations. Some combinations had a significantly greater impact on the period by which the rate of death was advanced than others with the same number of conditions, for example, 10.9 years (95% CI, 9.4-12.6) for MI and diabetes versus 6.4 years (95% CI, 4.3-8.5) for cancer and diabetes. CONCLUSIONS: Combinations of cancer and cardiometabolic conditions accelerate mortality rates in older adults differently. Although most studies investigating mortality associated with multimorbidity used disease counts, these provide little guidance for managing complex patients as they age.

    AB - BACKGROUND: The number of older people living with cancer and cardiometabolic conditions is increasing, but little is known about how specific combinations of these conditions impact mortality. METHODS: A total of 22,692 participants aged 65 years and older from four international cohorts were followed-up for mortality for an average of 10 years (8,596 deaths). Data were harmonized across cohorts and mutually exclusive groups of disease combinations were created for cancer, myocardial infarction (MI), stroke, and diabetes at baseline. Cox proportional hazards models for all-cause mortality were used to estimate the age- and sex-adjusted hazard ratio and rate advancement period (RAP) (in years). RESULTS: At baseline, 23.6% (n = 5,116) of participants reported having one condition and 4.2% (n = 955) had two or more conditions. Data from all studies combined showed that the RAP increased with each additional condition. Diabetes advanced the rate of dying by the most years (5.26 years; 95% confidence interval [CI], 4.53-6.00), but the effect of any single condition was smaller than the effect of disease combinations. Some combinations had a significantly greater impact on the period by which the rate of death was advanced than others with the same number of conditions, for example, 10.9 years (95% CI, 9.4-12.6) for MI and diabetes versus 6.4 years (95% CI, 4.3-8.5) for cancer and diabetes. CONCLUSIONS: Combinations of cancer and cardiometabolic conditions accelerate mortality rates in older adults differently. Although most studies investigating mortality associated with multimorbidity used disease counts, these provide little guidance for managing complex patients as they age.

    KW - Aging

    KW - Epidemiology

    KW - Multimorbidity

    KW - Risk factor

    UR - http://www.scopus.com/inward/record.url?scp=85061592015&partnerID=8YFLogxK

    U2 - 10.1093/gerona/gly053

    DO - 10.1093/gerona/gly053

    M3 - Article

    VL - 74

    SP - 366

    EP - 372

    JO - The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

    T2 - The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

    JF - The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

    SN - 1079-5006

    IS - 3

    ER -