Original Title: Análisis de la evolución de las principales causas de mortalidad en personas mayores de 65 años, de la Comunidad Autónoma del País Vasco (1986-2001)

Authors' objectives: i) To estimate specific mortality rates by cause of death, geographic area, sex, age and year of death. ii) To estimate, the risk of death, depending on the cause of death for each year of the total period time, adjusted by geographic area, sex, and age in the target population. iii) To calculate the risk of death due to different death causes for each age (from 65 to 100 years), adjusted by geographic area, sex, year of death in the population. iv) To know the trends of the risk of death by different causes along the period studied and the repercussion caused by the changes of the death risk over the life expectancy. v) To analyse comparatively observed life expectancy versus theoretical life expectancy, once it has been removed the deceases attributed to each cause of death.

Authors' results and conclusions: It was not found an only and unique statistical model to explain mortality by each cause of death, so it is necessary a different and specific model for each one of the possible death causes. The risk of death due to circulatory system pathology, decreases along the time of the study. This decrement is the main component of the general mortality decrement trend and simultaneously the reason of the considerable increment of life expectancy. The mortality rates and risk due to cancer tends to stay constant along the period time. It suggests that: i) mortality due to cancer is appearing at sooner ages in younger subjects or ii) a considerable increase in mortality due to cancer in males. The risk of death due to respiratory as well as digestive causes of death, diminishes along the time, but its repercussion on life expectancy is scarce. Never the less, digestive pathology suggests some success in preventive policy and treatment of this cause. Respect to mortality by booth nervous system and mental causes, there is an increment of risk by these causes along the time. This situation could be produced by a higher number of deceases or, an increment in the diagnosis of these diseases instead. The rest of death causes, does not show differential patterns in comparative terms with the ones argued before. In general, the increment of life expectancy, obtained by the decreasing mortality is likely to be less than 3 months.

Authors' recommendations: 1. To search new and better models in order to obtain an specific analysis of the issues derived from mortality in elderly. 2. Specific study, by depth cause, to measure mortality rates and their repercussion over life expectancy in 65 or older. 3. To continue with preventive activities in the context of circulatory pathology, promoting the prevention of cerebral and vascular processes, whose prevention could still increase the life expectancy in this age group of population. 4. To analyse exhaustively mortality and its repercussion on life expectancy in tumour and cancer pathology, because of the negative response to the present preventive and therapeutic policy. 5. To affront the realization of cost analysis studies, based on the theoretical improvement would be obtained if an specific preventive police was designed and applied. 6. Maintaining of the vigilance of mortality due to mental and developmental as well as central nervous system, with the objective of study the reasons of their higher mortality.

Authors' methods: The target population was defined as the pool formed by both males and females, whose age was equal or higher than 65, living in the Basque Country from 1986 to 2001. The analysis was performed under the definition of the reviewed list of main death causes, which was realized in collaboration with local mortality registries and the Spanish Institute of Statistics (INE). The Registry of Mortality of The Basque Country was use as data source, providing 204,579 deceases, on the other hand the Basque Country Institute of Statistics supplied the sizes of population by geographic area, sex, age and year. The processing of these data allows to calculate specific mortality rates and to analyse them by means of age-period-cohort models, based on Poisson regression. This procedure was complemented with the analysis of the repercussion of the mortality by cause of death on the life expectancy at 65.

Project Status: Completed

Year Published: 2005

URL for published report: https://www.euskadi.eus/contenidos/informacion/2005_osteba_publicacion/es_def/adjuntos/2005/d_05-05_mortalidad_mayores_65.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p>Basque Office for Health Technology Assessment, Health Department Basque Government (OSTEBA)</p>