Absolute risk charts for death within 10 years for Australians in their 70’s by behavioural risk factors

Annette Dobson, Deirdre McLaughlin, Nancy Pachana, Julie Byles, Janni Leung, Kieran McCaul, Leon Flicker, Osvaldo Almeida, Derrick Lopez,

Graeme Hankey.

NHMRC/ARC Ageing Well, Ageing Productively Grant

Background

Demographic changes, increasing age and longer life expectancy mean that more people will live into their 70s and 80s.

Aims of this studyProvide valid estimates of the combined effects of major behavioural factors on risk of death within 10 years for men and women already in their 70s

Present the results using simple charts to communicate the importance of combinations of risk factors

Australian Longitudinal Study on Women’s Health

1921-1926 cohort

Health, well-being and health service use

Surveyed every 3 years: 1996 – to at least 2015

National – over 40,000 participants

Funded by Australian Department of Health & Ageing

Health in Men StudyAged 65-83

Screened in 1996-1999 for Abdominal Aortic Aneurysm

Followed up in 2001-2004 for HIMS study

Perth area only

Physical examination, biomarkers, questionnaire

Funded by NHMRC project grants

MethodsN: 7438 women, 6053 menAge: 71 to 79 yearsOutcome: deaths from all causesFollow-up: 10 year

Women Men Age (years) 71-73 1 ref 1 ref 74-76 1.47 (1.20, 1.79) 1.65 (1.46, 1.87) 77-79 2.07 (1.64, 2.51) 2.47 (2.16, 2.84) Smoking status Never smoked 1 ref 1 ref Ex-smoker 1.45 (1.29, 1.63) 1.54 (1.35, 1.75) Current smoker 2.33 (1.85, 2.93) 2.68( .19, 3.29) BMI (kg/m2) Normal(18.5 to <25) 1 ref 1 ref Overweight (25 to <30) 0.82 (0.72, 0.92) 0.87 (0.77, 0.99) Obese (≥30) 1.03 (0.88, 1.21) 0.98 (0.83, 1.15) Alcohol consumption Weekly or more 1 ref 1 ref Less than weekly 1.27 (1.12, 1.44) 1.23 (1.10, 1.38) Physical activity (MET.minutes/week) None/low (<600) 1 ref 1 ref Moderate/high (≥600) 0.66 (0.58, 0.74) 0.68 (0.61, 0.76) Constant (not exp) -1.76 (-1.98, -1.53) -1.07 (-1.24, -0.90)

Odds ratios and 95% confidence intervals (95% CI) for each sex separately; logistic regression for death within 10 years

Absolute risk charts for death within 10 years; numbers in the cells are predicted risk (%) calculated from the logistic regression models.

Age: 71-73 yearsWomen Men

Alcohol consumption Alcohol consumption≥weekly <weekly ≥weekly <weekly

Physical activity (MET.mins/week) PA≥600 PA<600 PA≥600 PA<600 PA≥600 PA<600 PA≥600 PA<600

Smoking BMINever smoker Normal 10 15 13 18 19 26 22 30

Overweight 8 12 10 15 17 23 20 27 Obese 10 15 13 18 19 25 22 29

Ex-smoker Normal 14 20 17 24 27 35 31 39Overweight 12 17 15 21 24 32 28 36Obese 14 20 18 25 26 34 30 39

Current smoker Normal 21 29 25 34 39 48 44 53

Overweight 18 25 21 29 36 45 40 50Obese 29 29 26 34 38 48 43 53

<20% 20-39% 40-59% ≥60%

Absolute risk charts for death within 10 years; numbers in the cells are predicted risk (%) calculated from the logistic regression models.

Age: 74-76 yearsWomen Men

Alcohol consumption Alcohol consumption≥weekly <weekly ≥weekly <weekly

Physical activity (MET.mins/week) PA≥600 PA<600 PA≥600 PA<600 PA≥600 PA<600 PA≥600 PA<600

Smoking BMINever smoker Normal 14 20 17 24 28 36 32 41

Overweight 12 17 15 21 25 33 29 38 Obese 15 21 18 25 28 36 32 41

Ex-smoker Normal 19 27 23 32 37 47 42 52Overweight 16 23 20 28 34 43 39 48Obese 20 27 24 32 37 46 42 51

Current smoker Normal 28 37 33 43 51 60 56 65

Overweight 24 32 29 38 48 57 53 62Obese 28 38 33 43 51 60 56 65

<20% 20-39% 40-59% ≥60%

Absolute risk charts for death within 10 years; numbers in the cells are predicted risk (%) calculated from the logistic regression models.

Age: 77-79 yearsWomen Men

Alcohol consumption Alcohol consumption≥weekly <weekly ≥weekly <weekly

Physical activity (MET.mins/week) PA≥600 PA<600 PA≥600 PA<600 PA≥600 PA<600 PA≥600 PA<600

Smoking BMINever smoker Normal 19 26 23 31 37 46 42 51

Overweight 16 22 19 27 34 43 38 48 Obese 19 26 23 31 36 45 41 51

Ex-smoker Normal 25 34 30 39 47 57 52 62Overweight 21 29 26 34 44 53 49 58Obese 25 34 30 40 47 56 52 61

Current smoker Normal 35 45 40 51 61 70 66 74

Overweight 30 40 36 46 58 67 63 71Obese 35 46 41 52 60 69 65 73

<20% 20-39% 40-59% ≥60%

Conclusions• Overall the risks of death were high, almost all

exceeding 10% for women and 20% for men • Risks were substantially higher for men than women• For both sexes risk was highest those who:

• were in the oldest age group •smoked •did not drink alcohol weekly or more•reported little physical activity

Please visit our website for more details on our project

http://www.menwomenandageing.org