老年生存中的性别差异。

Gender differences in survival in old age.

作者信息

Jacobs Jeremy M, Cohen Aaron, Ein-Mor Eliana, Stessman Jochanan

机构信息

1 The Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center Mount Scopus, and Hebrew University-Hadassah Medical School , Mount Scopus, Jerusalem, Israel .

出版信息

Rejuvenation Res. 2014 Dec;17(6):499-506. doi: 10.1089/rej.2014.1587.

DOI:10.1089/rej.2014.1587

PMID:25285463

Abstract

BACKGROUND

Although increased survival among females is observed throughout much of adult life, supporting evidence among the oldest old is lacking.

OBJECTIVE

We examined the hypothesis that gender differences in survival diminish with advancing age.

METHODS

The Jerusalem Longitudinal Study follows a representative cohort born 1920-1921, comprehensively assessed at ages 70, 78, 85, and 90 (n=463, 927, 1224, and 673, respectively). Mortality data were collected during 1990-2013. Kaplan-Meier survival curves and mortality hazards ratios (HRs) were determined, adjusting for gender, marital status, education, loneliness, self-rated health, physical activity, functional status, neoplasm, diabetes mellitus, hypertension, and ischemic heart disease.

RESULTS

Survival between ages 70-78 was 77.3% (n=358/463), 78-85 was 68.9% (n=635/927), 85-90 years was 71.1% (n=870/1224), and 90-93 years was 80.5% (n=542/673). With advancing age, the survival advantage among females versus men declined-at ages 70-78 (85.6% vs. 71%, p<0.0001), 78-85 (74% vs. 63%, p=0.001), 85-90 (74% vs. 67.5%, p=0.06), and 90-93 (80% vs. 81%, p=0.92). Compared to females (HR=1.0), the adjusted HR for male mortality at ages 70-78 was 2.93 (95% confidence interval [CI] 1.75-4.91), ages 78-85 was 2.1 (95% CI 1.5-2.92), ages 85-90 was 1.6 (95% CI 1.2-2.2), and ages 90-93 was 1.1 (95% CI 0.7-1.8).

CONCLUSIONS

Our findings confirm the hypothesis that the increased longevity observed among females at age 70 gradually diminishes with advancing age, and disappears beyond age 90.

摘要

背景

尽管在成年期的大部分时间里女性的生存率有所提高，但在高龄老人中缺乏支持性证据。

目的

我们检验了随着年龄增长生存性别差异减小这一假设。

方法

耶路撒冷纵向研究追踪了一个出生于1920 - 1921年的代表性队列，在70岁、78岁、85岁和90岁时进行了全面评估（分别为n = 463、927、1224和673）。在1990 - 2013年期间收集了死亡率数据。确定了Kaplan - Meier生存曲线和死亡风险比（HRs），并对性别、婚姻状况、教育程度、孤独感、自评健康状况、身体活动、功能状态、肿瘤、糖尿病、高血压和缺血性心脏病进行了调整。

结果

70 - 78岁的生存率为77.3%（n = 358 / 463），78 - 85岁为68.9%（n = 635 / 927），85 - 90岁为71.1%（n = 870 / 1224），90 - 93岁为80.5%（n = 542 / 673）。随着年龄增长，女性相对于男性的生存优势下降——在70 - 78岁时（85.6%对71%，p < 0.0001），78 - 85岁时（74%对63%，p = 0.001），85 - 90岁时（74%对67.5%，p = 0.06），90 - 93岁时（80%对81%，p = 0.92）。与女性相比（HR = 1.0），70 - 78岁男性死亡的调整后HR为2.93（95%置信区间[CI] 1.75 - 4.91），78 - 85岁为2.1（95% CI 1.5 - 2.92），85 - 90岁为1.6（95% CI 1.2 - 2.2），90 - 93岁为1.1（95% CI 0.7 - 1.8）。