Marcus Ebeling is with the Institute of Environmental Medicine, Unit of Epidemiology, Karolinska Institute, Stockholm, Sweden, and the Laboratory of Population Health, Max Planck Institute for Demographic Research, Rostock, Germany. Anna C. Meyer and Karin Modig are with the Institute of Environmental Medicine, Unit of Epidemiology, Karolinska Institute.
Am J Public Health. 2023 Jul;113(7):786-794. doi: 10.2105/AJPH.2023.307281. Epub 2023 Apr 13.
To analyze variation in end-of-life trajectories with regard to elder care and medical care and how they relate to age, gender, and causes of death. We analyzed all deaths of persons at age 70 years and older between the years 2018 and 2020 in Sweden, using a linkage of population registers. We applied latent class analysis to identify distinct types of end-of-life trajectories. We identified 6 different types of end-of-life trajectories. The types differed substantially in the amount of utilized elder care and medical care before death. Deaths characterized by high levels of elder care and medical care utilization become more common with age. The trajectory types show distinct cause-of-death profiles. Most deaths today do not comply with what is often referred to as a "good" death (e.g., retaining control or requiring low levels of elder care). The results suggest that longer lifespans partly result from a prolonged dying process. The current modes of dying call for a discussion about how we want to die in an era of increasing lifespans and aging societies. (. 2023;113(7):786-794. https://doi.org/10.2105/AJPH.2023.307281).
分析临终轨迹在老年护理和医疗方面的差异，以及它们与年龄、性别和死因的关系。我们使用人口登记册的链接，分析了 2018 年至 2020 年期间瑞典所有 70 岁及以上人群的死亡情况。我们应用潜在类别分析来确定不同类型的临终轨迹。我们确定了 6 种不同类型的临终轨迹。这些类型在死亡前接受的老年护理和医疗服务的数量上存在显著差异。利用高水平老年护理和医疗服务的死亡变得更加常见随着年龄的增长。轨迹类型显示出不同的死因特征。今天的大多数死亡不符合通常所说的“善终”（例如，保持控制或需要低水平的老年护理）。结果表明，寿命的延长部分是由于死亡过程的延长。当前的死亡模式需要讨论在寿命延长和老龄化社会的时代，我们希望如何死亡。（2023 年；113（7）：786-794。https://doi.org/10.2105/AJPH.2023.307281）。
