Social and Behavioural Determinants of the Difference in Survival among Older Adults in Japan and England
Social and Behavioural Determinants of the Difference in Survival among Older Adults in Japan and England
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DOI：
10.1159/000485797
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发表时间：
2018-01-01
期刊：
影响因子：
3.5
通讯作者：
Watt, Richard G.
中科院分区：
文献类型：
--
作者：
Aida, Jun;Cable, Noriko;Watt, Richard G.
背景：人口迅速老龄化对卫生和社会保健服务提出了重大挑战。关于老年人生存情况的跨国比较研究有限。此外，日本这个预期寿命最长的国家很少被纳入这些跨国比较。目的：我们研究了社会和行为因素对日本和英国老年人生存差异的相对贡献。研究方法：我们使用来自日本老年学评估研究（JAGES; n = 13，176）和英国老龄化纵向研究（艾尔莎; n = 5，551）的数据，分析基线9.4年的全因死亡率。应用拉普拉斯回归模型，估计第15个生存百分位数差异。结果：在随访期间，艾尔莎中31.3%的女性和38.6%的男性死亡，而JAGES中19.3%的女性和31.3%的男性死亡。调整年龄和基线健康状况后，JAGES参与者的生存期比艾尔莎参与者长318.8天，男性长131.6天。以家庭为基础的社会关系使JAGES的生存时间比艾尔莎男性长105.4天。与艾尔莎组的男性相比，更少的基于友谊的社会关系使JAGES组的男性生存期缩短了45.4天。目前不吸烟有助于延长JAGES女性（197.7天）和艾尔莎男性（46.6天）的生存期，并且具有较低的BMI使JAGES参与者的生存期女性减少129.0天，男性减少212.2天。结论：与英国的参与者相比，日本老年人的寿命更长，主要是因为女性不吸烟，男性以家庭为基础的社会关系。相比之下，英国参与者中较低的体重不足率，男性更好的基于友谊的社会关系，以及较低的吸烟率有助于生存。(C)2018 S. Karger AG，巴塞尔。
Background: A rapidly ageing population presents major challenges to health and social care services. Cross-country comparative studies on survival among older adults are limited. In addition, Japan, the country with the longest life expectancy, is rarely included in these cross-country comparisons. Objective: We examined the relative contributions of social and behavioural factors on the differences in survival among older people in Japan and England. Methods: We used data from the Japan Gerontological Evaluation Study (JAGES; n = 13,176) and the English Longitudinal Study of Ageing (ELSA; n = 5,551) to analyse all-cause mortality up to 9.4 years from the baseline. Applying Laplace regression models, the 15th survival percentile difference was estimated. Results: During the follow-up, 31.3% of women and 38.6% of men in the ELSA died, whereas 19.3% of women and 31.3% of men in the JAGES died. After adjusting for age and baseline health status, JAGES participants had longer survival than ELSA participants by 318.8 days for women and by 131.6 days for men. Family-based social relationships contributed to 105.4 days longer survival in JAGES than ELSA men. Fewer friendship-based social relationships shortened the JAGES men's survival by 45.4 days compared to ELSA men. Currently not being a smoker contributed to longer survival for JAGES women (197.7 days) and ELSA men (46.6 days), and having lower BMI reduced the survival of JAGES participants by 129.0 days for women and by 212.2 days for men. Conclusion: Compared to participants in England, Japanese older people lived longer mainly because of nonsmoking for women and family-based social relationships for men. In contrast, a lower rate of underweight, men's better friendship-based social relationships, and a lower smoking rate contributed to survival among participants in England. (C) 2018 S. Karger AG, Basel.