Morbidity risks among older adults with pre-existing age-related diseases.
Abstract
Multi-morbidity is common among older adults; however, for many aging-related diseases
there is no information for U.S. elderly population on how earlier-manifested disease
affects the risk of another disease manifested later during patient's lifetime. Quantitative
evaluation of risks of cancer and non-cancer diseases for older adults with pre-existing
conditions is performed using the Surveillance, Epidemiology, and End Results (SEER)
Registry data linked to the Medicare Files of Service Use (MFSU). Using the SEER-Medicare
data containing individual records for 2,154,598 individuals, we empirically evaluated
age patterns of incidence of age-associated diseases diagnosed after the onset of
earlier manifested disease and compared these patterns with those in general population.
Individual medical histories were reconstructed using information on diagnoses coded
in MFSU, dates of medical services/procedures, and Medicare enrollment/disenrollment.
More than threefold increase of subsequent diseases risk was observed for 15 disease
pairs, majority of them were i) diseases of the same organ and/or system (e.g., Parkinson
disease for patients with Alzheimer disease, HR=3.77, kidney cancer for patients with
renal failure, HR=3.28) or ii) disease pairs with primary diseases being fast-progressive
cancers (i.e., lung, kidney, and pancreas), e.g., ulcer (HR=4.68) and melanoma (HR=4.15)
for patients with pancreatic cancer. Lower risk of subsequent disease was registered
for 20 disease pairs, mostly among patients with Alzheimer's or Parkinson's disease,
e.g., decreased lung cancer risk among patients with Alzheimer's (HR=0.64) and Parkinson's
(HR=0.60) disease. Synergistic and antagonistic dependences in geriatric disease risks
were observed among US elderly confirming known and detecting new associations of
wide spectrum of age-associated diseases. The results can be used in optimization
of screening, prevention and treatment strategies of chronic diseases among U.S. elderly
population.
Type
Journal articleSubject
AgingChronic disease onset
Comorbidity
Dependent risks
Geriatric disease
Medicare
Age Distribution
Age Factors
Aged
Aged, 80 and over
Aging
Chronic Disease
Comorbidity
Disease Susceptibility
Female
Humans
Incidence
Male
Medicare
Middle Aged
Proportional Hazards Models
Risk Assessment
Risk Factors
SEER Program
Time Factors
United States
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https://hdl.handle.net/10161/14832Published Version (Please cite this version)
10.1016/j.exger.2013.09.005Publication Info
Akushevich, Igor; Kravchenko, Julia; Ukraintseva, Svetlana; Arbeev, Konstantin; Kulminski,
Alexander; & Yashin, Anatoliy I (2013). Morbidity risks among older adults with pre-existing age-related diseases. Exp Gerontol, 48(12). pp. 1395-1401. 10.1016/j.exger.2013.09.005. Retrieved from https://hdl.handle.net/10161/14832.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Igor Akushevich
Research Professor in the Social Science Research Institute
Konstantin Arbeev
Associate Research Professor in the Social Science Research Institute
Konstantin G. Arbeev received the M.S. degree in Applied Mathematics from Moscow State
University (branch in Ulyanovsk, Russia) in 1995 and the Ph.D. degree in Mathematics
and Physics (specialization in Theoretical Foundations of Mathematical Modeling, Numerical
Methods and Programming) from Ulyanovsk State University (Russia) in 1999. He was
a post-doctoral fellow in Max Planck Institute for Demographic Research in Rostock
(Germany) before moving to Duke University in 2004 to work as a Resea
Alexander Kulminski
Research Professor in the Social Science Research Institute
Svetlana Ukraintseva
Research Professor in the Social Science Research Institute
Dr. Ukraintseva studies causes of human aging and related decline in resilience, to
identify genetic and other factors responsible for the increase in mortality risk
with age eventually limiting longevity. She explores complex relationships, including
trade-offs, between physiological aging-changes and risks of major diseases (with
emphasis on Alzheimer’s and cancer), as well as survival, to find new genetic and
other targets for anti-aging interventions and disease prevention. S
Anatoli I. Yashin
Research Professor in the Social Science Research Institute
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