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Early Life Exposure to the 1918 Influenza Pandemic and Old-Age Mortality by Cause of Death

tetano

Editor, Senior Moderator
Am J Public Health. 2013 May 16. [Epub ahead of print]
Early Life Exposure to the 1918 Influenza Pandemic and Old-Age Mortality by Cause of Death.
Myrskyl? M, Mehta NK, Chang VW.
Source

Mikko Myrskyl? is with Research Group Lifecourse Dynamics and Demographic Change, Max Planck Institute for Demographic Research, Rostock, Germany. Neil K. Mehta is with the Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA. Virginia W. Chang is with the Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY.
Abstract

Objectives. We sought to analyze how early exposure to the 1918 influenza pandemic is associated with old-age mortality by cause of death. Methods. We analyzed the National Health Interview Survey (n = 81 571; follow-up 1989-2006; 43808 deaths) and used year and quarter of birth to assess timing of pandemic exposure. We used Cox proportional and Fine-Gray competing hazard models for all-cause and cause-specific mortality, respectively. Results. Cohorts born during pandemic peaks had excess all-cause mortality attributed to increased noncancer mortality. We found evidence for a trade-off between noncancer and cancer causes: cohorts with high noncancer mortality had low cancer mortality, and vice versa. Conclusions. Early disease exposure increases old-age mortality through noncancer causes, which include respiratory and cardiovascular diseases, and may trigger a trade-off in the risk of cancer and noncancer causes. Potential mechanisms include inflammation or apoptosis. The findings contribute to our understanding of the causes of death behind the early disease exposure-later mortality association. The cancer-noncancer trade-off is potentially important for understanding the mechanisms behind these associations. (Am J Public Health. Published online ahead of print May 16, 2013: e1-e8. doi:10.2105/AJPH.2012.301060).

PMID:
23678911
[PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/23678911
 
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