Abstract
The aim of this study was to describe cohort differences in health indicators among four birth cohorts of 70-year old men and women from Göteborg, Sweden, born in 1901/2, 1905/6, 1911/12, and 1922. With special reference to gender, education, and obesity, it is hypothesized that changes in health among elderly men and women may not be occurring in a uniform manner. The variables studied were: systolic and diastolic blood pressures, triglycerides, cholesterol, height, weight, body mass index, waist–hip ratio, physical inactivity, current smoking, and alcohol consumption, plus selected prevalent diseases. Logistic and linear regression models were used to test for secular trends and effect modification by gender. Most trends in metabolic and lifestyle indicators varied in relation to gender as well as education. For instance, later-born male cohorts were more overweight than earlier-born groups while the later-born female cohorts had similar relative weights but a more centralized fat patterning. These cohort differences further varied by education where later-born men with less education and later-born women with higher education tended to be more overweight, compared to earlier-born cohorts. Finally, significant cohort differences in previously diagnosed myocardial infarction, stroke, and diabetes mellitus at age 70 were observed in men only. Interaction terms revealed that the gender difference was statistically significant only in the case of diabetes mellitus. In conclusion, secular trends in many obesity-related health indicators among 70-year old Swedish cohorts were dependent on both gender and socio-economic factors.
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References
Manton KG, Singer BH, Suzman RM (eds), Forecasting the Health of Elderly Populations, New York: Springer, 1993.
Vita AJ, Terry RB, Hubert HB, Fries JF. Ageing, health risks, and cumulative disability. N Engl J Med 1998; 338(15): 1035–1041.
Murray CJ, Lopez A. The Global Burden of Disease. Cambridge, MA: Harvard University Press, 1996.
Tuomilehto J. Health status in Finland and other Nordic countries with special reference to chronic noncommunicable diseases. Ann Nutr Metab 1991; 35(1): 41–52.
Dubos R. Man Adapting. New Haven: Yale University Press, 1965.
Omran A. The epidemiological transition: A theory of the epidemiology of population change. Milbank Mem Quart 1971; 49: 509–538.
Arber S, Ginn J. Gender and inequalities in health in later life. Soc Sci Med 1993; 36(1): 33–46.
Helset A. Elderly women in the Nordic countries; level of living and situation in life. Scand J Soc Med 1993; 21(4): 223–226.
Haavio-Mannila E. Inequalities in health and gender. Soc Sci Med 1986; 22(2): 141–149.
Gregory J, Foster K, Tyler H, Wiseman M. The Dietary and Nutritional Survey of British Adults. London: HMSO, 1990.
Seidell JC. Obesity in Europe: Scaling the epidemic. Int J Obes Rel Metab Dis 1995; 19(Suppl 3): S1–S4.
Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL. Increasing prevalence of overweight among US adults: The national health and nutrition examination surveys 1960-1991. J Am Med Assoc 1994; 272(3): 205–211.
Dey KD, Steen B. Overweight and Obesity in the Aged. In: Watson RR (ed.), Handbook of Nutrition in the Aged. 3rd ed. LLC: CRC Press, 2000; 12: 179–190.
Seidell JC, Visscher TL. Body weight and weight change and their health implications for the elderly. Eur J Clin Nutr 2000; 54(S3): S33–S39.
Dey DK, Rothenberg E, Sundh V, Bosaeus I, Steen B. Height and body weight in elderly adults: A 21-year population study on secular trends and related factors in 70-year-olds. Journal of Gerontology: Medical Sciences 2001; 56(12): M780–784.
Nelson TL, Vogler GP, Pedersen NL, Miles TP. Genetic and environmental influences on waist-hip ratio and waist circumference in an older Swedish twin population. Int J Obes 1999; 23: 449–255.
Peck MN, Lundberg O. Short stature as an effect of economic and social conditions in childhood. Soc Sci Med 1995; 41: 733–738.
Peck MN, Vågerö DH. Adult body height and childhood socioeconomic group in the Swedish population. J Epidemiol Comm Health 1987; 41: 333–337.
Rothenburg E, Bosaeus I, Steen B. Food habits and nutrient intake in three 70-year old free-living populations in Göteborg Sweden: A 22-year cohort study. Scand J Nutr 1996; 40: 104–110.
Rinder L, Roupe S, Steen B, Svanborg A. Seventy-year-old people in Göteborg. A population study in an industrialized Swedish city. Acta Med Scand 1975; 198: 397–407.
Steen B, Djurfeldt H. The gerontological and geriatric population studies in Göteborg, Sweden. Z Gerontol 1993; 26: 163–169.
Shock NW. Longitudinal changes of aging. In: Finch CE, Schneider CE (eds), Handbook of the Biology of Aging. New York: Van Nostrand Reinhold, 1985: 721–743.
Grimby G. Physical activity and muscle training in the elderly. Acta Med Scand 1986; 711: S233–S237.
Dey DK. Anthropometry in the elderly: Population studies on longitudinal changes, secular trends, and risk for morbidity and mortality, Göteborg University, Sweden: Department of Geriatric Medicine and Clinical Nutrition, 2001.
Dey DK, Rothenberg E, Sundh V, Bosaeus I, Steen B. Height and body weight in the elderly. I. A 25-year longitudinal population study from age 70 to 95 years. Eur J Clin Nutr 1999; 53(12): 905–914.
Mellström D. Recent trends in mortality among the elderly in Sweden. In: Brandström A, Tedebrand LG (eds), Society, Health and Population During the Demographic Transition. Stockholm: Almqvist and Widsell International, 1987: 157–172.
Guralnik JM, Fried LP, Salive ME. Disability as a public health outcome in the ageing population. Ann Rev Public Health 1996; 17: 25–46.
Steen B. The elderly yesterday, today, and tomorrow: Aspects on cohort differences from the gerontological and geriatric population studies in Göteborg Sweden (H-70). Arch Gerontol Geriatr Lakartidningen 2001; 98(6): 545–550.
Fried LP, Bush TL. Morbidity as a focus of preventive health care in the elderly. Epidemiol Rev 1988; 10: 48–64.
Shimokata H, Tobin JD, Muller DC, Elahi D, Coon PJ, Andres R. Studies in the distribution of body fat. I. Effects of age, sex and obesity. J Gerontol 1989; 44: 369–373.
Lissner L, Bengtsson C, Lapidus L, Bjö rkelund C. Smoking initiation and cessation in relation to body fat distribution: The population study of women in Göteborg, Sweden. Am J Public Health 1992; 82: 273–275.
Wilhelmson K, Allebeck P, Berg S, Steen B. Mortality in three different cohorts of 70 year-olds: The impact of social factors and health. Aging, Clin Exp Res 2002; 14(2): 143–151.
Bild DE, Fitzpatrick A, Fried LP, et al. Age-related trends in cardiovascular morbidity and physical functioning in the elderly: The cardiovascular health study. J Am Geriatr Soc 1993; 41(10): 1047–1056.
Burke GL, Arnold AM, Bild DE, et al. Factors associated with health ageing: The cardiovascular health study. J Am Geriatr Soc 2001; 49(3): 254–262.
Berg S. Psychological functioning in 70-and 75-year old people: A study in an industrialized city. Acta Psychol Scand 1980; 62: S1–S47.
Eriksson B, Mellström D, Svanborg A. Medical-social intervention in a 70-year-old Swedish population: A general presentation of methodological experience. Compendium Gerontol C 1987; 1: 49–56.
Manton KG. Past and future life expectancy increases at later ages: Their implications for the linkage of chronic morbidity, disability, and mortality. J Gerontol 1986; 41(5): 672–681.
Crimmins EM, Saito Y. Trends in healthy life expectancy in the United States, 1970-1990: Gender, racial, and educational differences. Soc Sci Med 2001; 52(11): 1629–1641.
Barker DJ. In utero programming of cardiovascular disease. Theriogenology 2000; 53(2): 555–574.
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Cabrera, C., Wilhelmson, K., Allebeck, P. et al. Cohort differences in obesity-related health indicators among 70-year olds with special reference to gender and education. Eur J Epidemiol 18, 883–890 (2003). https://doi.org/10.1023/A:1025687102375
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DOI: https://doi.org/10.1023/A:1025687102375