Mortality among the Least Frail: Lessons from Research on the APOE GENE

  • Douglas C. Ewbank
Part of the International Studies in Population book series (ISIP, volume 4)

Until recently, most research on the factors associated with mortality among adults was limited to the ages under 85. Now we find that mortality is declining rapidly over age 85 (Wilmoth et al. 2000) and the number of centenarians is increasing at a surprising rate. These trends have led to uncertainty about the prospects for further improvements in survival at the oldest ages. Recent research on health and mortality over age 85 suggests that the oldest-old may be different in many ways from the younger-old. Some of the physiological risk factors that are well established for those under age 85 may not work in the same way at the oldest ages. One reason for this is that survivors to the oldest ages are on average more robust (less frail) than average. That is, they have a lower frequency of risk factors for causes of premature mortality. Studying how risk factors change with age introduces several methodologically difficult issues. It requires new demographic and statistical approaches that model changes in the relative risks with age. It may also require different approaches to data collection and publication of results. Since few studies will be large enough to answer these questions, there is an increasing need for meta-analyses that combine data from numerous studies.


Life Table Unobserved Heterogeneity APOE Genotype APOE Gene Estimate Relative Risk 
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Copyright information

© Springer 2007

Authors and Affiliations

  • Douglas C. Ewbank
    • 1
  1. 1.Population Studies CentreUniversity of PennsylvaniaUSA

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