Article Text

Download PDFPDF

Original research
Estimating expected life-years and risk factor associations with mortality in Finland: cohort study
  1. Tommi Härkänen1,
  2. Kari Kuulasmaa1,
  3. Laura Sares-Jäske1,
  4. Pekka Jousilahti1,
  5. Markku Peltonen1,
  6. Katja Borodulin1,2,
  7. Paul Knekt1,
  8. Seppo Koskinen1
  1. 1Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
  2. 2Age Institute, Helsinki, Finland
  1. Correspondence to Dr Tommi Härkänen; tommi.harkanen{at}thl.fi

Abstract

Objective To develop a tool to inform individuals and general practitioners about benefits of lifestyle changes by providing estimates of the expected age of death (EAD) for different risk factor values, and for those who plan and decide on preventive activities and health services at population level, to calculate potential need for these.

Design Prospective cohort study to estimate EAD using a model with 27 established risk factors, categorised into four groups: (1) sociodemographic background and medical history, (2) lifestyles, (3) life satisfaction, and (4) biological risk factors. We apply a Poisson regression model on the survival data split into 1-year intervals.

Participants Total of 38 549 participants aged 25–74 years at baseline of the National FINRISK Study between 1987 and 2007.

Primary outcome measures Register-based comprehensive mortality data from 1987 to 2014 with an average follow-up time of 16 years and 4310 deaths.

Results Almost all risk factors included in the model were statistically significantly associated with death. The largest influence on the EAD appeared to be a current heavy smoker versus a never smoker as the EAD for a 30-year-old man decreased from 86.8 years, which corresponds to the reference values of the risk factors, to 80.2 years. Diabetes decreased EAD by >6.6 years. Whole or full milk consumers had 3.4 years lower EAD compared with those consuming skimmed milk. Physically inactive men had 2.4 years lower EAD than those with high activity. Men who found their life almost unbearable due to stress had 2.8 years lower EAD.

Conclusions The biological risk factors and lifestyles, and the factors connected with life satisfaction were clearly associated with EAD. Our model for estimating a person’s EAD can be used to motivate lifestyle changes.

  • multivariable prediction model
  • life expectancy
  • epidemiology
  • public health
  • statistics & research methods
  • survival analysis
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

View Full Text

Statistics from Altmetric.com

Footnotes

  • Twitter @MarkkuPeltonen

  • Contributors TH, KK and SK had central role in planning, conduct and reporting of the work, accept full responsibility for the work and/or the conduct of the study, had access to the data and controlled the decision to publish. LSJ, PJ, MP, KB and PK participated in planning, conduct and reporting of the work.

  • Funding The study received external funding from Duodecim Medical Publications and was supported by the Academy of Finland (grant numbers 266251 and 307907).

  • Disclaimer Researchers were independent of the funders. All authors had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Competing interests TH reports grants from Duodecim Medical Publications and grants from Academy of Finland during the conduct of the study.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval has been obtained according to the commonly required research procedures and Finnish legislation during each survey. The last three surveys were approved by the coordinating ethics committee of the Helsinki and Uusimaa Hospital District.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. The individual-level data cannot be distributed as they are sensitive data. However, there is a procedure for requesting access to individual data for research collaboration on https://thl.fi/en/web/thlfi-en/research-and-expertwork/population-studies/the-national-finrisk-study.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.