Increase In Life Expectancy Research Articles

Assessment of Coronary Artery Disease in Non-Valvular Atrial Fibrillation: Is This Light at the End of the Tunnel?

Non-valvular atrial fibrillation (NVAF) is the most common sustained arrhythmia worldwide, and is associated with significant morbidity and mortality. Increasing life expectancy, coupled with a surge in comorbidity burden, has resulted in a sharp increase in NVAF prevalence over the last three decades. Coronary artery disease (CAD) is an important and clinically relevant risk factor of AF. Concomitant CAD has significant implications for AF management and is a major determinant of the overall outcomes. Shared risk factors, a common pathophysiological basis, and heightened thrombogenesis culminating in cardiovascular adverse events, highlight the close association between the two. The clinical course of AF is worse when associated with CAD, resulting in poor heart rate control, increased propensity to develop stroke and myocardial infarction, increased likelihood of acute presentation with hemodynamic collapse and pulmonary edema, increased bleeding tendencies, and poor response to ablation therapies. Emerging research highlighting the significant role of underlying CAD as an independent predictor of thromboembolic risk has paved the way for the adoption of CAD beyond prior myocardial infarction into the symbol "V" of the CHA2DS2-VASc score. In our opinion, elderly patients aged >65 years with AF, with a history of one or more cardiovascular comorbidities, or evidence of atherosclerosis in other vascular beds should warrant a closer look and a dedicated effort to look for associated CAD. This would allow for a more holistic and comprehensive approach to patients with AF and ultimately help reduce the disease burden and improve the overall outcomes.

Repercussion of Primary Nucleation Pathway: Dementia and Cognitive Impairment.

Neurodegenerative diseases, such as Alzheimer's, Parkinson's, and prion disease, are characterized by the conversion of normally soluble proteins or peptides into aggregated amyloidal fibrils. These diseases result in the permanent loss of specific types of neurons, making them incurable and devastating. Research on animal models of memory problems mentioned in this article contributes to our knowledge of brain health and functionality. Neurodegenerative disorders, which often lead to cognitive impairment and dementia, are becoming more prevalent as global life expectancy increases. These diseases cause severe neurological impairment and neuronal death, making them highly debilitating. Exploring and understanding these complex diseases offer significant insights into the fundamental processes essential for maintaining brain health. Exploring the intricate mechanisms underlying neurodegenerative diseases not only holds promise for potential treatments but also enhances our understanding of fundamental brain health and functionality. By unraveling the complexities of these disorders, researchers can pave the way for advancements in diagnosis, treatment, and ultimately, improving the lives of individuals affected by neurodegenerative diseases.

Dysphasia: metastatic prostate cancer to the leptomeninges: a case report

BackgroundLeptomeningeal metastasis occurs in 5% of patients with prostate cancer and indicates a very poor prognosis.Case presentationA 60-year-old Caucasian male patient diagnosed with metastatic castration-resistant prostate cancer with sclerotic bone metastases and soft tissue metastases underwent multiple courses of chemotherapy and hormone therapy. The diagnosis of prostate cancer is based on elevated prostate-specific antigen levels and tissue biopsy. He subsequently presented with expressive aphasia. Nonspecific, diffuse irregular dural/pachymeningeal thickening enhancement was noted on magnetic resonance imaging. Upon evaluation by neurology, electroencephalogram was negative for an epileptiform correlate. The workup included a lumbar puncture to rule out infectious etiology. The patient’s neurological status stabilized, and he was discharged home with a plan for continued therapy with abiraterone and prednisone. Due to advanced malignancy, the patient enrolled in hospice and died 3 weeks after hospital discharge.ConclusionsCentral nervous system metastasis occurs very rarely in prostate cancer. With the increase in life expectancy and advances in oncologic therapy for prostate cancer, physicians should be aware of and consider central nervous system metastasis in men aged 50 years and above.

A strategic brand development framework for expanding cardiovascular and endocrinology treatments in emerging markets

This paper introduces a conceptual framework for strategic brand development in the pharmaceutical industry, specifically targeting the cardiovascular and endocrinology treatment sectors in emerging markets. The framework explores how stakeholder engagement, market segmentation, and brand positioning can enhance access to critical treatments, addressing growing public health challenges in these regions. Cardiovascular and endocrinological disorders, such as heart disease and diabetes, are rising rapidly in emerging markets due to lifestyle changes, urbanization, and increased life expectancy. Pharmaceutical companies face unique challenges in expanding their market presence in these regions, including varying healthcare infrastructure, economic disparities, and regulatory environments. The proposed framework emphasizes the importance of engaging key stakeholders—such as healthcare professionals, policymakers, and patients—through targeted educational campaigns, partnerships, and advocacy. Effective stakeholder engagement fosters trust and collaboration, which is essential for expanding access to life-saving treatments. In addition, market segmentation is a critical component of this strategy, allowing companies to tailor their marketing efforts to specific demographic groups, economic conditions, and healthcare needs in each region. By identifying the most relevant segments and understanding their unique needs, companies can ensure that their treatments reach the populations most at risk for cardiovascular and endocrinological diseases. Brand positioning is another cornerstone of this framework. By clearly defining and communicating the value of their treatments in terms of efficacy, affordability, and accessibility, pharmaceutical companies can differentiate themselves in increasingly competitive markets. Strategic positioning not only enhances brand visibility but also builds long-term customer loyalty, which is crucial for sustaining market growth in emerging economies. Overall, this conceptual framework provides a roadmap for pharmaceutical companies to strategically develop their brands in the cardiovascular and endocrinology sectors, ultimately contributing to improved public health outcomes in emerging markets.

Bone-Targeting Radionuclides in the Treatment of Metastatic Castration-Resistant Prostate Cancer: A Review on Radium-223 Chloride (Alpharadin) in Combination with Other Therapies.

Recent advances have broadened the range of therapeutic options for mCRPC, with several new treatments, including novel hormonal therapies (enzalutamide, abiraterone), chemotherapeutic agents (docetaxel, cabazitaxel), immunotherapies (sipuleucel-T), and bone targeting radiopharmaceuticals (radium-223) showing improved clinical outcomes and receiving U.S. Food and Drug Administration approval. These new treatments provide new avenues for improving patient survival and quality of life. Radium-223, a targeted alpha-emitter, specifically targets bone metastases, offering palliative benefits and a potential increase in life expectancy. The integration of radium-223 with other treatments shows promise for managing mCRPC. However, the optimal sequencing and combination of radium-223 with other therapies are still being explored, with various clinical trials investigating new therapeutic approaches. The integration of these therapies, especially to provide more effective, personalized treatment strategies, requires further investigation. A thorough literature review was conducted on current treatments for mCRPC, including chemotherapeutic agents, oral hormonal therapies targeting the androgen receptor axis, immunotherapies, and radium-223. Ongoing clinical trials investigating radium-233 in the context of other therapies for the treatment of mCRPC patients were also reviewed. Further studies should focus on determining the optimal sequencing and dosing and identifying biomarkers that predict treatment response to enhance outcomes of mCRPC patients. This review underlines the rational strategies of combining radium-223 with other therapies, investigating their impact on bone in terms of delaying skeletal-related events, and managing bone disease progression in mCRPC patients.

Discover the Factors of Longevity by Causal Discovery with PC Algorithm and Neural Networks

The study title has been to study the multilayered factors that govern a human prospect of living through the application of the PC Algorithm (Graph-Based Algorithm), logistic regression analysis, and the neural networks in combination. To realign the research purpose, a vast array of data can be used, which included socioeconomic status information alongside health and environmental aspects carefully chosen for their likely influence on how long people can live. This article will explain the longevity determinants by examining not only the conditions but also the environmental and health indicators and their combinatory effects. The PC algorithm can produce a directed acyclic graph (DAG) to see how elements like healthcare spending, education, and CO2 emissions are correlated with human longevity and how they influence each other. Moreover, the research takes other examples by analysis: researchers can examine hypothetical events. Neural networks were employed to depict the interrelationship among these variables which subsequently provided a user-appropriate understanding of their sudden joint influence. Consequently, a hypothesize was purposed that the potential interventions for the elongation of human life. Policy-making researchers can gain a better representation of the situation of health inequality and the new recommended solutions to tackle this problem and increase life expectancy by implementing complex analysis tools to blows away the criminal aspects of human longevity.

New low elastic modulus equimassic βeta Ti-Nb-Zr-(Ta-Mo) multiprincipal alloys

The increasing life expectancy, evolving patient demographics, and advancements in implant technologies underscore the need for better biomaterials, particularly alloys with superior mechanical and chemical biocompatibility for biomedical applications like orthopedic implants. β-Ti alloys are promising due to their mechanical properties, including an elasticity modulus (E) of 44–80 GPa, and chemical/biological attributes such as corrosion resistance and osseointegration. This work developed equimassic multicomponent high (HEA) and medium entropy (MEA) β-Ti alloys within the ternary Ti-33Nb-33Zr, quaternary Ti-25Nb-25Zr-25Ta, and quinary Ti-20Nb-20Zr-20Ta-20Mo weight percent systems to achieve an optimized elastic modulus. The study analyzed β-Ti alloys with different β-stabilizing elements, leading to varying entropy levels, and established a relationship between microstructure and properties for enhanced implant efficacy. For the high entropy quinary alloy, increasing the number of alloying elements decreases lattice parameters, increasing the elastic modulus and Vickers microhardness (HV), from 247 HV for the ternary alloy to 453 HV for the quinary alloy. This corresponds to an increase in the entropy degree from 1.041 R to 1.523 R. While a higher entropy degree hinders a low elastic modulus, medium entropy β-Ti alloys such as the quaternary β-Ti-25Nb-25Zr-25Ta alloy achieve an elastic modulus as low as 73 GPa.

Family support and depressive symptoms among the elderly in Gunungkidul Health Center Sumberejo-Yogyakarta, Indonesia

Background: The elderly represent an age group that undergoes various physical, biological, psychological, and social changes that impact their health. The elderly population in Indonesia continues to grow, reaching 11.49% in 2016 and is projected to reach 14.51% by 2020. Increased life expectancy does not always correlate with good health, making the elderly more vulnerable to various issues, including depression. The prevalence of elderly depression in Indonesia is 11.6%, with the highest rates occurring in the older age groups. Purpose: To examine the relationship between the level of family support received by the elderly and depressive symptoms they experience. Method: A quantitative study using a correlational analytic design with a cross-sectional research strategy. The sampling technique was random sampling, with 36 elderly individuals aged 60-74 years as the sample. Data was collected using a questionnaire to determine the relationship between family support and the depressive symptoms in the elderly. The data was analyzed using univariate and bivariate analyses with the Spearman’s rank correlation test. Results: The univariate analysis provided information on the respondents' characteristics, family support, and depressive symptoms. The majority of respondents received good family support (66.7%), while most respondents did not experience depressive symptoms (75%). The Spearman’s rank correlation test found a significant value of 0.001<0.05, indicating that family support is related to the incidence of depressive symptoms in the elderly. Conclusion: Providing family support can reduce depressive symptoms in the elderly, as indicated by the statistical test results showing a significance value of 0.001 <0.05. This means there is a relationship between family support and the incidence of depressive symptoms among the elderly.

Organic-Inorganic Biocompatible Coatings for Temporary and Permanent Metal Implants.

The general trend of increasing life expectancy will consistently drive the demand for orthopedic prostheses. In addition to the elderly, the younger population is also in urgent need of orthopedic devices, as bone fractures are a relatively common injury type; it is important to treat the patient quickly, painlessly, and eliminate further health complications. In the field of traumatology and orthopedics, metals and their alloys are currently the most commonly used materials. In this context, numerous scientists are engaged in the search for new implant materials and coatings. Among the various coating techniques, plasma electrolytic oxidation (PEO) (or micro-arc oxidation-MAO) occupy a distinct position. This method offers a cost-effective and environmentally friendly approach to modification of metal surfaces. PEO can effectively form porous, corrosion-resistant, and bioactive coatings on light alloys. The porous oxide surface structure welcomes organic molecules that can significantly enhance the corrosion resistance of the implant and improve the biological response of the body. The review considers the most crucial aspects of new combined PEO-organic coatings on metal implants, in terms of their potential for implantation, corrosion resistance, and biological activity in vitro and in vivo.

Assessing Health Gains: A Cost-Utility Analysis

Abstract Background With the increase in life expectancy and the consequent shift in the epidemiology of chronic diseases, the need to enhance and measure the population’s health status is even more imperative. The aim of this study is to assess health gains and their associated costs provided by an Italian clinic. Methods A retrospective study was conducted on 129 patients admitted for short-term planned hospitalization from June 2020 to August 2023. At both admission and discharge, these patients completed the EQ-5D-5L questionnaire. Quality-Adjusted Life Years (QALYs) were calculated from the difference in EQ-5D-5L scores between discharge and admission, assuming that health gains (discounted at a rate of 3.5%) accumulate up to two years after discharge. Cost-utility analysis was performed using QALYs and invoices issued by the clinic (cost of hospital stay: 250 Euro/day). Patients were stratified by gender, age (geriatric and non-geriatric), and length of stay (LoS). Descriptive statistics (median and interquartile range) and statistical analysis (Mann-Whitney test) were conducted using STATA software. Results The sample comprised 129 patients (55% female) with a median age of 81 [11] years and a median LoS of 16 [16] days. The median QALY gained was 0.33 [0.38], higher for males (0.35 [0.34]) than females (0.29 [0.45]). Patients younger than 65 years old experienced a greater gain in QALY (0.41 [0.42]) than geriatric patients (0.32 [0.38]) (p > 0.05). Patients with a longer LoS had a greater gain in QALY (0.35 [0.42]) than those with a shorter LoS (0.23 [0.29]) (p < 0.05). The median cost per QALY gained was 14,337 Euro, lower for males (13,803 Euro), non-geriatric patients (13,743 Euro), and those with a shorter LoS (10,670 Euro) (p > 0.05). Conclusions Despite disparities in QALY gains between groups, the median cost per QALY gained remained relatively constant. These findings underscore the importance of tailored interventions for effective resource allocation. Key messages • Differences in QALYs indicate the need for personalized healthcare strategies to optimize patient outcomes. • The constant cost per QALY underlines the importance of effective and efficient allocation of resources.

The impact of the tobacco law on tobacco-related hospitalizations in Portugal - a natural experiment

Abstract Introduction Tobacco is responsible for approximately 8 million deaths annually worldwide, with 1.2 million resulting from passive exposure to smoke, as reported by the WHO. Comprehensive tobacco control policies have been enacted across Europe, yet their impacts are seldom assessed. This study evaluates the effects of the anti-tobacco legislation enacted in Portugal in 2007 on tobacco-related hospitalizations between 2002 and 2018. Methods Data from all in-patient admissions in public hospitals throughout the 2002-2018 period were utilized. A quasi-experimental interrupted time series design was employed, treating 2008 as an exogenous shock. The dependent variables include the municipality-based incidence of hospitalizations by year for tobacco-related diseases, namely, Acute Myocardial Infarction, stroke, lower respiratory tract infections, chronic obstructive pulmonary disease, and asthma. The analysis was adjusted for the percentage of women, the percentage of individuals aged over 65, and purchasing power in the municipality. Time trend graphs for each variable were generated, followed by an adjustment using the Poisson regression model to forecast their trends. A comparison was conducted between observed post-law implementation data and projected values from the regression model to ascertain the percentage difference between the two. Expected Results The 2007 tobacco law led to significant reductions in tobacco-related disease incidence, with the most notable effects immediately post-implementation. The impact varies across age groups, with younger individuals (30-49 years) showing a sharper decrease. The effect diminished over time, as indicated by negative coefficients in time:law interactions, such as -0.03. Conclusions The anti-tobacco laws implemented in Portugal have effectively decreased hospitalizations related to tobacco use, suggesting potential increases in life expectancy and reduction in health system burden. Key messages • Public health policies are crucial for the long-term improvement of people’s health. • Non-exposure to tobacco can bring health gains on several levels.

Cardiac structure and function in people with cystic fibrosis

Abstract Background Cystic fibrosis (CF) is an autosomal recessive disease affecting multiple organs, however the extent of cardiac involvement in CF is yet to be determined. The remarkable therapeutic advancements with new highly effective CF transmembrane conductance regulator (CFTR) modulator treatment and subsequent increase in life expectancy substantiates further research. Purpose We aimed to explore the prevalence of abnormalities and potential subclinical alterations in cardiac structure and function in adults with CF compared to matched controls and investigate potential cardiovascular risk factors in people with CF (pwCF). Methods In this cross-sectional study, 104 adult pwCF in Denmark underwent clinical and echocardiographic examination. All participants were matched 1:1 with controls from the general population on age and sex. Uni- and multivariable linear regression models with adjustment for heart rate, FEV1, smoking status, hypertension and CF-related diabetes (CFRD) were used to test for differences in echocardiographic parameters between cases and controls. Abnormal cardiac function was defined as left ventricular ejection fraction (LVEF) <50%, left ventricular (LV) global longitudinal strain (GLS) < 16% or presence of diastolic dysfunction. Uni- and multivariable logistic regression models adjusted for age, sex, homozygous genotype, FEV1/FVC, BMI, smoking status, CFRD, pancreatic insufficiency, hypertension, and ischemic heart disease were performed to assess associations between potential risk factors and cardiac dysfunction in CF. Forest plots were constructed to visually represent the findings. Results Of 104 pwCF, 44% were female, mean age was 34 years, 93% received CFTR modulator treatment, and 91% had mutations with only minimal CFTR function (mutation class I-III). The prevalence of abnormal cardiac function in pwCF was 44% versus 22% in controls. Compared to controls, pwCF were found to have smaller LV dimensions, worse LV diastolic function, and more impaired right ventricle (RV) as well as LV systolic function (Table). After multivariable adjustment, LV diastolic function as well as LV and RV systolic function remained impaired in pwCF as compared to controls. Male sex and decreasing FEV1/FVC ratio remained independently associated with abnormal cardiac function in pwCF (male sex: OR 3.94 (1.56; 9.95), p=0.004 and FEV1/FVC ratio: OR 2.05 per 0.1 unit decrease (1.21; 3.52), p=0.008, respectively) (Figure). Conclusion Both left- and right-sided cardiac alterations were found in pwCF. After adjustments for potential risk factors, both RV and LV systolic measures remained altered in pwCF, compared to controls. Male sex and decreasing pulmonary function evaluated by FEV1/FVC-ratio were identified as factors associated with abnormal cardiac function in pwCF.Figure

What matters most to healthy older adults in treatment decision making: a discrete choice experiment

Abstract Introduction Shifting to a patient centered approach is crucial for a sustainable healthcare system. Understanding individuals’ priorities is essential for personalized care, especially in critical illness. Treatment decisions are often aimed at disease-specific outcomes such as life extension or survival, while patient-specific outcomes like maintaining independence may be equally vital. How healthy older adults prioritize treatment outcomes in case of a critical illness is currently unknown. Enhanced insight into their priorities can refine healthcare policy, for more personalized care. This study investigated outcomes (attributes) prioritized in hypothetical decision-making by healthy adults over 50 yr. Methods We conducted a Discrete Choice Experiment with individuals aged ≥50, comparing six pairs of hypothetical treatments with five attributes: life expectancy, independence, pain, memory complaints and societal costs. Attribute utility was analyzed using a conditional logit model, and latent class analyses were employed to explore preferences in groups. Results In 333 participants (mean age 70 +/- 7.7) all attributes emerged as impactful with independence being strongest (p < 0.05). Increased life expectancy had positive utility, but only for a two-year increase. Negative utility was found for all other attributes except mild pain and memory complaints. Latent class analyses identified two groups (22.4% and 77.6%). Group one valued life expectancy more (p .019 vs .940), whereas the second group valued independence (p .058 vs.<.001 and societal costs (p.053 vs. <.001) more. Conclusions In a hypothetical case of life-threatening disease, for people aged ≥ 50 life expectancy was not the sole relevant outcome for treatment decisions; pain, independence and societal costs are important and should be discussed in clinical decision making or healthcare policy. Key messages • Older adults find patient-specific outcomes relevant for decision making. • Societal costs are found relevant for decision making for treatment by older adults.

Systematic review of clinical effectiveness and safety of abdominal aortic aneurysm screening in men

Abstract Background Abdominal aortic aneurysm (AAA) is characterised by a bulging in the aortic wall. AAA is typically asymptomatic until aneurysm rupture, which is associated with a very high mortality rate (approximately 80%). In the context of an ageing population and increasing life expectancy, innovative approaches to early detection and intervention are needed. The aim of this review was to assess the clinical effectiveness and safety of one-time ultrasound screening for AAA in men. Methods Systematic searches were conducted in electronic databases and grey literature sources. The primary outcomes of interest were AAA-related mortality, AAA rupture, all-cause mortality, rate of surgical repair and safety. The following study designs were included: systematic reviews, randomised controlled trials (RCTs), comparative observational studies and population-based non-comparative observational studies. Results Results from a systematic review by the US Preventive Services Task Force analysed 4 population-based RCTs, showing that one-time population-based screening for AAA in men (≥ 65 years) led to significant reductions in AAA-related mortality (OR = 0.65, 95% CI: 0.57 to 0.74), AAA rupture (OR = 0.61, 95% CI: 0.54 to 0.69) and emergency surgeries (OR = 0.53, 95% CI: 95% CI: 0.44 to 0.64) at 13-15 years follow-up, relative to no screening. Separate to this systematic review an additional 24 studies reported on clinical effectiveness, safety and psychosocial harms of AAA screening. Limited evidence from these studies suggest screening was associated with a reduction in AAA-related mortality and rupture but also transient psychological distress in some cases. Conclusions One-time ultrasound screening in men ≥65 years appears to offer benefits in terms of reducing AAA ruptures and AAA-related mortality, though the balance of benefits and harms requires careful consideration. In an ageing population, AAA screening could be transformative, by reducing mortality and rupture risks. Key messages • One-time ultrasound screening for AAA in older men (≥ 65 years) can reduce AAA-related mortality and rupture. • In the context of an ageing population in Europe, AAA screening could be transformative, but benefits must be weighed against potential risks.

A propensity score matched analysis of transcatheter aortic valve replacement in failed bioprosthetic valves

Abstract Introduction While recently published data indicate similar long-term results of transcatheter aortic valve replacement (TAVR) compared to surgical procedures, surgical aortic valve replacement (SAVR) remains the standard of care in low-risk patients. However, since life expectancy increases, a non-negligible number of patients experience bioprosthetic valve dysfunction with the need for reintervention, but long-term data of TAVR in failed bioprosthetic valves is scarce. Purpose The aim of the study was to analyse long-term data of patients with TAVR in failed bioprosthetic valves compared to patients with native valve TAVR. The primary endpoint was 6-year all-cause mortality and the main secondary endpoint was echocardiographic valve function. Methods Patients undergoing TAVR for severe aortic valve disease between December 2012 and December 2020 were retrospectively analysed. Prior TAVR or aortic valve homografts led to exclusion from the study. A 2:1 propensity score matching by the optimal neighbor matching algorithm was performed to overcome differences in baseline characteristics. Results Between December 2012 and December 2020, 3,423 patients received TAVR for severe aortic valve disease and met inclusion criteria for the study. Of those, 3,287 patients underwent native valve TAVR, whereas 136 patients experienced bioprosthetic valve dysfunction and were treated with TAVR-in-SAV. After 2:1 propensity score matching, baseline characteristics without any relation to prior SAVR were similar between both groups. Concerning postprocedural echocardiographic function, a less pronounced gradient reduction (57.0 vs. 71.0 %, p < 0.01, Figure 1) and a higher number of patients with elevated mean pressure gradient > 20 mmHg could be found after prior SAVR (19.4 vs. 3.0 %, p < 0.01). However, there was no difference regarding 6-year all-cause mortality between both groups (log rank test p = 0.8, Figure 2). Conclusions Besides a less pronounced gradient reduction and higher mean aortic pressure gradients after TAVR-in-SAV compared to patients with native valve TAVR, no differences in 6-year all-cause mortality could be observed in a propensity score matched analysis.Reduction of mean pressure gradient6-year all-cause mortality

Can more CVD prevention increase life expectancy in Germany? Analysis with European data 2000-2019

Abstract Background Life expectancy (LE) in Europe is increasing since long - while mortality from cardiovascular diseases (CVD) declines, attributed to advances in therapy and prevention. Whether this is still applies the last 20 years is unclear. Recently, Germany’s low LE compared to other Western European countries (2019: 81.3 yrs; Spain: 84, Italy 83.6) was seen as result of high CVD mortality due to insufficient prevention. This led to the establishment of the German Federal Institute for Prevention and Education in Medicine, aimed at reducing CVD and -in the long term - narrowing the gap in LE. We explore whether data on CVD mortality and morbidity support this idea. Methods With data from OECD, WHO and IHME (GBD 2021), we calculated the mean annual change in LE and in age-standardised mortality (ASM) for CVD for 2000-2019 for European countries by sex. We estimated the linear association (adj R²) between the mean annual change in LE and ASM for CVD for West- and East-Europe, and -country-specific- between incidence and ASM from CVD. Results For 2000-2019, mean annual change in LE was lower in West- than in East-Europe: 0.25 yrs vs. 0.30 in men and 0.17 vs 0.22 in women; for ASM in CVD, it was about half as large: -6.6/100.000 vs. -11.1 for men and -4.1 vs. -8.0 for women. Similarly, the adj R² for the association between mean annual change in LE and in ASM for CVD was lower in West- compared to East-Europe: 0.43 vs. 0.24 in men and 0.21 vs. no association (adj R² -0.01) in women. Courses of CVD incidence were heterogeneous (linearly or wave-shaped in- or decreasing, stable or u-shaped). In Germany, it decreased wave-shaped, with an adj R² for linear association with ASM for CVD of 0.79 in women and 0.63 in men. The association between LE and ASM for CVD is low in West-European countries. Even if amplified prevention lowers CVD mortality, a positive effect on LE is questionable. Differences in LE are stable since long. Non-morbidity related factors might decisively effect LE. Key messages • Life expectancy in Europe-and it’s mean annual change since 2000 is not associated with age-standardised CVD mortality in women, and only moderate in men in West-Europe, in contrast to East-Europe. • Course of CVD incidence is country-specific and very heterogeneous and reveals no overall association with CVD mortality rates.

Quo vadis, the leading arrhythmia? Projecting the prevalence of atrial fibrillation up to 2070

Abstract Introduction The prevalence of atrial fibrillation (AF) is strongly associated with age, and with increasing life expectancy worldwide, the number of AF patients has been steadily rising. However, long-term projections of AF prevalence are scarse. Purpose To predict the prevalence and the number of patients with AF in Finland from 2021 until 2070. Methods In the Finnish Anticoagulation in Atrial Fibrillation (FinACAF) study we gathered data of all AF patients from all national health care registers (hospitalizations and outpatient specialist visits, primary health care contacts, and reimbursements for prescription medicines) from 2004 to 2018. The prevalence of AF on December 31st 2018 was calculated as the number of patients alive with AF divided by the number of Finnish population. We utilized age- and sex-specific prevalences on year 2018 to predict the prevalence by sex and 5-year age groups, using a 1-year time interval of AF in Finland between years 2021 and 2070. We obtained the projection for population structure in Finland between 2021 and 2070 from Statistics Finland. The prevalences in 2070 are provided for population ≥20 years as well as for populations ≥65 years, ≥75 years, and ≥85 years. Results In 2018, a total of 226 847 patients with the diagnosis of AF were documented in Finland. The number of adult patients with AF is predicted to increase strongly up to 2040 with a slower increase from 2040 to 2060, and again a faster increase is estimated from 2060 up to our final estimation of 2070. In total, the number of AF patients will increase with 60% until the year 2070. In 2021, prevalence of AF was 5.5% in adults and prevalence rate will increase to 8.6% in 2070. Proportion of men will be from 54.7 % to 56.0%, and the prevalence will be higher in men compared to women in all age groups with the exception in the age group ≥85 years. Among the population ≥65 years the prevalence in 2070 will be 19.7 %, and in the elderly, ≥75 years, the prevalence of AF will 25.6% and in the oldest, ≥85 years, 31.7%. In 2070 73.3 % of patients with AF are over 75 years, and 38.8% are over 85 years old. Conclusions Drawing upon extensive nationwide data covering all levels of care, our estimates indicate a continual rise in the number of AF patients in Finland until the year 2070. Notably, throughout the projected period, there is a discernible increase in the proportion of older and the oldest patients, highlighting the demographic shift in AF prevalence.Patients with AF 2021-2070 in Finland

1.L. Scientific session: Public Health data in support of healthy ageing policies

Abstract As Europe grapples with an ageing population, the imperative of health policies that promote healthy ageing is increasingly critical. This workshop aims to explore the significant role of public health data in shaping and supporting such policies. By integrating insights from administrative records to sophisticated research infrastructures, we will highlight the multifaceted uses of data in public health, particularly in the realms of non-communicable diseases and health-related behaviours in older populations. The session will open by examining how administrative records have been utilised within Lombardy’s regional health system to understand the epidemiology and access to care for people living with dementia. The discussion will then cover the advantages and challenges associated with integrating health data from diverse sources, emphasising the importance of quality, privacy, and the potential for real-time surveillance and response systems in healthcare. Following this, the focus will shift to the determinants of good health among older adults, presenting findings from a comprehensive cross-sectional study that identifies key factors contributing to what can be termed as “superhero” health status: seniors who maintain excellent physical and mental health. This analysis will delve into socioeconomic, behavioural, and environmental factors that influence health outcomes in the elderly, providing evidence-based recommendations for public health interventions and highlighting the potentialities of ad hoc surveys in examining health outcomes during emergencies. Thirdly, the workshop will also address the impact of significant life transitions on health behaviours, specifically the transition to retirement and its effects on alcohol consumption. Leveraging longitudinal data from a pan-European multidisciplinary research infrastructure, it will be demonstrated how retirement affects daily habits and lifestyles, including changes in alcohol consumption patterns. This segment will explore the implications of these findings for public health planning and policy formulation. In conclusion, there will be a discussion about healthcare system policies that support healthy ageing and the global impact of ageing on economics and health economics. These discussions will draw from the presented data sources and studies to suggest ways in which public health policies can be designed to reduce disparities and improve overall health outcomes among the elderly. This workshop is designed to provide a comprehensive overview of how data-driven insights can inform effective public health strategies and interventions to support an ageing society. By exploring various aspects of health data application, from individual behaviour to systemic policy adjustments, the session aims to highlight the critical role of data in promoting sustainable health and well-being in older adults, especially in the context of increasing life expectancy and prolonged retirement periods. Key messages • Harnessing data from diverse sources is crucial for understanding and enhancing healthy ageing processes. • Utilising longitudinal studies and robust data to design informed public health policies is essential for effective ageing interventions.

Impacts of chronic diseases and multimorbidity on health-related quality of life among community-dwelling elderly individuals in economically developed China: evidence from cross-sectional survey across three urban centers

ObjectiveAs the ageing process in China further accelerates and the average life expectancy increases, chronic disease prevalence and multimorbidity rates are constantly rising, especially among elderly individuals. However, few previous studies have explored the impacts of chronic diseases and multimorbidity on health-related quality of life (HRQoL). This study aimed to investigate this association among community-dwelling elderly individuals in China.MethodsA cross-sectional study was conducted in communities in three cities (Suzhou, Qingdao, and Guangzhou). The basic characteristics, chronic diseases and HRQoL of participants were collected, and HRQoL was measured by the EuroQol 5-Dimensions 3-Level version (EQ-5D-3L). Logistic regression, Tobit regression and generalized linear models were used to assess the impacts of chronic diseases and multimorbidity on HRQoL.ResultsApproximately 83.2 percent of the 1,218 respondents had chronic conditions, with 30 percent having multimorbidity. After controlling for sociodemographic and health behaviour factors, patients with stroke were more likely to report problems in all five dimensions of the EQ-5D and had a lower EQ-5D utility index (UI) (b = -0.342) than patients with other chronic conditions. Patients with chronic pulmonary obstruction had a lower EuroQol Visual Analog Scale (EQ-VAS) (b = -11.169) than patients with other chronic conditions. Furthermore, patients with multimorbidity had worse HRQoL (P < 0.001).ConclusionsBoth chronic condition probability and multimorbidity rates were high among Chinese community-dwelling elderly individuals. Different disease types had varying degrees of impact on HRQoL, and patients with multimorbidity had worse HRQoL. This study proposes that the government enhance the quality of life of community-dwelling elderly individuals with multimorbidity by establishing long-term care insurance and expanding comprehensive community-based home health care services.

Impact of age at HBsAg seroclearance on hepatic outcomes and life expectancy in men with chronic HBV infection based on multi-state modeling of the natural history.

The effects of age at HBsAg seroclearance on clinical outcomes and survival in chronic hepatitis B (CHB) have not been adequately assessed. We evaluated the impact of age at HBsAg seroclearance on long-term outcomes, along with how coexisting factors modified risks and life expectancy in CHB patients. We used multi-state modeling approach to examine transitions through the CHB continuum in a longitudinal cohort study of male civil servants recruited in 1989-1992. Hepatic outcomes and deaths were identified by clinical evaluation and linkage with national health databases. Four sets of risk factors (CHB-related, metabolic, lifestyle, and genetic factors) were assessed. Of 2551 HBsAg carriers, with follow-up until 2021 or death, 695 achieved HBsAg seroclearance, 490 developed cirrhosis (88 decompensated), 252 developed hepatocellular carcinoma (HCC), and 652 died. The cumulative rates for HCC were 1.1% and 1.5% at 10years after HBsAg seroclearance, respectively, for patients achieving seroclearance at age 50 and 60; correspondingly, the rates for cirrhosis were 2.3% and 3.0%. Developing HBsAg seroclearance was associated with a reduced risk of cirrhosis (HR = 0.37, 95% CI 0.15-0.92) but not HCC. Patients experiencing HBsAg seroclearance lived longer years free of major liver diseases than HBsAg-persistent patients, and achieving seroclearance at age 50 (vs 60) led to a greater increase in the disease-free life expectancy. However, obesity and smoking were associated with adverse hepatic outcomes and loss of the disease-free life expectancy following HBsAg seroclearance. Our findings highlight the benefit of earlier HBsAg seroclearance for gains in disease-free life expectancy and the impact of obesity and smoking on loss of the life years free of major liver diseases following HBsAg seroclearance.