title: Impact of smoking, diabetes and hypertension on survival time in the elderly: the Dubbo Study.
abstract: OBJECTIVE
  To study the impact of various risk factors on survival time in a cohort of elderly Australians.
  
  
  METHODS
  A longitudinal, prospective cohort study conducted in Dubbo, NSW. Participants were men and women aged 60 years or over living in the community, first assessed in 1988-1989 and followed for 15 years.
  
  
  METHODS
  Mortality rates; risk factors; survival times.
  
  
  RESULTS
  There were 668 deaths in 1233 men (54%) and 625 deaths in 1572 women (40%). Coronary heart disease was the major cause of death, rates being higher in men than women until age group 80+ years; stroke death rates were similar in both sexes; cancer and respiratory death rates were higher in men than women across all ages. In a proportional hazards model, the independent predictors of mortality were cigarette smoking, diabetes, very high blood pressure (BP), impaired peak expiratory flow (PEF), physical disability, and zero intake of alcohol. Over 15 years, the average reductions in survival time associated with various risk factors, in men and women respectively, were smoking, 22 and 15 months; diabetes, 18 and 18 months; very high BP, 16 and 9 months; impaired PEF, 14 and 17 months; physical disability, 16 and 12 months; zero alcohol intake, 9 and 5 months. Combinations of selected risk factors were associated with a multiplier effect.
  
  
  CONCLUSIONS
  The reduction in survival time in elderly citizens demonstrated in the presence of smoking, diabetes and hypertension highlights a potential benefit to healthy ageing to be gained from prevention and intervention.
authors.affiliation: Lipid Research Department, University of New South Wales, St Vincent's Hospital, Darlinghurst, NSW 2010, Australia. L.Simons@notes.med.unsw.edu.au
authors.forename: Leon A
authors.initials: LA
authors.lastname: Simons
authors.forename: Judith
authors.initials: J
authors.lastname: Simons
authors.forename: John
authors.initials: J
authors.lastname: McCallum
authors.forename: Yechiel
authors.initials: Y
authors.lastname: Friedlander
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D015331:Cohort Studies; D003327:Coronary Disease / Q000401:mortality; D003920:Diabetes Mellitus / Q000401:mortality*; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006973:Hypertension / Q000401:mortality*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D009517:New South Wales / Q000453:epidemiology; D010366:Peak Expiratory Flow Rate; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012140:Respiratory Tract Diseases / Q000401:mortality; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000401:mortality*; D016019:Survival Analysis