Sex differential in mortality trends of old-aged Danes: a nation wide study of age, period and cohort effects.
OBJECTIVE
Over the last half century the mortality rates in Denmark for females above age 80 have declined dramatically whereas the decline for males have been modest, resulting in a change in sex-ratio for centenarians from 2 to 5. Here we investigate whether this mortality pattern is mainly explained by period effects, cohort effects or both. This can provide clues for where to search for causes behind the changes in sex differential in mortality seen in many Western countries during the last decades.


METHODS
Age-period-cohort study of mortality for all Danish women and men aged 79-98 during the period 1949-2006.


METHODS
Relative risks for deaths and second order differences for exploration of the nonlinear variation.


RESULTS
Both the overall trends in mortality differences and the fluctuations in mortality for both men and women were better explained by period effects than by cohort effects. The observed rates were better described by the age, period and cohort model than by other models.


CONCLUSIONS
Our results suggest that causes for both the overall increased difference in mortality and the short term fluctuations in mortality rates are primarily to be found in the period dimension. Cohort effects on the mortality of the oldest Danish women and men played a significant but minor role compared to period effects.
Institute of Public Health, Epidemiology, University of Southern Denmark, Odense C, Denmark. rjacobsen@health.sdu.dk
Rune
R
Jacobsen
Anna
A
Oksuzyan
Henriette
H
Engberg
Bernard
B
Jeune
James W
JW
Vaupel
Kaare
K
Christensen
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends*; D012737:Sex Factors