title: Age-period-cohort effects on mortality from cerebrovascular disease in southern Spain.
abstract: BACKGROUND
  The aim of this article is to evaluate the age-period-cohort effects on mortality from cerebrovascular disease in Andalusia (southern Spain) as a whole and in each of its 8 provinces during the period 1981-2008.
  
  
  METHODS
  A population-based ecologic study was conducted. In all, 145,867 deaths were analyzed for individuals between the ages of 15 and 84 years who died in Andalusia in the period of study. A nonlinear regression model was estimated for each gender group and geographic area. The effects of age, year of death, and birth cohort were parameterized using spline smoothing functions.
  
  
  RESULTS
  There is an upward trend in mortality from the age of 25 years. The risk of death was downward for cohorts born after 1896, decreasing after 1970 with steep slope. The analysis of the period effect showed that death rate first declined from 1981 to 1995 and then increased between 1995 and 2000, only to decrease again until 2008.
  
  
  CONCLUSIONS
  There is a similar age-period-cohort effect on male and female mortality from cerebrovascular disease in all the provinces of Andalusia and for Andalusia as a whole. A significant reduction of male and female mortality has been observed during the last decade.
authors: Escuela Andaluza de Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria de Granada, Granada, Spain. Electronic address: ricardo.ocana.easp@juntadeandalucia.es.
authors: Ricardo
authors: R
authors: Ocaña-Riola
authors: Departamento de Farmacología, Facultad de Medicina, Universidad de Málaga, Málaga.
authors: Encarnación
authors: E
authors: Blanco-Reina
authors: Eulalia
authors: E
authors: Navarro-Moreno
authors: Escuela Andaluza de Salud Pública, Granada, Spain; Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Hospital Universitario Virgen de las Nieves, Granada, Spain.
authors: Eulalia
authors: E
authors: Moreno-Navarro
authors: Servicio de Epidemiología y Salud Laboral, Consejería de Salud de la Junta de Andalucía, Sevilla, Spain.
authors: José María
authors: JM
authors: Mayoral-Cortés
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000401:mortality*; D015988:Cohort Effect; D003627:Data Interpretation, Statistical; D005260:Female; D005843:Geography; D006801:Humans; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Andalusia; Cerebrovascular disease; Poisson regression; Spain; age-period-cohort models; mortality