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Lookup NU author(s): Dr Yu-Tzu WuORCiD, Dr Martin Prince, Professor Matthew Prina
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2021 Joule Inc. or its licensors.BACKGROUND: Women generally have longer life expectancy than men but have higher levels of disability and morbidity. Few studies have identified factors that explain higher mortality in men. The aim of this study was to identify potential factors contributing to sex differences in mortality at older age and to investigate variation across countries. METHODS: This study included participants age ≥ 50 yr from 28 countries in 12 cohort studies of the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) consortium. Using a 2-step individual participant data meta-analysis framework, we applied Cox proportional hazards modelling to investigate the association between sex and mortality across different countries. We included socioeconomic (education, wealth), lifestyle (smoking, alcohol consumption), social (marital status, living alone) and health factors (cardiovascular disease, diabetes, mental disorders) as covariates or interaction terms with sex to test whether these factors contributed to the mortality gap between men and women. RESULTS: The study included 179 044 individuals. Men had 60% higher mortality risk than women after adjustment for age (pooled hazard ratio [HR] 1.6; 95% confidence interval 1.5-1.7), yet the effect sizes varied across countries (I2 = 71.5%, HR range 1.1-2.4). Only smoking and cardiovascular diseases substantially attenuated the effect size (by about 22%).
Author(s): Wu Y-T, Niubo AS, Daskalopoulou C, Moreno-Agostino D, Stefler D, Bobak M, Oram S, Prince M, Prina M
Publication type: Article
Publication status: Published
Journal: CMAJ
Year: 2021
Volume: 193
Issue: 11
Pages: E361-E370
Online publication date: 15/03/2021
Acceptance date: 26/08/2020
Date deposited: 15/03/2023
ISSN (print): 0820-3946
ISSN (electronic): 1488-2329
Publisher: Canadian Medical Association
URL: https://doi.org/10.1503/cmaj.200484
DOI: 10.1503/cmaj.200484
PubMed id: 33722827
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