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首页> 外文期刊>Journal of nursing and healthcare of chronic illness >Incidence of cardiovascular disease and cancer in advanced age: prospective cohort study
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Incidence of cardiovascular disease and cancer in advanced age: prospective cohort study

机译：老年心血管疾病和癌症的发病率：前瞻性队列研究

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Objective To investigate the influence of increasing age on the incidence and remaining lifetime risk of cardiovascular disease and cancer in a cohort of older men. Design Prospective cohort study. Setting United States. Participants 22 048 male doctors aged 40-84 who were free of major disease in 1982. Main outcome measures Incidence and remaining lifetime risk of major cardiovascular disease (myocardial infarction, stroke, and death from cardiovasculardisease) and cancer. Results 3252 major cardiovascular events and 5400 incident cancers were confirmed over 23 years of follow-up. The incidence of major cardiovascular disease continued to increase to age 100. Beginning at age 80, however, major cardiovascular disease was more likely to be diagnosed at death. The incidence of cancer peaked in those aged 80-89 and then declined. Cancers detected by screening accounted for most of the decline, whereas most cancers for which there Was no screening continued to increase to age 100. Unadjusted cumulative incidence overestimated the risk of cardiovascular disease by 16% and cancer by 8.5%. The remaining lifetime risk of cancer at age 40 was 45.1% (95% confidence interval 43.8% to 46.3%) and at age 90 was 9.6% (7.2% to 11.9%). The remaining lifetime risk of major cardiovascular disease at age 40 was 34.8% (33.1% to 36.5%) and at age 90 was 16.7% (12.9% to 20.6%).Conclusions In this prospective cohort of men, the incidence of new cardiovaspular disease continued to increase after age 80 but was most often diagnosed at death. The decrease in incidence of cancer late in life seemed largely due to a decline in cancers usually detected by screening. These findings suggest that people aged 80 and older have a substantial amount of undiagnosed disease. The remaining lifetime risk of both diseases approached a plateau in the 10th decade. This may be due to decreased detection of disease and reporting of symptoms and increased resistance to disease in those who survive to old ag...
机译：目的探讨年龄增长对一群老年男性心血管疾病和癌症的发病率和终生风险的影响。设计前瞻性队列研究。设置美国。参加研究的1982年有40到84岁的22 048名男医生，没有大病。主要结果指标重大心血管疾病（心肌梗塞，中风和心血管疾病死亡）和癌症的发生率和终生风险。结果在23年的随访中，确认了3252例重大心血管事件和5400例癌症。重大心血管疾病的发病率一直上升到100岁。但是从80岁开始，死亡时更容易诊断出重大心血管疾病。癌症的发病率在80-89岁年龄段达到峰值，然后下降。通过筛查发现的癌症占下降的大部分，而没有进行筛查的大多数癌症则持续上升到100岁。未经调整的累积发生率高估了心血管疾病的风险16％，高估了8.5％的癌症。 40岁时癌症的终生终生风险为45.1％（95％置信区间43.8％至46.3％），而90岁时为9.6％（7.2％至11.9％）。在40岁时，剩余的主要心血管疾病终生风险为34.8％（33.1％至36.5％），在90岁时为16.7％（12.9％至20.6％）。结论在这一预期人群中，新的心血管疾病的发生率在80岁以后继续增加，但最常被诊断为死亡。晚期癌症的发病率下降似乎主要是由于通常通过筛查发现的癌症下降。这些发现表明80岁以上的人患有大量未确诊的疾病。在这十年中，这两种疾病的终生风险都达到了平稳期。这可能是由于幸存下来的老年人中疾病的检测减少和症状的报告以及对疾病的抵抗力增强所致。

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