Risk Factors for All-Cause and Coronary Heart Disease Mortality in the Oldest-Old:  The Adventist Health Study

Gary E. Fraser, MBChB, PhD; David J. Shavlik, MSPH
Arch Intern Med. 1997;157(19):2249-2258. doi:10.1001/archinte.1997.00440400099012.
Text Size: A A A
Published online

Background:  The oldest-old population (≤84 years of age) is growing rapidly and consumes a disproportionate amount of health care dollars. Risk factors for disease have not been extensively studied in this group.

Methods:  A cohort study of non-Hispanic white SeventhDay Adventists from California allowed follow-up for mortality from 1976 through 1988. Associations between traditional risk factors, consumption of selected foods, and both coronary heart disease (CHD) and all-cause mortality were evaluated in the oldest-old portion of this population, using proportional hazards regression analyses.

Results:  We observed 364 cases of CHD and 1387 total deaths during 11 828 person-years of follow-up. Men had higher risk of both all-cause mortality and mortality from CHD. The relative risks (RRs) associated with diabetes mellitus were 1.51 (95% confidence interval [CI], 1.24-1.84; P<.001) for all deaths and 1.95 (95% CI, 1.38-2.76; P<.001) for mortality from CHD. The apparent effects of hypertension were small unless subjects were currently taking antihypertensive medications. Compared with those with no regular vigorous activity, subjects who exercised at least 3 times each week had RRs of death of 0.80 (95% CI, 0.70-0.91; P<.001) and 0.74 (95% CI, 0.56-0.97; P<.05) for mortality from CHD. Subjects who consumed nuts 5 times per week had RRs of death of 0.82 (95% CI, 0.70-0.96; P<.01) and 0.61 (95% CI, 0.45-0.83; P<.001) for death from CHD compared with those consuming nuts less than weekly. In men, regular consumption of donuts appeared hazardous for both all-cause mortality (RR, 1.40; 95% CI, 1.05-1.88) and mortality from CHD (RR, 2.10; 95% CI, 1.15-3.81), and consumption of beef 4 times weekly was associated with a 2-fold RR for CHD compared with vegetarians, but there was no increase in risk for women.

Conclusions:  Even in the oldest-old, certain traditional risk factors and dietary habits are associated with mortality.Arch Intern Med. 1997;157:2249-2258


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 69

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.