Determinants of Longevity and Ageing in Good Health (DELAG)

Website of Dr. Marc Luy and his Research Team


17.10.2019: New Publication
The male-female health-mortality paradox
Di Lego, Vanessa; Lazarevič, Patrick; Luy, Marc
Encyclopedia of Gerontology and Population Aging. 2019 Oct 17; 10.1007/978-3-319-69892-2_798-2
Abstract: The differences in life expectancy between women and men remained more or less constant until the first half of the twentieth century, with a female advantage of around 2–3 years, and started to increase thereafter. This increase of the gap coincided with a rise among men in cardiovascular diseases, cancer, and accidents and a fall in maternal mortality and in causes of death related to pregnancy among women. Since the beginning of the 1980s, the gap between women and men in overall life expectancy has been slowly narrowing in the developed world. In light of this universal observable male excess mortality, it is surprising that studies on gender differences in morbidity report that women are in worse health than men and that women spend a higher proportion of their total life expectancy in poor health and with limitations. Researchers have most commonly addressed this paradox by focusing either on male excess mortality or on female excess morbidity. Another complementary approach has been to attribute at least a part of the paradox to methodological artifacts that arise due to the survey framework and the behavior dynamics between respondents and interviewers. This encyclopedia entry summarizes all these issues and provides corresponding empirical evidence.

New Publication
Was misst Self-Rated Health? Die Basis subjektiver Gesundheit und Unterschiede nach Geschlecht, Alter und Kohorte in Europa und Kanada
Lazarevič, Patrick
Springer VS. 2019 Nov 27; 10.1007/978-3-658-28026-0
Abstract: Die Definition und Messung von Gesundheit ist der analytische Dreh- und Angelpunkt vieler empirischer Studien. Aus pragmatischen Gründen ist es jedoch oft nicht möglich, umfassende Gesundheitsdaten zu erheben, weshalb häufig eine subjektive Bewertung der Befragten ("Self-Rated Health") verwendet wird. Doch inwieweit wird dabei aufgrund unterschiedlicher Erwartungen, Maßstäbe oder Erfahrungen derselbe Gesundheitsstatus unterschiedlich bewertet? Diese und andere Fragen stehen im Fokus dieser Arbeit. Dabei stellt sich z. B. heraus, dass es große Altersunterschiede darin gibt, welche Gesundheitsaspekte in welchem Ausmaß in die Bewertung eingehen.

08.08.2019: New Publication
Life expectancy: frequently used, but hardly understood
Luy, Marc; Di Giulio, Paola; Di Lego, Vanessa; Lazarevič, Patrick; Sauerberg, Markus
Gerontology. 2019 Aug 08; 10.1159/000500955
Abstract: Period life expectancy is one of the most used summary indicators for the overall health of a population. Its levels and trends direct health policies, and researchers try to identify the determining risk factors to assess and forecast future developments. The use of period life expectancy is often based on the assumption that it directly reflects the mortality conditions of a certain year. Accordingly, the explanation for changes in life expectancy are typically sought in factors that have an immediate impact on current mortality conditions. It is frequently overlooked, however, that this indicator can also be affected by at least three kinds of effects, in particular in the situation of short-term fluctuations: cohort effects, heterogeneity effects, and tempo effects. We demonstrate their possible impact with the example of the almost Europe-wide decrease in life expectancy in 2015, which caused a series of reports about an upsurge of a health crisis, and we show that the consideration of these effects can lead to different conclusions. Therefore, we want to raise an awareness concerning the sensitivity of life expectancy to sudden changes and the menaces a misled interpretation of this indicator can cause.

30.05.2019: REVES Poster Award for Patrick Lazarevič
Congratulations! Patrick Lazarevič received the REVES Poster Award for his poster "A New Short Generic Measure of Health: Is the Minimum European Health Module an Option?"

10.05.2019: PhD to Patrick Lazarevič
Patrick Lazarevic successfully defended his PhD thesis at TU Dortmund today. CONGRATULATIONS from the whole DELAG team!!!

08.03.2019: New Publication
The impact of increasing education levels on rising life expectancy: a decomposition analysis for Italy, Denmark, and the USA
Luy, Marc; Zannella, Marina; Wegner-Siegmundt, Christian; Minagawa, Yuka; Lutz, Wolfgang; Caselli, Graziella
Genus. 2019 Mar 07; 75: 11; 10.1186/s41118-019-0055-0
Abstract: Significant reductions in mortality are reflected in strong increases in life expectancy particularly in industrialized countries. Previous analyses relate these improvements primarily to medical innovations and advances in health-related behaviors. Mostly ignored, however, is the question to what extent the gains in life expectancy are related to structural changes in the populations due to increasing education levels. We decompose changes of the total populations’ life expectancy at age 30 in Italy, Denmark, and the United States, over the 20-year period between 1990 and 2010 into the effects of education-specific mortality changes ("M effect") and changes in the populations' educational structure ("P effect"). We use the "replacement decomposition technique" to further subdivide the M effect into the contributions by the individual education groups. While most of the increases in life expectancy are due to the effect of changing mortality, a large proportion of improvements in longevity can indeed be attributed to the changing structure of the population by level of education in all three countries. The estimated contribution of the P effect ranges from around 15 percent for men in the United States to approximately 40 percent for women in Denmark. This study demonstrates strong associations between education and overall population health, suggesting that education policies can also be seen as indirect health policies.

04.02.2019: New Publication
Socioeconomic disparity in adult mortality in India: estimations using the orphanhood method
Saikia, Nandita; Bora, Jayanta Kumar; Luy, Marc
Genus. 2019 Feb 04; 75: 7; 10.1186/s41118-019-0054-1
Abstract: Due to a lack of data, no study has yet documented differences in adult life expectancy in India by education, caste, and religion. Our objective was therefore to examine disparities in socioeconomic status (SES) in the adult mortality rate (40q30) and life expectancy at age 15 (e15) in India. We estimated adult mortality by SES with the orphanhood method to analyze information related to the survival of respondents’ parents. We used data from the India Human Development Survey 2011–2012. SES was measured by education, caste, religion, and income of the either deceased adults or their offspring. A consistency analysis between orphanhood estimates and official statistics confirmed the robustness of the estimates. Mortality is higher among adults who are illiterate, belong to deprived castes or tribes, have children with a low level of education, and have a low level of household income. The adult mortality rate varies marginally by religion in India. Life expectancy at 15 (e15) is about 3.50 and 5.7 years shorter for illiterate men and women, respectively, compared with literate men and women. The parameter e15 also varies significantly by educational attainment of offspring. On average, parents of children educated to higher secondary level (and above) gain an extra 3.8–4.6 years of adult life compared to parents of illiterate children. Disparity in e15 by caste and religion is smaller than disparity by education or income. These findings reveal that the adult mortality burden falls disproportionately on illiterate adults and adults with less educated offspring. Thus, educational disparity in adult mortality appears to be prominent in Indian context. In the absence of adult mortality statistics by SES in India, we recommend that large-scale surveys should continue collecting data to allow indirect techniques to be applied to estimate mortality and life expectancy in the country

05.12.2018: New Publication
Immediate versus delayed detection of Takotsubo syndrome after epileptic seizures
Stöllberger, Claudia; Sauerberg, Markus; Finsterer, Josef
Journal of the Neurological Sciences. 2019 Feb 15; 397: 42-47
Abstract: Takotsubo syndrome (TTS) is often preceded by emotional or physical stress. Epileptic seizures are described in >100 cases. It is unknown whether patients with immediate and delayed detection of seizure-induced TTS differ. We screened the literature and compared clinical and electrocardiographic (ECG) findings. In 48 cases with seizure-associated TTS, the time between seizure and TTS-detection was reported. Troponin levels were elevated in 37/40. ECG abnormalities were negative T-waves (40%), ST-elevations (33%) and ventricular fibrillation/flutter (10%). Immediate detection was reported in 23 patients, in the remaining 25 patients, TTS was detected 5–288 h postictally. Patients did not differ in gender, age or symptoms. Negative T-waves were more frequent in patients with delayed detection (64 vs. 13%, p = .0009), whereas ECG-abnormalities suggesting acute myocardial infarction tended to be more prevalent in patients with immediate detection. Due to lack of typical symptoms, seizure-induced TTS can be overlooked. Postictally, an ECG should be recorded and troponin levels measured. New T-wave inversions might indicate seizure-induced TTS.

29.11.2018: New Publication
Soziale Unterschiede in der Lebenserwartung [Social differences in life expectancy]
Lampert, Thomas; Hoebel, Jens; Kroll, Lars Eric; Luy, Marc
Public Health Forum. 2018 Nov 28; 26(4): 325-327
Abstract: Social differences in mortality can be understood as an extreme form of social and health inequalities. The studies available for Germany prove that the average life expectancy at birth in the socially disadvantaged population groups is about 5–10 years lower than in the socially better-placed population groups. Furthermore, if only the life-time spent in good health is taken into account, the social differences are even greater. Similar social differences in life expectancy are reported for other European countries and also for the USA.
Zusammenfassung: Soziale Unterschiede in der Mortalität können als extreme Ausprägungsform sozialer und gesundheitlicher Ungleichheiten verstanden werden. Die für Deutschland vorliegenden Studien sprechen dafür, dass die mittlere Lebenserwartung bei Geburt in den sozial benachteiligten Bevölkerungsgruppen etwa 5–10 Jahre niedriger liegt als in den sozial besser gestellten Bevölkerungsgruppen. Wird nur die bei guter Gesundheit verbrachte Lebenszeit berücksichtigt, fallen die sozialen Unterschiede sogar noch größer aus. Für andere europäische Länder und auch die USA werden ähnlich ausgeprägte soziale Unterschiede in der Lebenserwartung berichtet.

31.05.2018: REVES Poster Award for Patrick Lazarevič
Congratulations! Patrick Lazarevič received the third prize of the REVES Poster Award for his poster "Self-rated health as a generic health measurement? Identifying the health information used and the role of gender, age, and country"

27.04.2018: PAA Poster Award for Markus Sauerberg and Marc Luy
Markus Sauerberg and Marc Luy received the PAA Poster Award for their poster "Decreasing Life Expectancy in the United States Between 2014 and 2015: Severe Health Crisis or Just Tempo Effects?"

01.04.2018: New DELAG team member
The Research Group "Health and Longevity" of the Vienna Institute of Demography welcomes our new team member Patrick Lazarevič (see DELAG Team). Patrick is sociologist and he started his Ph.D. project on methodological difficulties in the examination of age(ing) at the TU Dortmund University. He will continue this work inside the LETHE project (see Projects).

10.03.2018: Award for Vanessa Di Lego
Vanessa Di Lego et al.'s article "Mortality selection among adults in Brazil: The survival advantage of Air Force officers" was chosen by editors of the journal Demographic Research as one of the very best papers in Volume 37 of Demographic Research. Congratulations!!! [Link to Article]

01.02.2018: New DELAG team member
The Research Group "Health and Longevity" of the Vienna Institute of Demography welcomes our new team member Vanessa Di Lego (see DELAG Team). Vanessa completed her Ph.D. in demography at the Center for Development and Regional Planning (Cedeplar) in Brazil. Vanessa will work primarily inside the LETHE project (see Projects).

20.10.2017: New publication
Acute coronary syndrome in immigrants and non-immigrants. Results of an Austrian prospective pilot study
Gündüz, Duygu; Lejak, Anita; Wiedemann, Angela; Avanzi, Marion; Winkler, Walther-Benedikt; Ucar-Altenberger, Hadice; Stöllberger, Caludia; Weidinger, Franz
Wiener klinische Wochenschrift. 2017 Oct 20; 129(23-24): 900-905.
Abstract: There are indications that immigrant patients with acute coronary syndrome (ACS) differ in demographic characteristics and clinical presentation from non-immigrant patients. The aim of this prospective pilot study was to gather clinical and sociodemographic data from patients with ACS and to compare immigrants with non-immigrants. Included were consecutive patients who underwent acute coronary angiography in one cardiological department for ACS from September 2011 to September 2013. Information was gathered about age, sex, results of the coronary angiography, classical risk factors, socioeconomic characteristics as well as ethnicity. Patients who had their place of birth outside Austria were specified as immigrants. A total of 100 patients (29% female) with a mean age of 60 years (range 34–91 years) were included. Of the patients 35 (35%) were immigrants, 12 came from Serbia, 4 from Bosnia, 3 from South America, 2 from Germany, 2 from Turkey, 2 from the Czech Republic, 2 from Croatia, 2 from Macedonia, and 1 each from Bangladesh, Poland, Romania, Libya, Bulgaria and Pakistan. Immigrants tended to be younger on average (56 vs. 62 years, p = 0.04) and had a two or multivessel disease more often than the non-immigrants but this difference was not significant (51% vs. 38%, p = 0.29). There were no differences between non-immigrants and immigrants concerning the classical risk factors for ACS (hypercholesterinemia 60% vs. 69%, nicotine abuse 51% vs. 60%, hypertension 69% vs. 79%) except diabetes mellitus (15% vs. 37%, p = 0.02). Sociodemographic data showed differences in education and socioeconomic status (SES). Non-immigrants had jobs with high skill level more often than immigrants (30% vs. 4%, p = 0.02), although there was no difference between immigrants and non-immigrants in the level of high education (9% each); however, immigrants more often had low education (31% vs. 11%, p = 0.01) and a monthly income below 1000 € than non-immigrants (41% vs. 14%, p = 0.03). These results reveal that immigrants with ACS suffered more often from coronary two or multivessel disease and diabetes mellitus and were slightly younger than non-immigrants, although they did not differ regarding classical risk factors. Results suggest that the lower SES of immigrants compared with non-immigrants might contribute to the severity of coronary heart disease.

01.09.2017: Start of the ERC project LETHE / Beginn des ERC-Projekts LETHE
Today started our new research ERC project LETHE for the duration of 5 years (until August 2022). It’s main aim will be to better understand the measurement and estimation sensitivity of the "Health Expectancy" indicator (see Projects).

01.08.2017: New DELAG team member
The Research Group "Health and Longevity" of the Vienna Institute of Demography welcomes our new PhD student Markus Sauerberg (see DELAG Team). Markus studied demography at the University of Rostock and completed successfully the program of the European Doctoral School of Demography. His main tasks will be inside the LETHE project (see Projects)