Search resultsRisk factors for mortality in the nurses' health study: A competing risks analysis
Title
Risk factors for mortality in the nurses' health study: A competing risks analysis
Publication type
Journal Article
Year of Publication
2011
Authors
Journal
American Journal of Epidemiology
Volume
173
Issue
3
Pagination
319 - 329
Date published
2011
ISBN
00029262 (ISSN)
Keywords
Adolescent, Adult, age, alcohol, alcohol consumption, article, body mass, cancer, cardiovascular disease, cause of death, cereal, Cholesterol, cholesterol bile level, Chronic Disease, clinical evaluation, Death, diabetes, diabetes mellitus, diet, disease association, Exercise, Female, fiber, Follow-Up Studies, glycemic load, Health Behavior, health status, heart infarction, height, hospital sector, human, Humans, Life Style, lifestyle, menopause, Middle Aged, model, mortality, neoplasm, nurse, Nurses, nut, obesity, physical activity, polyunsaturated fatty acid, Proportional Hazards Models, Questionnaires, risk assessment, risk factor, Risk Factors, smoking, survival, systolic blood pressure, United States, weight change, Young Adult
Abstract
Few studies have examined multiple risk factors for mortality or formally compared their associations across specific causes of death. The authors used competing risks survival analysis to evaluate associations of lifestyle and dietary factors with all-cause and cause-specific mortality among 50,112 participants in the Nurses' Health Study. There were 4,893 deaths between 1986 and 2004: 1,026 from cardiovascular disease, 931 from smoking-related cancers, 1,430 from cancers not related to smoking, and 1,506 from all other causes. Age, body mass index at age 18 years, weight change, height, current smoking and pack-years of smoking, glycemic load, cholesterol intake, systolic blood pressure and use of blood pressure medications, diabetes, parental myocardial infarction before age 60 years, and time since menopause were directly related to all-cause mortality, whereas there were inverse associations for physical activity and intakes of nuts, polyunsaturated fat, and cereal fiber. Moderate alcohol consumption was associated with decreased mortality. A model that incorporated differences in the associations of some risk factors with specific causes of death had a significantly better fit compared with a model in which all risk factors had common associations across all causes. In the future, this new model may be used to identify individuals at increased risk of mortality.