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Global burden of disease

1997; Elsevier BV; Volume: 350; Issue: 9071 Linguagem: Inglês

10.1016/s0140-6736(05)61849-1

1474-547X

Kozo Matsubayashi, Kiyohito Okumiya, Tomoko Nakamura, Michiko Fujisawa, Yasushi Osaki,

Frailty in Older Adults

Projections by Murray and colleagues in their four papers on the global burden of disease study1Murray CJL Lopez AD Mortality by cause for eight regions of the world: Global Burden of Disease Study.Lancet. 1997; 349: 1269-1276Summary Full Text Full Text PDF PubMed Scopus (3379) Google Scholar, 2Murray CJL Lopez AD Regional patterns of disability-free life expectancy and disability-adjusted life expectancy: Global Burden of Disease Study.Lancet. 1997; 349: 1347-1352Summary Full Text Full Text PDF PubMed Scopus (324) Google Scholar, 3Murray CJL Lopez AD Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study.Lancet. 1997; 349: 1436-1442Summary Full Text Full Text PDF PubMed Scopus (3309) Google Scholar, 4Murray CJL Lopez AD Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study.Lancet. 1997; 349: 1498-1504Summary Full Text Full Text PDF PubMed Scopus (5588) Google Scholar have impressed us greatly. As you comment in your accompanying editorial what disease we will die of is a serious problem, and how we will die, especially for an elderly person. We have investigated in apparently healthy elderly people living in two towns in Japan about the disease that they would want to avoid most at their last stage of life. Each individual was asked to select one such disease, from cancer, stroke, and heart disease, which are three leading causes of death,1Murray CJL Lopez AD Mortality by cause for eight regions of the world: Global Burden of Disease Study.Lancet. 1997; 349: 1269-1276Summary Full Text Full Text PDF PubMed Scopus (3379) Google Scholar and dementia, which is also one of the leading underlying diseases causing death in the elderly. The study population consisted of 661 men and 852 women aged 65 years or more (mean age 74·4 [SD 7·0]) living in Kahoku in Kochi Prefecture, and 242 men and 396 women (74·0 [6·0]) living in Kamiyaku in Kagoshima Prefecture. Kahoku is a rural town located in the south of Shikoku, with a rapidly increasing elderly population,5Matsubayashi K Okumiya K Wada T Osaki Y Doi Y Ozawa T Secular improvement in self-care independence of old people living in Kahoku, Japan.Lancet. 1996; 347: 60Summary Full Text PDF PubMed Scopus (54) Google Scholar and Kamiyaku is located in the south island of Kyushu, whose nearest city is Kagoshima, 100 km away. In both populations the disease that people least wanted to die from was dementia, followed by cancer, stroke, and heart disease: Tabled 1DementiaCancerStrokeHeart diseaseKahoku (n=1513)972 (64%)331 (22%)186 (12%)24 (2%)Kamiyaku (n=638)441 (69%)129 (20%)53 (8%)14 (2%) Open table in a new tab Because the findings for the two communities were closely similar, these data are probably representative of most elderly Japanese. The Japanese elderly population seems to want to avoid the disabilities or impairment of quality of life rather than death itself. We think that a future strategy for the prevention or the treatment of diseases in elderly people should be drawn up in consideration of the views of the elderly population. Global burden of diseaseAuthors' reply Full-Text PDF