1. Epidemiology and Global Health

Future life expectancy in Europe taking into account the impact of smoking, obesity and alcohol

  1. Fanny Janssen  Is a corresponding author
  2. Anastasios Bardoutsos
  3. Shady El Gewily
  4. Joop De Beer
  1. Netherlands Interdisciplinary Demographic Institute (NIDI) & Dept of Demography, Faculty of Spatial Sciences, University of Groningen, Netherlands
  2. Faculty of Spatial Sciences, University of Groningen, Netherlands
https://doi.org/10.7554/eLife.66590
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  1. Fanny Janssen
  2. Anastasios Bardoutsos
  3. Shady El Gewily
  4. Joop De Beer
(2021)
Future life expectancy in Europe taking into account the impact of smoking, obesity and alcohol
eLife 10:e66590.
https://doi.org/10.7554/eLife.66590
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Abstract

Introduction: In Europe, women can expect to live on average 82 years, and men 75 years. Forecasting how life expectancy will develop in the future is essential for society. Most forecasts rely on a mechanical extrapolation of past mortality trends, which leads to unreliable outcomes because of temporal fluctuations in the past trends due to lifestyle 'epidemics'.

Methods: We project life expectancy for 18 European countries by taking into account the impact of smoking, obesity, and alcohol on mortality, and the mortality experiences of forerunner populations.

Results: We project that life expectancy in these 18 countries will increase from, on average, 83.4 years for women and 78.3 years for men in 2014 to 92.8 years for women and 90.5 years for men in 2065. Compared to others (Lee-Carter, Eurostat, United Nations), we project higher future life expectancy values and more realistic differences between countries and sexes.

Conclusions: Our results imply longer individual lifespans, and more elderly in society.

Funding: Netherlands Organisation for Scientific Research (NWO) (grant no. 452-13-001).

Data availability

Some of our original data regarding lifestyle-attributable mortality were based on previous publications, which, in turn, used data that are openly available. The all-cause mortality data and the exposure data can be obtained through the Human Mortality Database. We have provided source data files for all our tables and figures. These comprise the numerical data that are represented in the different figures, and the output on which the different tables are based. In addition, one excel file with all the final numerical / output data that were used as input for the tables and figures will be made available at the Open Science Framework: https://osf.io/ghu45/. In addition, we will upload there the underlying observed age-specific mortality rates (all-cause mortality, non-lifestyle-attributable mortality, lifestyle-attributable mortality) as well as the adjusted and projected age-specific mortality rates (medians and 90% and 95% projection intervals). The different R codes used for the different steps of the data analyses will be shared - as well - through the Open Science Framework link above.

Article and author information

Author details

  1. Fanny Janssen

    NA, Netherlands Interdisciplinary Demographic Institute (NIDI) & Dept of Demography, Faculty of Spatial Sciences, University of Groningen, The Hague, Netherlands
    For correspondence
    janssen@nidi.nl
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-3110-238X

  2. Anastasios Bardoutsos

    Demography Department, Faculty of Spatial Sciences, University of Groningen, Groningen, Netherlands
    Competing interests
    The authors declare that no competing interests exist.

  3. Shady El Gewily

    Demography Department, Faculty of Spatial Sciences, University of Groningen, Groningen, Netherlands
    Competing interests
    The authors declare that no competing interests exist.

  4. Joop De Beer

    NA, Netherlands Interdisciplinary Demographic Institute (NIDI) & Dept of Demography, Faculty of Spatial Sciences, University of Groningen, The Hague, Netherlands
    Competing interests
    The authors declare that no competing interests exist.

Funding

the Netherlands Organisation for Scientific Research (Innovational Research Incentives Scheme Vici,452-13-001)

  • Fanny Janssen
  • Anastasios Bardoutsos
  • Shady El Gewily

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Reviewing Editor

  1. Belinda Nicolau, McGill University, Canada

Version history

  1. Received: January 15, 2021
  2. Accepted: June 28, 2021
  3. Accepted Manuscript published: July 6, 2021 (version 1)
  4. Version of Record published: August 4, 2021 (version 2)

Copyright

© 2021, Janssen et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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  1. Fanny Janssen
  2. Anastasios Bardoutsos
  3. Shady El Gewily
  4. Joop De Beer
(2021)
Future life expectancy in Europe taking into account the impact of smoking, obesity and alcohol
eLife 10:e66590.
https://doi.org/10.7554/eLife.66590

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    Association between bisphosphonate use and COVID-19 related outcomes

    Jeffrey Thompson, Yidi Wang ... Ulrich H von Andrian
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    Background:

    Although there are several efficacious vaccines against COVID-19, vaccination rates in many regions around the world remain insufficient to prevent continued high disease burden and emergence of viral variants. Repurposing of existing therapeutics that prevent or mitigate severe COVID-19 could help to address these challenges. The objective of this study was to determine whether prior use of bisphosphonates is associated with reduced incidence and/or severity of COVID-19.

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    A retrospective cohort study utilizing payer-complete health insurance claims data from 8,239,790 patients with continuous medical and prescription insurance January 1, 2019 to June 30, 2020 was performed. The primary exposure of interest was use of any bisphosphonate from January 1, 2019 to February 29, 2020. Bisphosphonate users were identified as patients having at least one bisphosphonate claim during this period, who were then 1:1 propensity score-matched to bisphosphonate non-users by age, gender, insurance type, primary-care-provider visit in 2019, and comorbidity burden. Main outcomes of interest included: (a) any testing for SARS-CoV-2 infection; (b) COVID-19 diagnosis; and (c) hospitalization with a COVID-19 diagnosis between March 1, 2020 and June 30, 2020. Multiple sensitivity analyses were also performed to assess core study outcomes amongst more restrictive matches between BP users/non-users, as well as assessing the relationship between BP-use and other respiratory infections (pneumonia, acute bronchitis) both during the same study period as well as before the COVID outbreak.

    Results:

    A total of 7,906,603 patients for whom continuous medical and prescription insurance information was available were selected. A total of 450,366 bisphosphonate users were identified and 1:1 propensity score-matched to bisphosphonate non-users. Bisphosphonate users had lower odds ratios (OR) of testing for SARS-CoV-2 infection (OR = 0.22; 95%CI:0.21–0.23; p<0.001), COVID-19 diagnosis (OR = 0.23; 95%CI:0.22–0.24; p<0.001), and COVID-19-related hospitalization (OR = 0.26; 95%CI:0.24–0.29; p<0.001). Sensitivity analyses yielded results consistent with the primary analysis. Bisphosphonate-use was also associated with decreased odds of acute bronchitis (OR = 0.23; 95%CI:0.22–0.23; p<0.001) or pneumonia (OR = 0.32; 95%CI:0.31–0.34; p<0.001) in 2019, suggesting that bisphosphonates may protect against respiratory infections by a variety of pathogens, including but not limited to SARS-CoV-2.

    Conclusions:

    Prior bisphosphonate-use was associated with dramatically reduced odds of SARS-CoV-2 testing, COVID-19 diagnosis, and COVID-19-related hospitalizations. Prospective clinical trials will be required to establish a causal role for bisphosphonate-use in COVID-19-related outcomes.

    Funding:

    This study was supported by NIH grants, AR068383 and AI155865, a grant from MassCPR (to UHvA) and a CRI Irvington postdoctoral fellowship, CRI2453 (to PH).

    1. Epidemiology and Global Health

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    Sleep regularity and mortality: a prospective analysis in the UK Biobank

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    Background:

    Irregular sleep-wake timing may cause circadian disruption leading to several chronic age-related diseases. We examined the relationship between sleep regularity and risk of all-cause, cardiovascular disease (CVD), and cancer mortality in 88,975 participants from the prospective UK Biobank cohort.

    Methods:

    The sleep regularity index (SRI) was calculated as the probability of an individual being in the same state (asleep or awake) at any two time points 24 hr apart, averaged over 7 days of accelerometry (range 0–100, with 100 being perfectly regular). The SRI was related to the risk of mortality in time-to-event models.

    Results:

    The mean sample age was 62 years (standard deviation [SD], 8), 56% were women, and the median SRI was 60 (SD, 10). There were 3010 deaths during a mean follow-up of 7.1 years. Following adjustments for demographic and clinical variables, we identified a non-linear relationship between the SRI and all-cause mortality hazard (p [global test of spline term]<0.001). Hazard ratios, relative to the median SRI, were 1.53 (95% confidence interval [CI]: 1.41, 1.66) for participants with SRI at the 5th percentile (SRI = 41) and 0.90 (95% CI: 0.81, 1.00) for those with SRI at the 95th percentile (SRI = 75), respectively. Findings for CVD mortality and cancer mortality followed a similar pattern.

    Conclusions:

    Irregular sleep-wake patterns are associated with higher mortality risk.

    Funding:

    National Health and Medical Research Council of Australia (GTN2009264; GTN1158384), National Institute on Aging (AG062531), Alzheimer’s Association (2018-AARG-591358), and the Banting Fellowship Program (#454104).