SHORT-TERM ALL-CAUSE MORTALITY AND ITS DETERMINANTS IN ELDERLY MALE POPULATIONS IN FINLAND, THE NETHERLANDS, AND ITALY - THE FINE STUDY

Background. This study aims at identifying determinants of all-cause m ortality in elderly populations of different countries. Methods. Men a ges 65-84 years from defined administrative areas were enrolled in Fin land (rural areas of east and west Finland; N = 693), in the Netherlan ds (the town of Zutphen; N = 851), and in Italy (the rural areas of Cr evalcore and Montegiorgio; N = 682). They were survivors of cohorts st udied for 25 years within the Seven Countries Study with the addition of a sub-group of the same ages in the Netherlands. Results. Five-year death rates from all causes were higher in Finland (297 per 1000), in termediate in the Netherlands (231 per 1000), and lower in Italy (191 per 1000). Five-year all-cause mortality was studied in relation to me asurements taken at entry (age, systolic and diastolic blood pressure, non-high-density lipo-protein (HDL) and HDL cholesterol, body mass in dex, heart rate, smoking habits, and presence of coronary heart diseas e manifestations). Univariate and multivariate analyses were performed (in the latter models, both linear and quadratic terms were used for most variables) with all-cause mortality as endpoint. Results suggeste d significant predictive power of age (direct relationship) and, in mo st cases, U-shaped relationships of risk factors to mortality. Non-HDL cholesterol showed significant relationships with mortality in Finlan d and the Netherlands, HDL cholesterol in all three countries, systoli c blood pressure only in Finland, body mass index in Finland and the N etherlands, smoking habits only in Finland, and heart rate in none. Le vels of risk factors associated with the lowest death rate in the pool of all countries were 183.3 mg/dl for non-HDL cholesterol, 59.8 for H DL cholesterol, 177.5 mm Hg for blood pressure, and 30.2 kg/m square f or body mass index. Conclusions. In these elderly men the association of traditional risk factors with all-cause mortality is reduced, U-sha ped, or even inverted. This is probably due to selection due to previo us mortality, to comorbidity, and to changes in homeostatic mechanisms . (C) 1996 Academic Press, Inc.